Data Managers Council Minutes October 6, Data Managers Council Annual Meeting. October 6, 2014

Transcription

1 National Association of State EMS Officials Data Managers Council Annual Meeting October 6, 2014 Chair: Paul Sharpe, Virginia Chair- Elect: Lindsey Narloch, North Dakota Secretary: Ryan Tyler, Arkansas Immediate Past Chair: Joe Moreland, Kansas Call to order by Paul Sharpe on October 6, 2014 at 8:35 am EST. Introductions Attendees: Guest: Anne Vossbrink - AZ Chris Drucker - TX Chuck Happel - WI Cynthia Romero - NM Dagan Wright - OR Dan Smiley - CA Doug Fuller - NE Drew Chandler - KY Gary Shirley - TN Jason Cantera - MD Jay Ostby - WY Jean Speck - CT Jenna Protzko - VT John Cramer - ID John New - MD Juan Esparza - FL Juan Pua - NMI Kevin Putman - MI Ben Barnett - Zoll Clay Mann - NEMSIS Jeff Robertson - EMSPIC Joe Graw - ImageTrend Josh Legler - Data Consultant Mark Miller - AK Mark Roberts - CA Martin Lansdale - OK Melissa Belgau - WA MisChele White - AL Murray Lawry - IN Paul Phillips - KY Paul Sharpe - VA Ridgely Ficks - MA Ryan Tyler - AR Shari Graham - MT Shari Hunsaker - UT Steve McCoy - FL Sue Morris - OH Terry Smith - IA Tim Seplaki - NJ Tom McGinnis - CA Karen Jacobson - NEMSIS Rachael Alter - NASEMSO Rene Nelson - Zoll Sue McHenry - NHTSA William Traughber - EMSPIC 1 Data Managers Council Minutes

2 State Updates Each participating State Data Manager gave an update on pressing issues going on in each state and the transition to NEMSIS version 3. Each state brought up a recurring theme: 1. Air Medical Data Reporting 2. Compliance with Data submission 3. Compliance with Data Quality 4. Need for an additional FTE for data task 5. Contract issues with vendor 6. Offering assistance for setting up validity rules and related training. 7. Switching Vendors and Vendor information NASEMSO and Federal Partner Updates NHTSA: Sue McHenry gave an update from the Office of EMS. The current initiatives are placed on Education, Workforce, Safety, Research, Advancing EMS Systems, Preparedness, NEMSIS, and 911 systems. Sue wanted the group to be aware of Ambulance Crash Data Analysis. Here is the link: gacd.htm NASEMSO: Dia Gainor and Jim DeTienne updated the group on the largest cooperative agreement between NASEMSO and NHTSA. The new CAP 7 will be comprehensive Performance Measures that will be used at the local, state and national level. New Performance Measures will be comprehensive that focus on financial, clinical, and operational aspects of an EMS System. The Performance Measures will help link the new Clinical Guidelines with evidence based protocols. Jim DeTienne also mentioned the need to update NASEMSO strategic plan/business plan that allows for growth of the organization. Strategic plan update will ensure resources are available to the councils. He was also concerned about the notion of a closed door meeting. He feels the organization should be transparent in all aspects of the organization. If a member would like to chat with him on the issue, he is open California EMS Core Quality Measures Project Dan Smiley and Tom McGinnis presented to the DMC Council on the California EMS Core Measures. These measures were derived largely from a set of quality indicators developed through a project by the National Quality Forum. Additionally, NHSTA has published Performance Measures for emergency medical services. These California core measures will begin to benchmark the performance of EMS systems, perform recommended treatments determined to get the best results for patients with certain medical conditions, and transport patients to the most appropriate hospital. Information about these treatments are taken from the pre- hospital care reports and converted into a percentage. The measures are based on scientific evidence about processes and treatments that are known to get the best results for a condition or illness. Core Measures help emergency medical services systems improve the quality of patient care by focusing on the actual results of care. 2 Data Managers Council Minutes

