New York NEMSIS v3 Conversion

Table of Contents

Timeline

 the NEMSIS v3 export was enabled for all of New York. EMS Services were presented with error messages when advancing charts, but were not required to complete all the errors at the time, with the exception of designated pilot agencies.

12 pilot agencies have completed and passed certification with their respective regions without errors.

 New York NEMSIS v3 validation will be enforced for all EMS Services. Charts will be prevented from advancing if validation errors are encountered, EMS Services will be required to correct errors before charts can be locked. Common errors encountered during testing can be found below: Common Errors

 To facilitate a NY validation rule, the Pertinent Negatives option was enabled on behalf of all NY agencies. 

 NY releases '2019 - 01 NYS N3 Schematron Update', introducing some new required elements for data reporting, as well as adjustments to existing rules. See Upcoming New York Changes (07/15/2019) for common errors encountered during testing.

 NY Releases "2019 - 01 Revision 1" 2019 - 01 (Revision 1) NYS Validation Rule and Schematron Updates.pdf


NOTE

"Disabling v2" will not affect your charting except that you will no longer be subject to the older v2 validations.  You will not be switching charting applications.


Steps Required:

  • Complete DOH 5136 (see requirement below) and submit to respective Regional EMS Program Agency for Regional endorsement
      • Program Agency submits the endorsed DOH 5136 to New York State (BEMSATS) for approval
      • BEMSATS emails approved DOH 5136 to (The approval email will include information essential for the ePCR platform to submit data):
          • Program Agency (Reminder: Regions require Integration Accounts)
          • Agency (ePCR Data Coordinator)
          • ePCR Platform
  • Prepare configuration for NEMSIS v3.4.0 in emsCharts - see "emsCharts Configuration Requirements" below



5136 Endorsement Requirement


Agencies are reminded that the Approval from NYS DOH BEMSATS is required BEFORE activation as a new agency documenting electronically, completing an annual renewal, changing ePCR software vendors or upgrading to the NEMSIS 3.4.0 documentation standard. Agencies must submit the 5136 to the REMSCO for endorsement .

2018 NYS DOH 5136 EPCR Update Form_emsCharts.pdf



emsCharts Configuration Requirements

In addition to the standard NEMSIS v3 mapping requirements (units, outcomes, categories, impressions, etc), the following are required:

  • Onset time
  • Received Time
  • Final Acuity

Verify that your Agency Number (State ID) is entered correctly in your Service Configuration under the Export tab, specifically in the General section.

Remember to map your code tables! 

As part of the NY conversion to NEMSIS v3.4.0, it is imperative for your Service to be properly configured for NEMSIS v3.4.0 in emsCharts. If you have not already, please go through the NEMSIS v3 Quick Start Guide for detailed information on setting up in NEMSIS v3



Common Validation Errors

Errors will be represented with a red background. Warnings, with a yellow background, will not prevent a chart from advancing:

The following is a list of common errors and the suggested solution / place in the chart to make changes.

Error MessageSolution
Providers Primary Impression is a required field when Arrived at Patient is not blank (eSituation.11). !Ensure your impressions are mapped and impressions are completed on Page 2
Method of Heart Rate Measurement Must be Populated if Heart Rate is Present (eVitals.11) !Page 8 - HR Method
Method of ECG Interpretation Not Documented (eVitals.05) !Page 8 - ECG Method
Initial Patient Acuity (eSituation.13) Cannot be Blank For Patient Contact !Page 2 - Initial Patient Acuity
1Crew Member Role (eCrew.03) must be documented.  Not Values are not accepted. !Page 1 - Crew Member Roles
eHistory.18 Pregnancy Must Be Assessed for Female Patients of Child-Bearing Age !Page 5 Exam - Obstetrics
Respiratory Effort (eVitals.15) Can NOT Be Populated if Respiratory Rate is Blank !Page 8 - Make sure both Resp Rate and Resp Effort are filled out together.
Reason for Choosing Destination (eDisposition.20) is a required field when Patient Arrived at Destination is not blank. !Page 1 - Destination Basis
Pulse Rhythm Can NOT be Populated if Heart Rate is Blank (eVitals.13) !Values affected: 3313003(eVitals.13) Page 8 - HR and Rhythm must be filled out together
Social Security Number is blank or improperly entered (ePatient.12).  Enter all zeros if unobtainable !Also see NY Supplement (https://stash.utahdcc.org/stash/projects/NES/repos/new-york/browse/DataDictionary/NY_DataDictionary.pdf?raw&at=master) for "last 4" option
Unit Canceled Date/Time (etimes.14)  cannot be blank if call is cancelled based on disposition. !Page 1 - Cancelled times required
Time of Symptom Onset/Last Normal (eSituation.01) is a required field when Arrived at Patient is not blank. !Page 1 - Onset Time (enabled for all NY services) must be completed
PSAP Call Date/Time cannot be a Not Value. !Page 1 - Received time (enabled for all NY services) must be completed
Procedure Complication (eProcedures.07) is a required field when Time Procedure Performed is not blank. !Page 8 - Complication must be completed for applicable procedures
Based on Outcome, the following should be recorded: EMS Transport MethodUnit Codetable ensure your units are mapped to NEMSIS 3 Transport Method
Hospital Capability (eDisposition.23) is required when Destination Type is Hospital or Freestanding ED. !Page 1 - Receiving Hospital Designation/Capability
Role/Type of Person Administering Medication (eMedications.10) Must Be a NYS Licensure or Certification Value !Values affected: 9905009(eMedications.10) Page 8 - Ensure medications have crew member and crew member has NY licensure
Dispatch Complaint is required. Ensure mapping is complete via code tables.Command Facility code table - make sure your custom "Patient Categories/Dispatched As" value used on Page 1 has a NEMSIS v3 mappings






New York Changes (07/15/2019) -

UPDATE: See   update linked above. The following details may change due to that release.

