Tennessee NEMSIS v3 Conversion

Table of Contents

Timeline

 Implementation of custom requirements and elements for Tennessee begins.

 the NEMSIS v3 validation was enabled for all of Tennessee. EMS Services are presented with error messages when advancing charts, but are not required to complete all the errors at the time. 

 Enforcement of validation rules, requiring correction by crews if encountered, has been scheduled for Tuesday, October 1st, 2019. 

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.


Your Attention Is Required

Tennessee NEMSIS v3 Set-Up Deadline is Approaching

On September 24th, ahead of the October 1st enforcement date, emsCharts will be activating TN NEMSIS validation rules.

What does this mean?

  • Beginning September 24th, EMS crews will begin to see error messages when their documentation does not satisfy the new TN rules.
  • From September 24 until October 1st, validation locks will not be enabled and these error messages will not prevent charts from locking.

Use the time between September 24th and October 1st to do the following:

  • Educate your crew members on the error messages and how to satisfy the requirements. Beginning October 1st, unsatisfied errors WILL prevent the charts from locking.
  • Consider creating service level data validation rules to flag the errors within the chart before they cause a failure when the crew members attempt to lock.
  • If you have questions, please reach out before October 1 when the errors will be enforced and will prevent charts from locking.



Required Steps

  • Prepare configuration for NEMSIS v3.4.0 in emsCharts - see "emsCharts Configuration Requirements" below




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 TN 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

Please choose your Response Mode Descriptors (traffic management) option(s) *

Page 1 - Document Referring Mode Descriptors on Page 1.

Please choose your Transport Mode Descriptors (traffic management) option(s) !

Page 1 - Document Receiving Mode Descriptors on Page 1.

Providers Primary Impression is a required field when Arrived at Patient is not blank. !

Page 2 - Document Impression on Page 2.

Alcohol/Drug Use Indicators required field when there is a patient. *

Page 2 - Document Drug/Alcohol Indicators on Page 2

Document Stroke Scale Score OR Select a Pertinent Negative OR Select Not Recorded *

Page 8 - Document stroke scale score on Page 8. This rule is triggered by the outcome and impression(s) on the call.

Criteria for stroke scale requirement

If a combination of the following outcome and impression(s) are on the call, the requirement for stroke scale score will be enforce:

Transport Outcomes/Patient Disposition ('NEMSIS3 Value', Command Facility Code Table):
Patient Treated, Transported by this EMS Unit
Patient Treated, Transported by Law Enforcement
Patient Dead at Scene-Resuscitation Attempted (Without Transport)
Patient Treated, Released (per protocol)
Patient Treated, Released (AMA)

Complaint Impression ('NEMSIS3 Value', Command Facility Code Table):
Cerebral infarction, unspecified
Altered mental status, unspecified
Unspecified visual disturbance
Headache
Transient cerebral ischemic attack, unspecified
Other malaise
Syncope and collapse
Weakness
Disorientation, unspecified

Crew Member ID cannot be blank. !

Service Configuration → User Roster → Ensure crews have licensure information documented

How Patient Was Transported From Ambulance (eDisposition.15) cannot be blank when patient was transported and a transfer of care was completed. *

Page 2 - Document Moved From Vehicle Via under Patient Movement header

Position of Patient During Transport (eDisposition.14) cannot be blank when a patient was treated, transported by this EMS Unit. *

Page 2 - Document Position in Vehicle under Patient Movement header

Cause of injury must be entered even if there was no actual injury. !

Page 2 - Document NEMSIS 2 Injury Cause in Add'l Injury Details section

Procedure Complication is a required field when there is a procedure. Will flag Not Value. *

Page 8 - For any procedure, document Complication

A crew name/state licensure must be entered for medications given. !

Service Configuration → User Roster → Ensure crews have licensure information documented

Based on Incident/Patient Disposition, the following should be recorded:      Type of Destination *Values affected: 4212033(eDisposition.12)

Page 1 - Document Other Type for Receiving location when Other is selected.

Crew Member Completing this Report (eOther.08) is blank. !

Service Configuration → User Roster → Ensure crews have licensure information documented

Pregnancy cannot be blank if patient gender is  "Female " and age is greater than 8 or less than 60. !

Page 5 - Document Is Patient Pregnant? in Obstetrics section

Destination County (eDisposition.06) cannot be blank when patient was transferred and arrived at a destination. !

Page 1 - Document County for Receiving location

Reason for choosing destination is blank. *

Page 1 - Document Dest. Basis under Receiving facility

Incident county is blank. !

Page 1 - Document County for Referring location

Role/Type of Person Administering Medication must be identified. Must identify licensure level. !

Service Configuration → User Roster → Ensure crews have licensure information documented

Crew Member Response Role is blank. !

Page 1 - Document Roles under Crew Roster for any crew members

Medication Administered Route (eMedications.04) is blank. !

Page 8 - Document Route for any given medication

Dispatch Complaint is required. Ensure mapping is complete via code tables.

Page 1 - Document Dispatch As under General header

Patient Arrived at Destination Time is a required field when Destination Name is not blank. !

Page 1 - Document Arrive Rec under Times

Unit Arrived on Scene Time is a required field when Unit Left Scene is not blank. !

Page 1 - Document On Scene under Times



Upcoming Tennessee Changes


The following is a list of future changes that TN will be making to the V3 validation rules. There are currently none noted.

TN Validation RuleTarget SiteSummary of Issue




























Additional References

TN State NEMSIS Page

It is important to understand how this conversion will impact you as a provider. Tennessee 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:

Tennessee NEMSIS V3 State Resources

TN NEMSIS v3 Export Forum

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

Britnei D Outland

Data Manager

Office of Emergency Medical Services


Tennessee Department of Health - Emergency Medical Services

665 Mainstream Drive

NashvilleTN 37423

ph: 615-532-4572 | britnei.outland@tn.gov

https://www.tn.gov/health/health-program-areas/health-professional-boards/ems-board/ems-board/run-data.html