3 To find more information about the California EMS Core Quality Measure Project go to the following address: To view the current Core Measures go to the following address: Washington State v3 KPI development Melissa Belgau presented to the DMC Council on the Key Performance Indicators (KPI) development for NEMSIS version 3 in Washington State. Summary of Washington State EMS Key Performance Indicators 1. Critical Trauma Patient Management 1.1 Percent of Step 1 & Step 2 trauma patients with an EMS scene time <10 minutes (arrival- to- departure of ambulance) 1.2 Percent of Step 1 & Step 2 trauma patients transported to a designated trauma center. 2. Heart Failure Patient Management 2.1 Percent of suspected heart failure patients who received CPAP or had the CPAP protocol documented 2.2 Percent of suspected heart failure patients who received nitroglycerine (NTG) or had NTG protocol documented 3. Asthma Patient Management 3.1 Percent of bronchospasm patients with respiratory distress, indicative of wheezing or known history of asthma or reactive airway disease, who received a beta- agonist or had the beta- agonist administration protocol documented by the first EMS crew able to provide such treatment. 4. Seizure Patient Management 4.1 Percent of still seizing (upon EMS arrival) and post seizure patients who received blood glucose (BG) check. 4.2 Percent of still seizing (upon EMS arrival) or recurrent seizure patients treated with benzodiazepines by EMS. 5. ACS/Chest Pain Patient Management 5.1 Percent of patients >35 years old with suspected cardiac chest pain/discomfort or other ACS symptoms who received aspirin from EMS or had the aspirin protocol documented. 5.2 Percent of patients >35 years old with suspected cardiac chest pain/discomfort or other ACS symptoms with 12- Lead ECG acquired by EMS. 5.3 Percent of patients >35 years old with suspected cardiac chest pain/discomfort or other ACS symptoms with 12- Lead ECG acquired by EMS. 5.4 Percent of patients >35 years old with suspected cardiac chest pain/discomfort or other ACS symptoms with an EMS scene time (arrival- to- departure of ambulance) <20 minutes. [Option: Measure of suspected STEMI patients only.] 5.5 Percent of suspected STEMI patients in which a CODE STEMI alert is activated prior to hospital arrival. 5.6 Percent of suspected STEMI patients transported to a designated cardiac receiving center. 3 Data Managers Council Minutes

4 6. Stroke/TIA Patient Management 6.1 Percent of suspected CVA/TIA patients with a FAST exam (i.e. neuro screening) performed and all elements documented or documentation of why an exam could not be performed. 6.2 Percent of suspected CVA/TIA patients who received blood glucose (BG) check. 6.3 Percent of suspected CVA/TIA patients with an EMS scene time (arrival- to- departure of ambulance) <20 minutes. 6.4 Percent of suspected CVA/TIA patients with Time Last Normal <6 hours to hospital arrival, in which a Code Stroke alert is activated prior to hospital arrival 6.5 Percent of patients transported to a designated stroke receiving center. 7. Cardiac Arrest Patient Management 7.1 Percent of non- traumatic cardiac arrest patients who received bystander CPR. 7.2 Percent of patients (in cardiac arrest before EMS arrival) in an initially shockable rhythm who were defibrillated in <8 minutes, from time the 911 call was received at fire/ems dispatch. 7.3 Percent of patients (in cardiac arrest before EMS arrival) with a witnessed collapse, in an initially shockable rhythm, with survival to discharge from an acute care hospital. 7.4 Percent of overall non- traumatic cardiac arrest patients with survival to discharge from an acute care hospital. 8. Advanced Airway Patient Management 8.1 Percent of patients intubated with first- pass success. 8.2 Overall percent of patients who are successfully intubated with an ET tube. 8.3 Overall percent of patients with successful placement of a superglottic (SGA) airway. 8.4 Percent of ET intubated patients and patients with SGAs with documentation of continuous wave- form ETCO2. DMC Priorities and Strategies Time was allotted for workgroups to get together to discuss issues within each workgroup. Joint Meeting with State Directors V3 Discussion Jim DeTienne talked with Data Managers; State Directors; and other stakeholders present about ensuring the communication process with the NEMSIS TAC and stakeholders is open and transparent. His was concern was that information was getting twisted and failing to convey the importance of moving to NEMSIS version 3. Jim is creating a communication committee to be an avenue of working through issues with the NEMSIS TAC. If you are interested in being on the committee, please contact Dia. 4 Data Managers Council Minutes

5 Adjournment There being no further business, the meeting concluded for Monday October 6, The next meeting will be Tuesday, October 7, :00 am - 5:00 pm (Eastern). Lunch break tomorrow will be extended from 12:00 pm til 1:30 pm to allow for individuals to walk to local eateries. Call to order by Paul Sharpe on October 7, 2014 at 8:00 am EST. Introductions Attendees: Guest: NEMSIS TAC Drew Chandler - KY Anne Vossbrink - AZ Chris Drucker - TX Chuck Happel - WI Cynthia Romero - NM Dagan Wright - OR Doug Fuller - NE Gary Shirley - TN Jason Cantera - MD Jay Ostby - WY Jean Speck - CT Jenna Protzko - VT John New - MD Juan Esparza - FL Kevin Putman - MI Ben Barnett - Zoll Clay Mann - NEMSIS Jeff Robertson - EMSPIC Joe Graw - ImageTrend Josh Legler - Data Consultant Mark Miller - AK Mark Roberts - CA Martin Lansdale - OK MisChele White - AL Murray Lawry - IN Paul Sharpe - VA Ridgely Ficks - MA Ryan Tyler - AR Shari Hunsaker - UT Steve McCoy - FL Sue Morris - OH Terry Smith - IA Tim Seplaki - NJ Tom McGinnis - CA Karen Jacobson - NEMSIS Rachael Alter - NASEMSO Rene Nelson - Zoll Sue McHenry - NHTSA William Traughber - EMSPIC Karen Jacobson performed a review of NEMSIS version 3.X.X element release for March Data Managers Council was only able to review four out of 26 elements up for review. A debate on edisposition.12 Incident/Patient Disposition brought about a round of discussion and debate on the how the edisposition.12 would look if separated. 5 Data Managers Council Minutes