There are two configurations that we recommend that you review at the Service level and the Command Facility level:

  • Under Configuration → Service → Chart Tab, set Use Pertinent Negatives to "Yes"
  • Under Configuration → Command Facility → Chart Tab, below the Chart Times header, set Onset to "Normal" or "Default Unused"

For a full list of the changes provided by NY, please see this PDF. The following table are the most common errors and how to solve them. We will add to this list as we work with the agencies.

Error MessageSolution
Heart Rate (eVitals.10) Cannot be Populated if Pulse Rhythm (eVitals.13) is BlankEnsure Pulse Rhythm is documented whenever Heart Rate is entered on Page 8.
Time of Symptom Onset/Last Normal (eSituation.01) is a required field when Arrived at Patient is not blank. Ensure that if At Patient field on P1: Dispatch has been filled out (is not blank) that the Onset field on P1: Dispatch is also filled out.
Glasgow Coma Score - Qualifier (eVitals.22) Must Not Be Not Reporting (for all but care provided in New York City) If time at patient is documented, document Glasgow Coma Score Qualifier on Page 3 or Page 8
Document Total Glasgow Coma Score If time at patient is documented, document Glasgow Coma Score on Page 8. Pertinent Negative 'Unable to Complete' will be accepted. GCS will be required on any activity log entry with other vitals signs.
Incident Number is a required field. If enabled, the Dispatch ID field on P1: Dispatch cannot be empty. 
eResponse.04 must not be blank If enabled, the Local ID field on P1: Dispatch cannot be empty.
Current Medications is a recommended field when Arrived at Patient is not blank. Current Medications on the Patient page is recommended when the At Patient field on P1: Dispatch has been filled out.
eProcedures.11 Must be Completed for Procedures Performed The Authorization field must be completed on any procedure performed via the P8: Activity Log page. 
eHistory.08 Medical/Surgical History Does Not Accept Not Reporting The Patient Medical History field on the Patient page may not be "Not Reporting". The field defaults to "None Reported" when no selection is made by user.
eHistory.06 Medication Allergies does not accept Not ReportingThe Current Allergies field on the Patient page may not be "Not Reporting"
Primary Symptom is a required field when Arrived at Patient is not blank (eSituation.09).The Symptoms field must have a primary symptom designated from the symptoms modal (appears after clicking on the Symptoms field) if the At Patient field on P1:Dispatch is not empty.
Medication Allergies must be populated (NVs not allowed)The Current Allergies field on the Patient page cannot contain not values.
Procedure Crew Member ID (eProcedures.09) must be Recorded for All Procedures Performed (Except Procedures Performed PTA and Not Values)Unless a procedure was performed prior to arrival or has a not value, the Performed By field must be filled out. 
eMedications.11 (Authorization) must be populated if Medication is AdministeredFor all medications administered, the Authorization field must be filled out. 
Medical Consult - MD (Medication Authorizing Physician) Must be Populated if Medication is Administered and is not Standing Protocol !Page 8 - Medical Consult should be added with the authorizing physicians name and corresponding method (Written Orders, On-Scene, etc). Select this newly created option in the Medication's 'Authorization' field, rather than the generic option such as Written Orders (Patient Specific).
Procedure (criteria) Authorizing Physician (Procedure Authorizing Physician) Must Be Completed if Medical Control Order is Documented. !Page 8 - Medical Consult should be added with the authorizing physicians name and corresponding method (Written Orders, On-Scene, etc). Select this newly created option in the Procedure's 'Authorization' field, rather than the generic option such as Written Orders (Patient Specific).

Additional Reference:

NY State Data Dictionary

It is important to understand how this conversion will impact you as a provider. New York has made the following resource available, their Data Dictionary, that details the requirements for submitting NEMSIS v3.4.0 data. This document defines what data elements are required, as well as under what circumstances:

NY State Bureau of EMS Supplement to the NEMSIS Version 3.4.0 Data Dictionary

NY NEMSIS v3 Implementation Tools and Timeline

NYS NEMSIS V3.4 Software Vendor Guidance Document

NY NEMSIS v3 Export Forum

For more information and updates regarding NY NEMSIS v3 Export, please reference the forum on the topic: NY NEMSIS v3 Export 

To subscribe to this Forum, click "Customize" in the upper right.  Scroll all the way to the bottom and select categories to subscribe.  This Forum thread exists in the "Recent Changes and Updates".


State Contact

Peter L. Brodie, BS, EMT

EMS Data Coordinator

Bureau of Emergency Medical Services and Trauma Systems


New York State Department of Health

875 Central Avenue

Albany, New York 12206

ph: 518.402.0996 | peter.brodie@health.ny.gov

http://www.health.ny.gov