DAR File No. 40178

Health, Family Health and Preparedness, Emergency Medical Services

Rule R426-7

Emergency Medical Services Prehospital Data System Rules

Notice of Proposed Rule

(Amendment)

DAR File No.: 40178
Filed: 02/01/2016 09:39:16 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The data standards have changed. The amendment allows for needed updates.

Summary of the rule or change:

The amendment updates data collection requirements for data elements to comply with National Emergency Medical Service (EMS) Standards, and improves the ability for health providers to use data more rapidly to possibly improving patient care. The elements are deleted from the rule and are referenced as Department policy. This allows timely updates as new national standards are adopted.

State statutory or constitutional authorization for this rule:

• Title 26, Chapter 8a

Anticipated cost or savings to:

the state budget:

State budget will not be impacted as data collection is currently administered.

local governments:

Local government budgets may be impacted as EMS providers are required to enter data within 14 days after the end or middle of the month instead of up to 2 months. Impacts would be slight, if incurred. Therefore, most likely no impacts.

small businesses:

Small business budgets may be impacted as EMS providers are required to enter data within 14 days after the end or middle of the month instead of up to 2 months. Impacts would be slight, if incurred. Therefore, most likely no impacts.

persons other than small businesses, businesses, or local governmental entities:

Other businesses, individuals, etc., may be impacted as EMS providers are required to enter data within 14 days after the end or middle of the month instead of up to 2 months. Impacts would be slight, if incurred. Therefore, most likely no impacts.

Compliance costs for affected persons:

Compliance costs for affected persons (patients) would not be likely due to improved data submission times and new data elements.

Comments by the department head on the fiscal impact the rule may have on businesses:

There is no fiscal impact to business because the changes are related to new submission deadlines but do not include substantive additions to submission requirements.

Joseph Miner, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Family Health and Preparedness, Emergency Medical Services
3760 S HIGHLAND DR
SALT LAKE CITY, UT 84106

Direct questions regarding this rule to:

• Guy Dansie at the above address, by phone at 801-273-6671, by FAX at 801-273-4165, or by Internet E-mail at gdansie@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

03/16/2016

This rule may become effective on:

03/23/2016

Authorized by:

Joseph Miner, Executive Director

R426. Health, Family Health and Preparedness, Emergency Medical Services.

R426-7. Emergency Medical Services Prehospital Data System Rules.

R426-7-100 . Authority and Purpose.

(1) This rule is established under Title 26 Chapter 8a.

(2) The purpose of this rule is to establish minimum mandatory EMS data reporting requirements.

 

R426-7-200 . Prehospital Data Set.

(1) Emergency medical service providers shall collect data as identified by the Department in this rule.

(2) Emergency Medical Services Providers shall submit the data to the Department electronically in the National Emergency Medical Services Information System (NEMSIS) format for every dispatch instance, regardless of patient disposition. In cases of mass casualty, data is required for every individual with whom EMS had contact, whether care was given or refused.[For Emergency Medical Services Providers directly using a reporting system provided by the Department, the data is considered submitted to the Department as soon as it has been entered or updated in the Department-provided system.]

(3) The Department adopts by reference the National Highway Traffic Safety Administration (NHTSA) Uniform Pre-Hospital Emergency Medical Services (EMS) Dataset version 3.4 published in 2015 and the Utah NEMSIS 3.4 Elements and Values List published in 2016.

(4) Emergency Medical Services Providers shall submit NEMSIS Demographic data elements within 30 days after the end of each calendar quarter in the format defined in the NEMSIS EMSDemographicDataSet. Some data may change less frequently than quarterly, but Emergency Medical Services Providers shall submit all required data elements quarterly regardless of whether the data have changed. For Emergency Medical Services Providers directly using a reporting system provided by the Department, the data is considered submitted to the Department as soon as it has been entered or updated in the Department-provided system.

[(4)](5) Emergency Medical Services Providers shall submit NEMSIS EMS incident data elements for each Patient Care Report[within 30 days of the end of the month in which the EMS incident occurred,] in the format defined in the NEMSIS EMSDataSet[. ], as follows: incidents occurring between the 1st and 15th of a calendar month shall be submitted no later than the last day of the same calendar month; incidents occurring between the 16th and last day of a calendar month shall be submitted no later than the 15th of the following calendar month.

(a) For Emergency Medical Services Providers directly using a reporting system provided by the Department, the data is considered submitted to the Department as soon as it has been entered or updated in the Department-provided system.

