NEMSIS Validation and the State Trauma Registry

If your run report qualifies for upload to the state trauma registry, then it must pass NEMSIS validation.

What is NEMSIS?

NEMSIS stands for National EMS Information Systems, an industry standards group whose goal is to standardize the exchange of EMS data. For example, if AngelTrack sends PCR data to your state health department, the data will be formatted according to a standard published by NEMSIS.

The current NEMSIS standard is version 3.4, soon to be 3.5, and all states in America are adopting -- or have already adopted -- the NEMSIS format for uploads of data to their trauma registries.

What is a State Trauma Registry?

Every state in America operates its own trauma registry, which is a statewide database of all EMS encounters. The data is used for epidemiological research, for budget allocation, and to shape future regulations.

States require all of their EMS providers to upload their PCR reports to the database. In the past these uploads took many forms, but the NEMSIS 3.x standard is now universal.

The state trauma registry then forwards a copy of the data to the NEMSIS national repository, like this:

NEMSIS data flow overview

Which Reports Get Uploaded to the Registry?

Each state can have its own particular requirements for which encounters must be uploaded, but the typical upload requirement is for all BLS and higher trips to be uploaded, even if no patient contact occurs.

If your report meets the criteria for upload in your state, then it will be uploaded to the trauma registry. In order to be uploaded to the trauma registry, the report must pass NEMSIS validation.

NEMSIS validation examines all the data in your PCR report, to verify that the required datafields are filled in, and that none of the datafields contain contradictory values.

National, State, and County Validations

There is a single national NEMSIS standard, which applies to all PCR reports in all states. The national standard is pre-installed in AngelTrack, and will be applied to all reports eligible for upload to your state trauma registry.

States and counties can develop their own standards, which expand the national standard with additional requirements and checks. If your state or county has such a standard, then it will be installed on your AngelTrack cloud server, and it will be applied to your PCR reports.

Cryptic error messages

If you receive any validation errors when attempting to send your report to QA, they are probably not coming the national standard; rather, they are probably coming from your state's or your county's validation standard. States and counties can impose any rules they wish on the PCR; some are lax, others are strict.

Unfortunately, AngelTrack LLC does not control the contents of these state and county standards. As a result, you may recieve fragmentary and cryptic error messages. Sometimes you'll have to guess why the standard is complaining. AngelTrack attempts to translate the error messages into plain language, but for a variety of reasons, can't do very much in this regard.

Your state might've published a guide to its data validation rules. The rules are usually called a "schematron", so you might find the guide by searching for that term.

To see where each NEMSIS datafield comes from in AngelTrack, and thereby figure out how to satisfy the validation rules, refer to the AngelTrack NEMSIS Crosswalk.

If all else fails, contact AngelTrack Support.

Warning messages

You may see warning messages returned by your state's data validation rules, with the option to ignore the warnings and submit the report anyway.

Talk to your supervisor about which warnings are important versus which are not.

In any case, you will not always be able to resolve all of the warnings, because the data validation rules can sometimes contain bugs. Furthermore, the rules were written by your state's trauma registry, and so often do not take account of non-emergent interfacility transfer trips which do not have complaints, injuries, or acute symptoms.

Who Performs the Upload?

AngelTrack automatically handles all uploads to the state trauma registry. If your PCR report is eligible, then it will be uploaded after it passes QA. Some jurisdictions require the upload to occur as soon as you complete your report -- meaning: AngelTrack will upload it when you send it to QA.

If any of the PCR data or dispatch data is later modified, then the PCR report will be validated again and uploaded again.

Further Reading

To learn more about NEMSIS validation and how and where it is done in AngelTrack, read the State Trauma Registry Uploads guide.

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