What Do You Do With That Data?

A decade after its inception, the National EMS Information System is up and rolling. Thirty-three states and two U.S. territories now contribute to its growing national repository of standardized EMS data, and of the rest just one (Puerto Rico) remains in the lowest category of “limited progress” made.

Now comes the trickier part: Doing something with all that data we’re compiling.

That needn’t fall just to states; individual systems can also use NEMSIS to improve the way they operate and the care they provide. The director of NEMSIS, Karen E. Jacobson, BA, NREMT-P, will offer a primer on doing that with a presentation called “Using Your Data to Change the Role of EMS” at this year’s EMS World Expo, Oct. 29–Nov. 2 in New Orleans. Here she offers a preview.

What led to this presentation? Are people making enough use of the data they’re collecting?

EMS agencies have always documented patient care. But frequently, other than moving paper reports forward for billing purposes, nothing was ever done with the information collected. So one of our purposes right now is to be able to identify what’s happening within agencies. What types of calls are ambulance services are going on? We want to be able to measure trends within services’ own delivery processes. As they work to identify trends, they can then do SWOT-type analyses—strengths, weaknesses, opportunities and threats—and identify areas and strategies for improvement, and ways in which they can measure improvement.

We’re going to demonstrate what some of those clinical characteristics may be within a community. For example, people always want to know what’s happening with cardiac arrest. If you have those cardiac arrests and are tracking where they occur, you can use the NEMSIS standard of data collection to identify if CPR was used prior to the arrival of the ambulance crew. If there are areas where that’s not happening, you can target those, provide educational outreach and determine over time whether there’s improvement.

What advantages does the version 3 data set bring to this?

One of the things we want people to be able to do moving forward is receive outcome data. We believe the version 3 data set is a much stronger data set that will allow data to flow more smoothly between EMS agencies and hospital emergency departments, so EMS agencies can compare dispatch complaints to eventual hospital diagnoses and outcomes and see how their care made a difference.

Agencies can utilize this information for educational purposes as well. Knowing what kinds of calls you’re seeing, you can reinforce education and examine things like protocol compliance. On the flip side, if there are types of calls you’re not seeing—for example, pediatric patients—you’ll know it’s important to maintain an educational focus on those.

Is there enough data now to start meaningful benchmarking? What kinds of tools are there for that?

A couple of different things are happening with benchmarking. We’re working on development of what are called agency profiles. Our goal is that a user can, with just a couple of clicks, see how they’re doing against like systems. Levels of service (ALS, BLS) and organizational status and type (volunteer or paid; hospital-based vs. fire-based vs. government non-fire, etc.) are some of the primary elements we’re going to be using for benchmarking purposes.

One key is that a lot of people don’t even know that once they submit data, there’s a reporting engine that they can use. We want them to be aware of those options. It’s under our Reporting Tools (https://www.nemsis.org/reportingTools/index.html)—we have two reports. The most powerful is what’s called a Cube report (https://www.nemsis.org/reportingTools/reports/nationalReports/createAReport.html). People can go in today and look at that data. The user name and password are public.

What are other current goals and priorities for 2013 and beyond?

As we go through version 3 compliance testing with the software companies, those resources will be available to EMS agencies. But one of the things we want people to know is that the data is more robust. The data quality will improve, which will also help with billing purposes. And it’ll be a big advantage with outcome data from hospitals. So that’s going to be a major focus for us, making people aware of the advantages of version 3, in addition to the growth of our reporting tools.