(b) Emergency Medical Services Providers shall provide the Department 90 days notice when changing reporting systems.

[(5)](6) If the Department determines that there are errors in the data, it may ask the data supplier for corrections. The data supplier shall correct the data and resubmit it to the Department within 30 days of receipt from the Department. If data is returned to the supplier for corrections, the Emergency Medical Services Provider is not in compliance with this rule until corrected data is returned, accepted and approved by the Department.

[(6) The minimum required demographic data elements that must be reported under this rule include the following NEMSIS EMSDemographicDataSet elements:

D01_01 EMS Agency Number

D01_02 EMS Agency Name

D01_03 EMS Agency State

D01_04 EMS Agency County

D01_05 Primary Type of Service

D01_06 Other Types of Service

D01_07 Level of Service

D01_08 Organizational Type

D01_09 Organization Status

D01_10 Statistical Year

D01_11 Other Agencies In Area

D01_12 Total Service Size Area

D01_13 Total Service Area Population

D01_14 911 Call Volume per Year

D01_15 EMS Dispatch Volume per Year

D01_16 EMS Transport Volume per Year

D01_17 EMS Patient Contact Volume per Year

D01_18 EMS Billable Calls per Year

D01_19 EMS Agency Time Zone

D01_20 EMS Agency Daylight Savings Time Use

D01_21 National Provider Identifier

D02_01 Agency Contact Last Name

D02_02 Agency Contact Middle Name/Initial

D02_03 Agency Contact First Name

D02_04 Agency Contact Address

D02_05 Agency Contact City

D02_06 Agency Contact State

D02_07 Agency Contact Zip Code

D02_08 Agency Contact Telephone Number

D02_09 Agency Contact Fax Number

D02_10 Agency Contact Email Address

D02_11 Agency Contact Web Address

D03_01 Agency Medical Director Last Name

D03_02 Agency Medical Director Middle Name/Initial

D03_03 Agency Medical Director First Name

D03_04 Agency Medical Director Address

D03_05 Agency Medical Director City

D03_06 Agency Medical Director State

D03_07 Agency Medical Director Zip Code

D03_08 Agency Medical Director Telephone Number

D03_09 Agency Medical Director Fax Number

D03_10 Agency Medical Director's Medical Specialty

D03_11 Agency Medical Director Email Address

D04_01 State Certification Licensure Levels

D04_02 EMS Unit Call Sign

D04_04 Procedures

D04_05 Personnel Level Permitted to Use the Procedure

D04_06 Medications Given

D04_07 Personnel Level Permitted to Use the Medication

D04_08 Protocol

D04_09 Personnel Level Permitted to Use the Protocol

D04_10 Billing Status

D04_11 Hospitals Served

D04_13 Other Destinations

D04_15 Destination Type

D04_17 EMD Vendor

D05_01 Station Name

D05_02 Station Number

D05_03 Station Zone

D05_04 Station GPS

D05_05 Station Address

D05_06 Station City

D05_07 Station State

D05_08 Station Zip

D05_09 Station Telephone Number

D06_01 Unit/Vehicle Number

D06_03 Vehicle Type

D06_07 Vehicle Model Year

D07_02 State/Licensure ID Number

D07_03 Personnel's Employment Status

D08_01 EMS Personnel's Last Name

D08_03 EMS Personnel's First Name

(7) The minimum required Patient Care Report data elements that must be reported under this rule include the following NEMSIS EMSDataSet elements:

E01_01 Patient Care Report Number

E01_02 Software Creator

E01_03 Software Name

E01_04 Software Version

E02_01 EMS Agency Number

E02_02 Incident Number

E02_04 Type of Service Requested

E02_05 Primary Role of the Unit

E02_06 Type of Dispatch Delay

E02_07 Type of Response Delay

E02_08 Type of Scene Delay

E02_09 Type of Transport Delay

E02_10 Type of Turn-Around Delay

E02_12 EMS Unit Call Sign (Radio Number)

