NEMSIS v3 Quick Start Guide

To ensure that a service is going to be successful in submitting NEMSIS 3 data, there are several areas that will need addressed.

This is a quick start guide to setting up your service to export to NEMSIS v3.  While NEMSIS v3 will still occur mostly behind the scenes when you lock the chart, there are a number of differences between the NEMSIS v2 setup within emsCharts.  We acknowledge some of the mapping options repeat what was in v2 but with minor textual differences. However, these are provided as NEMSIS provided them to us. Please remember the goal of data collection is to provide accurate data collection and analysis to fuel performance measures and improve patient care.

Prerequisite Reading

Please see the NEMSIS v3 site for more information about the NEMSIS project. Specifically, if you click on Support, V3, and State and Territory, you can select your state to find out any specific state details and a contact person for your state.

The NEMSIS site also contains information about compliant software and compliance testing schedule.  emsCharts is currently v3.3.4 compliant but can create v3.4.0 files. We are actively testing v3.4.0 and are implementing Receive & Process software.

Additionally, please see the bottom of this page for potential links to other documentation in our system that is relevant to this topic.

DEMS - Demographic Export Only

Please note, items marked with "DEMS" is for the demographics dataset only. Each agency is "required" to create a demographics dataset before submitting to the NEMSIS dataset, however often the receiving state has their own system in which this information should be setup. emsCharts can create the demographics dataset on your behalf, but it is yet to be seen if the states will accept this dataset in substitution for their own system (sometimes referred to as licensure system). The common "NEMSIS Dataset" is technically their "EMS" dataset which is the per chart (ePCR) record. We create that upon locking of every chart. If the item below is marked "DEMS" then you can theoretically ignore unless your state requires it.

Command Configuration

Within the command configuration there are several options/areas to consider.  Outlined below starts with the chart configuration tab, then proceeds through a check of existing NEMSIS v3 values and an import of new NEMSIS v3 values.

Chart Tab

  • Anatomical Exam: Yes, V3 -or- Yes V3 Text (Web Only)

(Note if using Mobile 3, the “Yes V3” option should be chosen as that is what Mobile 3 utilizes.)

Code Tables

For most code tables listed below, there is a column named NEMSIS3 in which you should map your custom values.

  • Patient Category

  • Destination Basis
  • DNR Types
  • EKG Rhythms
  • Hospital Alert
  • Injury Mechanism
  • Injury Symptoms
  • Injury Systems
  • Impressions
  • MVI Risk Factors
  • Mental Assessment
  • Neurological Assessment
  • Protocols
  • Safety Equipment, including NEMSIS3 OSHA
  • Transport Outcomes

These are the common tables that will need mapped, if running the compliance setup, the blue “Need to Map Options” hyperlink will load the table in a separate window to allow for this to be easily modified. 


Codetables and Value Import

After mapping command code tables, please make sure to read the NEMSIS v3 Command Configuration Tool guide to import new NEMSIS v3 Suggested List values. Also, NEMSIS v3 Assessment & Injury Exam values are standardized. They do not utilize the customized lists that we had in v2 with a few exceptions such as Mental and Neuro exam. Most of the custom values utilized by services have been included by NEMSIS.


Service Configuration

Chart Tab

Here are a few newer items to configure. All are required for complete data and in some cases state validation rules.

  • Top-Left generic section, Use Pertinent Negatives: Yes: See Guide to emsCharts / NEMSIS v3 Pertinent Negatives for more information
  • Crew Section, Crew Roles Layout on New Chart: NEMSIS v3 (New Layout)
  • Patient Section, Medical/Surgical History: While "Basic" will work, ICD/NEMSIS Basic is recommended. (ICD/NEMSIS Standard is the full list and is more complex, but may work for some agencies)
  • Page 2 Section, Injury Cause: NEMSIS 3 (ICD 10)  - or BOTH if you concurrently export to NEMSIS v2 and V3 for Billing Companies and/or States.
  • Page 2 Section, Condition or Final Acuity: If v3.4 state, use Final Acuity or BOTH similar to above.
  • Page 8 Section, NEMSIS 3 Procedure Select Box: Yes

(For this option, most of these are mapped, however there may be an instance in which they must perform a mapping on page 8 of the chart)

  • “Other Pages Section” Anatomical Exam: Yes V3 -or- Yes V3 Text (Web Only)

(This may or may not show up on the chart tab in the service, depending on the command configuration, else this would need turned on in the command.  See above. Note that if using Mobile 3, the “Yes V3” option should be chosen as that is what Mobile V3 utilizes).

