Version 3 Update. Purpose of NEMSIS Version 3 Improve Data Quality –Business Intelligence, Schematron Enhance performance assessment –Incorporation of

Version 3 Update

Purpose of NEMSIS Version 3

• Improve Data Quality– Business Intelligence, Schematron

• Enhance performance assessment– Incorporation of performance measures

• Address need for state flexibility (with control)– Sharepoint, XSD header information

• Prepare for next step (HL7)– Synchronization of clinical content – Data Linkage

Development and Maintenance of NEMSIS V3 XSD

a. Generate V3 Data Dictionary from XSD Tablesi. Software Development tools (i.e. SDK)ii. Provider data dictionary

b. XSDs Available Through SharePoint i. NEMSIS will provide complete V3 XSDs.ii. NEMSIS will provide complete national XSD

(national required elements). In state folders.iii. NEMSIS will provide information for chosen state

and custom elements along with how state implement extension and new elements.


b. XSDs Available Through SharePoint (cont’d)iv. States may post XSD for “custom field”

elements, but must demonstrate relationship to compliant NEMSIS element. In state folders.

v. NEMSIS or states may post “updates” to the XSDs and interested states/vendors will be notified of updates through SharePoint.


c. Enumerated Tables/Lists Available Through SharePoint

i. NEMSIS will provide “suggested lists” for NEMSIS elements with value code sets that are expansive or periodically updated (e.g., ICD-10 [procedures], RxNorm [medications], state GNIS, etc).

ii. States may host “suggested lists” associated with NEMSIS lists requiring tailoring to a state, but must demonstrate that list fits the “pattern” for that NEMSIS element.


d. Develop Calendar Schedule for Review and modification of XSD/Data Dictionary

i. Must conform with HL7 Balloting process.

NEMSIS V3 Custom Elements Overview

• Adding a new element outside the NEMSIS V3 Standard

• Extending the values of a NEMSIS V3 Element– Select a NEMSIS value first, but provides more details

• Adding a value to a NEMSIS V3 Element– Create a new value for an element

• Limiting the values of a NEMSIS V3 Element• Do not display an existing value to EMS professional

NEMSIS V3 Custom Elements Overview

• Think of the NEMSIS elements as a puzzle!

NEMSIS Elements XML Schema

NEMSIS V3Custom Elements – Adding an Element

• Adding an element outside the NEMSIS Standard

• e.g., Patient Eye Color

V2.2.1 – Research Element

V3 – Custom Element

NEMSIS Standard Additional Elements

NEMSIS V3 Custom Elements – Extending the Values

• Extending the values of a NEMSIS Element• e.g., moose vs. car crash (Cause of Injury)

– V2.2.1 allowed a “modification” of the Cause of Injury value list

– Rolling up into existing value, but this didn’t always happen result: BAD data nationally & within states

NEMSIS Standard

EInjury.01 (v3)

NEMSIS V3 Custom Elements – Extending the Values

• Extending the values of a NEMSIS V3 Element• e.g., car vs. moose crash

– V3 – Custom element

How is it Implemented? • Dynamically – with Business Intelligence?• Schematron Rule ?

Up to the Developer!

End result is the same

NEMSIS V3 Custom Elements – Adding a Value

• Adding a value to a NEMSIS V3 Element• Adding “police action” to Scene Delay

– V3 – Custom element• Utilize Scene Delay eResponse.10

– Choose “police action” among choices– Activates “Safety” in eResponse.10

NEMSIS Standard Additional Elements

NEMSIS V3 Custom Elements – Adding a Value or Limiting the Values

• Limiting the values of a NEMSIS V3 Element– Reason for Choosing Destination eDisposition.20

• Display only: “Closest Facility”, “Protocol”, etc• Hide values: “Family Choice”, “Patient Choice”, etc

Breaks the “spirit” of the standard

• Adding a value to a NEMSIS V3 element that cannot be associated with an existing value – CAUTION!!

Development and Maintenance of NEMSIS V3 Business Rules

NEMSIS will develop a core set of business rules, associated with NEMSIS elements, that are to be applied at the “field level” to each EMS record before formal completion and export.

Ensure proper value for applicable elements Ensure proper use of optional elements

Will allow for errors and warnings Only warnings for state and national

submissions


a. NEMSIS business rules will be technical in nature

i. No clinical business rulesb. NEMSIS business rules will be expressed as

Schematron script.c. States/Software may develop additional

business rules for application at the field or state aggregation level. These will be posted in state folder.


d. Application of a Schematron file will be required for record level validation, but will not be mandated at levels of case aggregation.

Development and Maintenance of NEMSIS V3 Web Services

a. The NEMSIS WSDL will be revisedi. Represent a nominal implementationii. Require “file size” featureiii. Optional “search” featureiv. NEMSIS will develop the standard WSDL

and post in state folder.a) States may revise the WSDL

b. NEMSIS will support web services development based upon SOAP or REST.

NEMSIS Version 3 Software Capabilities, Requirements,

& Compliance

Development and Maintenance of the NEMSIS V3

Software Compliance Testing Process

a. NEMSIS to host website for pretesting software applications against the national XSD and Schematron file using sample test cases



b. Software Products Tested by the NEMSIS Compliance Team

i. “Free standing” software will be requested and loaded at NEMSIS.

ii. Web (server) based software, NEMSIS will request an account/admin rights.

iii. If neither is possible, testing will be done via web conference.



c. Attributes to be Tested.i. Installation/Setup.

1) Require published procedure for installation/setup (we will utilize).



c. Attributes to be Tested (cont’d)ii. XSD Structure and Content

a) Validate National NEMSIS XSD1) 12 to 16 test cases focused on

national/generic state elements2) Test cases are event-based

Trauma Cardiac Stroke

3) Errors included in test cases



c. Attributes to be Tested (cont’d)iii. XSD Structure and Content

a) Application of NEMSIS developed business rules

b) Generate valid National XMLc) Export via web services



d. Ability to Exporti. Demographic (Agency) XML (via test cases)

All Version 3 elements National elements only (subset)

ii. EMS (Event) XML (via test cases) All Version 3 elements National elements only (subset)

e. Ability to Importi. CAD XMLii. Medical device XML

Release of NEMSIS V3 Products

• First Phase of “Implementation Release”– July 21, 2011

• Data Dictionaries (developer and provider versions)

• D and E XSDs• Within One Week:• “Suggested lists” associated with related elements

– RXNorm medication list, GNIS codes, etc.

• Sample XML file with clinical data• Documentation regarding header use• Documentation regarding NOT Values / Pertinent

Negative Values / Nill (blank) use

Release of NEMSIS V3 Products

• Additional Phases of “Implementation Release”

– August 11, 2011 - Second Phase Release• Web-Services Documentation

• Compliance Testing Process

– August 25, 2011 - Third Phase Release• Schematron• Business rules• Web-Service Portal

• NEMSIS Version 3 “Official Release” late October 2011

• Compliance testing to begin late October, 2011

NEMSIS Version 3 - Assistance

• All questions related to NEMSIS, Version 3 or Version 2.2.1 should be directed to the NEMSIS TAC in Utah– www.NEMSIS.org – Clinical / General Information

• [email protected]• 801-585-1631

– Technical Information• [email protected]• 801-213-3822

http://www.nemsis.org/

mailto:[email protected]

mailto:[email protected]

Documents

Version 3 Update. Purpose of NEMSIS Version 3 Improve Data Quality –Business Intelligence, Schematron Enhance performance assessment –Incorporation of