E02_20 Response Mode to Scene

E03_01 Complaint Reported by Dispatch

E03_02 EMD Performed

E04_01 Crew Member ID

E05_01 Incident or Onset Date/Time

E05_02 PSAP Call Date/Time

E05_03 Dispatch Notified Date/Time

E05_04 Unit Notified by Dispatch Date/Time

E05_05 Unit En Route Date/Time

E05_06 Unit Arrived on Scene Date/Time

E05_07 Arrived at Patient Date/Time

E05_08 Transfer of Patient Care Date/Time

E05_09 Unit Left Scene Date/Time

E05_10 Patient Arrived at Destination Date/Time

E05_11 Unit Back in Service Date/Time

E05_12 Unit Cancelled Date/Time

E05_13 Unit Back at Home Location Date/Time

E06_01 Last Name

E06_02 First Name

E06_03 Middle Initial/Name

E06_04 Patient's Home Address

E06_05 Patient's Home City

E06_06 Patient's Home County

E06_07 Patient's Home State

E06_08 Patient's Home Zip Code

E06_09 Patient's Home Country

E06_10 Social Security Number

E06_11 Gender

E06_12 Race

E06_13 Ethnicity

E06_14 Age

E06_15 Age Units

E06_16 Date of Birth

E06_17 Primary or Home Telephone Number

E07_01 Primary Method of Payment

E07_15 Work-Related

E07_16 Patient's Occupational Industry

E07_17 Patient's Occupation

E07_34 CMS Service Level

E07_35 Condition Code Number

E08_05 Number of Patients at Scene

E08_06 Mass Casualty Incident

E08_07 Incident Location Type

E08_11 Incident Address

E08_12 Incident City

E08_13 Incident County

E08_14 Incident State

E08_15 Incident ZIP Code

E09_01 Prior Aid

E09_02 Prior Aid Performed by

E09_03 Outcome of the Prior Aid

E09_04 Possible Injury

E09_05 Chief Complaint

E09_06 Duration of Chief Complaint

E09_07 Time Units of Duration of Chief Complaint

E09_11 Chief Complaint Anatomic Location

E09_12 Chief Complaint Organ System

E09_13 Primary Symptom

E09_14 Other Associated Symptoms

E09_15 Providers Primary Impression

E09_16 Provider's Secondary Impression

E10_01 Cause of Injury

E10_02 Intent of the Injury

E10_03 Mechanism of Injury

E10_04 Vehicular Injury Indicators

E10_05 Area of the Vehicle impacted by the collision

E10_06 Seat Row Location of Patient in Vehicle

E10_07 Position of Patient in the Seat of the Vehicle

E10_08 Use of Occupant Safety Equipment

E10_09 Airbag Deployment

E10_10 Height of Fall

E11_01 Cardiac Arrest

E11_02 Cardiac Arrest Etiology

E11_03 Resuscitation Attempted

E11_04 Arrest Witnessed by

E11_05 First Monitored Rhythm of the Patient

E11_06 Any Return of Spontaneous Circulation

E11_08 Estimated Time of Arrest Prior to EMS Arrival

E11_10 Reason CPR Discontinued

E12_01 Barriers to Patient Care

E12_08 Medication Allergies

E12_14 Current Medications

E12_18 Presence of Emergency Information Form

E12_19 Alcohol/Drug Use Indicators

E12_20 Pregnancy

E13_01 Run Report Narrative

E14_01 Date/Time Vital Signs Taken

E14_02 Obtained Prior to this Units EMS Care

E14_03 Cardiac Rhythm

E14_04 SBP (Systolic Blood Pressure)

E14_05 DBP (Diastolic Blood Pressure)