6 The Data Managers Council requested a rational from the steering committee on NEMSIS version 3 revision process. Also the council requests a rational on International Address and the potential addition of a Postal Code element. Joshua Legler gave a presentation on how NEMSIS version 3 elements would work with the Emergency Medical Service Performance Measures from 2009 for benchmarking performance in an EMS system. Here is a list of the Performance Measure supported in NEMSIS version 3: Performance ID Number Performance Measure Supported in NEMSIS v Emergency Medical Dispatch Type Not Supported 1.2 Emergency Medical Dispatch Impact on Response Mode Not Supported 1.3 Emergency Medical Dispatch Impact on Response Level Not Supported 2.0 Annual Turnover Rate Not Supported 3.1 Average Defibrillation Time Supported th Percentile Defibrillation Time Supported 4.1 Average Initial Rhythm Analysis Time Supported th Percentile Initial Rhythm Analysis Time Supported 5 Major Trauma Triage to Trauma Center Rate Supported 6.1 Pain Relief Rate Supported 6.2 Pain Worsened Rate Supported 6.3 Pain Unchanged Rate Supported 6.4 Pain Intervention Rate Supported Lead Performance Rate Supported 8 Aspirin Administration for Chest Pain/Discomfort Rate Supported 9 STEMI Triage to Specialty Center Rate Supported 10.1 Mean Emergency Patient Response Interval Supported th Percentile Emergency Patient Response Interval Supported 10.3 Mean Emergency Scene Interval Supported th Percentile Emergency Scene Interval Supported 10.5 Mean Emergency Transport Interval Supported th Percentile Emergency Transport Interval Supported 11 Per Capita Agency Operating Expense Not Supported 12 Patient Care Satisfaction Rate Not Supported 13 Patient Care Satisfaction Survey Rate Not Supported 14 Rate of Appropriate Oxygen Use Supported 15 Undetected Esophageal Intubation Rate Supported 16.1 Delay- Causing Crash Rate per 1,000 EMS Responses Supported 16.2 EMS Crash Rate per 100,000 Fleet Miles Not Supported 16.3 EMS Crash Injury Rate per 100,000 Fleet Miles Not Supported 6 Data Managers Council Minutes

7 Performance ID Number Performance Measure Supported in NEMSIS v EMS Crash Death Rate per 100,000 Fleet Miles Not Supported 17.1 Call Complaint Distribution Supported 17.2 Call Complaint Rate Supported 18.1 EMS Cardiac Arrest Survival Rate to ED Discharge Supported 18.2 EMS Cardiac Arrest Survival Rate to Hospital Discharge Supported N1 Mass Casualty Incident Rate Additional Supported N2 Stroke Triage to Specialty Center Rate Additional Supported N3 Patient Care Report Completeness Additional Supported Here is a link to the EMS Performance Measures. Dr. Clay Mann went over the new Performance Dashboard and reporting tool generated by Tableau for each State. All data is pulled from the NEMSIS repository for each state. To view you state s data login into the following address with your NDX username and password. Go to the password reset site State Schematron Rules Steve McCoy and Juan Esparza present the council on State Schematron Rules. Schematron is a rule- based language for XML document validation. Much of the validation in NEMSIS is accomplished via the use of W3C XML Schemas (known as XSD). XML Schemas constrain the structure of NEMSIS XML documents and the contents of elements and attributes within those documents using grammar- based validation. However, XML Schemas are not capable of context- sensitive validation, such as constraining the contents of one element based on the contents of another element. The rule- based validation provided by Schematron fills the gap. Lessons Learned during the development of schematron rules: 1. What data quality means to the state. What are the definitions and metrics. 2. Take ownership. 3. Develop a strategy. 4. Develop the rules in plain language so they can be understood by everyone. 5. Develop an implementation method a. How will the schematron file be created 6. Test 7 Data Managers Council Minutes

8 Priorities, Strategies, and Hot Topics Carry over from Monday October 6, This allowed time for members to meet and work with each other on finding solutions that can ease the burden of day to day duties as a data manager. State Stroke and STEMI Systems Dr. Peter Taillac gave a presentation describing their state s experience in creating state stroke system and/or STEMI system of care. Dr. Tailliac was able to show data was used to decrease the door to balloon time and the pitfalls associated with creation of a regional system of care. Election Results Chair- Elect: Lindsey Narloch Secretary: Chuck Happel East Region: Chip Cooper West Region: Anne Vossbrink Adjournment There being no further business, the meeting concluded at the motion of Doug Fuller and second by Chuck Happel, respectively. There will be no monthly DMC call on Tuesday October 21, Next meeting will be on Tuesday November 18, Meeting Record respectfully submitted by Secretary Ryan Tyler 8 Data Managers Council Minutes