How AngelTrack Handles NEMSIS and NFIRS Validation for Upload to Your State

Learn about the state data validation process, which ensures your charts meet the requirements imposed by your state trauma registry.

What is NEMSIS?

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

Your state then forwards your charts to the national database run by NEMSIS TAC.

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 NFIRS?

NFIRS stands for National Fire Incident Reporting System, a national database of fire response data run by FEMA. When AngelTrack sends your fire incident reports up to your state, the data is formatted according to the standard published by FEMA.

Your state then forwards your reports to the national database run by DHS.

The current NFIRS standard is version 5.0. AngelTrack is officially listed as a NFIRS 5.0 compliant fire reporting application.

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 data standard is now universal.

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


What is a State Fire Database?

Your state operates a database of fire incident reports, in the NFIRS data format. It contains a report for every fire-related response that occurs anywhere within the state. It then forwards copies of the data to the national fire database run by FEMA.



Which Reports Get Uploaded to the State?

For EMS (NEMSIS) reports, each state can have its own particular requirements for which encounters must be uploaded... but the typical upload requirement asks for all BLS and higher responses to be uploaded, even if no patient contact occurs.

If your report meets the criteria for upload in your state, then it will be subject to Data Validation Rules, and once it passes validation, will be uploaded to the trauma registry.

For fire (NFIRS) reports, every state wants a report of every fire-related response, plus a monthly no-activity report from any small volunteer departments that did not have any response during that month. All NFIRS reports are subject to Data Validation Rules.

Data Validation Rules - National, State, and County 

For EMS, 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 also 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 is already installed on your AngelTrack cloud server, and it will be applied to your PCR reports.

For fire, there is a single national NFIRS standard, which applies to all fire incident reports in all states. This standard contains 184 "relational edit" rules, plus 19 "incident module" rules, plus "star rules" which reflect the "required field" stars printed on paper NFIRS forms. All these rules are implemented in AngelTrack, which uses them to check each incident report for suitability for upload to the database.

Cryptic error messages during EMS validations

You might receive a few data validation errors when attempting to send your report to QA.

AngelTrack LLC does not control the contents of the Data Validation Rules. The rules are published by third parties, and they sometimes contain bugs, typos, and fragmentary or cryptic error messages. Sometimes you'll have to guess why the rules are complaining.

To assist you with this, AngelTrack has a feature called the Contextualizer. It analyzes each error message, attempting to identify all datafields that are contributing. Whenever it identifies one, it adds a link you can click, which will take you straight to the PCR field in question, which it will highlight, like this:


To learn more, look at the Contextualizer Guide.

If still no luck, then you can see where each NEMSIS datafield comes from in AngelTrack -- and thereby figure out how to satisfy the validation rules -- by using the AngelTrack NEMSIS Crosswalk.

If all else fails, contact AngelTrack Support.

Warning messages

You may see warning messages returned by the 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 might not always be able to resolve all of the warnings, because the data validation rules can sometimes contain bugs.

Furthermore, for EMS reports, 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, acute symptoms, or EMD actions.

Facility codes / eDisposition.02 / "Destination Transferred To - Code"

If you are getting error messages about the destination code, your dispatcher must attach the relevant facility record to your trip ticket as its destination. To learn more, take a look at the State Facility Codes Guide.

Who Performs the Upload?

AngelTrack automatically handles all uploads to your state.

If your report is eligible for upload, 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 as soon as you submit it to QA.

If you later modify any PCR data or dispatch data, then AngelTrack will validate the report again, and re-upload it afterward.

Further Reading

To learn more about NEMSIS/NFIRS validation and how and where it is done in AngelTrack, read the State Trauma Registry Uploads Guide for EMS, and the State Fire Database Uploads Guide for fire.