E14_07 Pulse Rate

E14_09 Pulse Oximetry

E14_10 Pulse Rhythm

E14_11 Respiratory Rate

E14_14 Blood Glucose Level

E14_15 Glasgow Coma Score-Eye

E14_16 Glasgow Coma Score-Verbal

E14_17 Glasgow Coma Score-Motor

E14_18 Glasgow Coma Score-Qualifier

E14_19 Total Glasgow Coma Score

E14_20 Temperature

E14_22 Level of Responsiveness

E14_24 Stroke Scale

E14_26 APGAR

E14_27 Revised Trauma Score

E14_28 Pediatric Trauma Score

E15_01 NHTSA Injury Matrix External/Skin

E15_02 NHTSA Injury Matrix Head

E15_03 NHTSA Injury Matrix Face

E15_04 NHTSA Injury Matrix Neck

E15_05 NHTSA Injury Matrix Thorax

E15_06 NHTSA Injury Matrix Abdomen

E15_07 NHTSA Injury Matrix Spine

E15_08 NHTSA Injury Matrix Upper Extremities

E15_09 NHTSA Injury Matrix Pelvis

E15_10 NHTSA Injury Matrix Lower Extremities

E15_11 NHTSA Injury Matrix Unspecified

E16_01 Estimated Body Weight

E16_02 Broselow/Luten Color

E16_03 Date/Time of Assessment

E16_04 Skin Assessment

E16_05 Head/Face Assessment

E16_06 Neck Assessment

E16_07 Chest/Lungs Assessment

E16_08 Heart Assessment

E16_09 Abdomen Left Upper Assessment

E16_10 Abdomen Left Lower Assessment

E16_11 Abdomen Right Upper Assessment

E16_12 Abdomen Right Lower Assessment

E16_13 GU Assessment

E16_14 Back Cervical Assessment

E16_15 Back Thoracic Assessment

16_16 Back Lumbar/Sacral Assessment

E16_17 Extremities-Right Upper Assessment

E16_18 Extremities-Right Lower Assessment

E16_19 Extremities-Left Upper Assessment

E16_20 Extremities-Left Lower Assessment

E16_21 Eyes-Left Assessment

E16_22 Eyes-Right Assessment

E16_23 Mental Status Assessment

E16_24 Neurological Assessment

E18_01 Date/Time Medication Administered

E18_02 Medication Administered Prior to this Units EMS Care

E18_03 Medication Given

E18_04 Medication Administered Route

E18_05 Medication Dosage

E18_06 Medication Dosage Units

E18_07 Response to Medication

E18_08 Medication Complication

E18_09 Medication Crew Member ID

E18_10 Medication Authorization

E19_01 Date/Time Procedure Performed Successfully

E19_03 Procedure

E19_04 Size of Procedure Equipment

E19_05 Number of Procedure Attempts

E19_06 Procedure Successful

E19_07 Procedure Complication

E19_08 Response to Procedure

E19_09 Procedure Crew Members ID

E19_10 Procedure Authorization

E19_12 Successful IV Site

E19_13 Tube Confirmation

E19_14 Destination Confirmation of Tube Placement

E20_01 Destination/Transferred To, Name

E20_03 Destination Street Address

E20_04 Destination City

E20_05 Destination State

E20_06 Destination County

E20_07 Destination Zip Code

E20_10 Incident/Patient Disposition

E20_14 Transport Mode from Scene

E20_15 Condition of Patient at Destination

E20_16 Reason for Choosing Destination

E20_17 Type of Destination

E22_01 Emergency Department Disposition

E22_02 Hospital Disposition

E23_03 Personal Protective Equipment Used

E23_09 Research Survey Field

E23_10 Who Generated this Report?

E23_11 Research Survey Field Title

(8) Emergency Medical Services Providers shall use elements E23_09 and E23_11 to report biosurveillance indicators. When any of the following indicators are present in an incident, the Emergency Medical Services Provider shall provide an instance of E23_09 and E23_11, with E23_09 set to "true" and E23_11 set to one of the following:

B01_01 Abdominal Pain

B01_02 Altered Level of Consciousness

B01_03 Apparent Death

B01_04 Bloody Diarrhea

B01_05 Fever

B01_06 Headache

B01_07 Inhalation

B01_08 Rash/Blistering

B01_09 Nausea/Vomiting

B01_10 Paralysis

B01_11 Respiratory Arrest

B01_12 Respiratory Distress

B01_13 Seizures]

[(9)](7) Emergency Medical Services Providers are not required to submit other NEMSIS data elements but may optionally do so. [Emergency Medical Services Providers may also use additional instances of E23_09 and E23_11 for their own purposes.]

[(10)](8) For each patient transported to a licensed acute care facility or a specialty hospital with an emergency department, each responding emergency medical services provider unit that cared for the patient during the incident shall provide a report of patient status, containing information critical to the ongoing care of the patient, to the receiving facility within one hour after the patient arrives at the receiving facility in at least one of the following formats:

(a) NEMSIS XML; or

(b) Paper form.

[(11)](9) For each patient transported to a licensed acute care facility or a specialty hospital with an emergency department, the receiving facility shall provide at least the following information to each Emergency Medical Services Provider that cared for the patient, within 24 hours of [upon ]request by the Emergency Medical Services Provider:

(a) The patient's emergency department disposition;[and]

(b) the patient's hospital disposition[.]; and

(c) the patient's demographic information, including payment source.

 

KEY: emergency medical services

Date of Enactment or Last Substantive Amendment: [October 18, 2013]2016

Notice of Continuation: November 10, 2015

Authorizing, Implemented, or Interpreted Law: 28-8a