Code Tables

  • Base Sites  - NEMSIS3 Location Type (DEMS)
  • Units  - NEMSIS3 Transport Method, provides more detail than just ground/air for the unit.
  • Response Codes - Ensure lights and sirens, emergency response, and Dispatch Priority are all mapped appropriately,
  • Common Addresses
    • NEMSIS3 State Facility (where applicable) is the mapping of a common address for your state
    • NEMSIS3 Demographic Facility Type (DEMS)
  • User Titles
    • NEMSIS3 Primary Job Role, similar to your "Position" entries (DEMS)
    • NEMSIS3 Admin Type, provides detail for agency contact job titles (DEMS)
  • Chart Attachment Categories
  • Chart Summary - see the options for Generation Method - only if you utilize V3 BILL Dataset.
  • Global/System Reports - activate the NEMSIS v3 reports in order to view XML Export reports.

Export Tab

Left Side

The export tab contains a few settings with regards to locking the chart and docking V3 "schematron" validation rules. Please see Close Chart / Validation Updates for NEMSIS v3 for more information on those settings.

The General Configuration link for each state currently (11-02-2016) contains 3 settings per state. More detail on these settings can be found at 2016.10.11 - NEMSIS v3 Settings: Overrides, Attachments, Signatures, Labs

Right Side

On the right side there's a section specific to NEMSIS Version 3, as show in the image below.  There are two options for "V3 Messages Inline", the default is to only show ERROR messages. For states with Data Quality scores, often they base their scoring on optional WARNINGS, so it would be helpful to show both errors and warnings.


Also if you click "Verify Setup", it will load the previously mentioned configuration check and add a few service-specific items at the bottom of the list. These are seen in the image below. If the item is a blue link, the it is recommended to be changed for NEMSIS v3. Here's a description of the optional setups:

  1. Crew Roles - For V3 it allows you to select more than 1 crew role. If you have the old option enabled, we just export that old value. This is optional, but recommended to change.
  2. Mode Descriptors are a NEMSIS v3 field, that contains specific details about the Emergent / Non-Emergent call. This is optional. It's not typically required, unless a state enforces it in the Schematron.
  3. Ref/Rec Mode - Emergent vs. Lights & Sirens. It is recommended to use the Emergent notation as to not conflict w/ the L&S value found in Mode Descriptors.
  4. Injury Cause - it is highly recommended to use NEMSIS 3 or Both if you need to have the NEMSIS 2 standard for billing or during the v2 to v3 transition.  V2 uses an ICD-9 standard while V3 uses the ICD-10 standard.
  5. Page 8 Procedures - it is highly recommended to turn on this option so the user has confirmation & control over what SNOMED procedure code will be sent.
  6. PMHX Layout - it is highly recommended to use one of the ICD-based options for sending over patient medical history



User Roster

See the "User / My Account section below"


User / My Account

General Tab

The general table includes a number of field changes and are all generally Demographic dataset (DEMS) fields. They include:

  • Additional Emails
  • Driver's License Types
  • Highest Education and Education Type of Study
  • Foreign Languages

Licensures

  • Medical Director Credentials (DEMS) such as Degree, Fellowship, Board Certifications, only applicable if this user is a Medical Director

How Data Gets To My State/Region

NEMSIS v3 has defined system-wide web services which instruct each state and vendor how to transmit and receive files. All states and regions should be following the same design to transmit. As emsCharts goes state-by-state to transition customers to the NEMSIS v3 standard, we are sending a list of active and implementing services to the state and receiving corresponding usernames, passwords, and organization IDs that are used to communicate with the state. 

Additionally, as we work towards an interconnected healthcare environment, all ePCRs are automatically transmitted upon initial locking and sent again as updates should they occur. There is not a setting to prevent the transmission of the charts to the state prior to a specific QA level. This setting in v2 was not properly utilized by agencies and caused many agencies to "under report" to their states. Furthermore, it delays obtaining information from hospitals and causes system delays as large exports are created.

The information is typically transmitted on an hourly1 basis to the state.  If enabled, you can use the 2016.11.02 - Global / System Reports to view NEMSIS v3 transmission details.


If you are not part of the initial roll out in your state, you must contact emsCharts to obtain a username/password combination (from the state via emsCharts) to transmit to the state.  The settings found on the export tab are for V2 only, which was not a standardized system. Please contact your sales representative or our training department for more information.

Related articles

See Also: NEMSISv3CompliancePass-LocalLevel.pdf


1 Times are subject to change or differ per state and state volume