Welcome to the NEMSIS 101 page. Here you will find various resources and links that will help you to understand various aspects of NEMSIS including development, implementation and support of the National EMS Data Standard.

If you have questions that are not reflected on this resource page, please reach out to the NEMSIS Technical Assistance Center at and we will be happy to connect you to the knowledge and support material you need.

This video provides a concise introduction to NEMSIS. Feel to use and share as needed!

Annual Meeting Resources

The NEMSIS v3 Implementation Annual Meetings bring together the many voices of EMS data. This group includes State/Territory Offices of EMS, EMS Software Vendors, NHTSA’s Office of EMS, and other National EMS partners. By facilitating critical conversations and open discussion, this gathering helps to ensure that the collection and utilization of EMS data meets the rapidly evolving needs of EMS service and care.

The 2020 Annual Meeting was held virtually over three days of presentations, dialog, breakout sessions, and discussion. Over 150 key EMS stakeholders participated. Located below are resources and presentations from the Annual Meeting.

Annual NEMSIS v3 Implementation Meeting 2020 Recordings
2020 NEMSIS Annual Meeting Day One 9-15-2020
2020 NEMSIS Annual Meeting Day Two 9-16-2020
2020 NEMSIS Annual Meeting Day Three 9-17-2020

Agenda and Notes
Annual NEMSIS v3 Implementation Meeting 2020 Agenda 
2020 NEMSIS Annual Meeting Breakout Session Notes – These are the notes captured during open discussion after the various Breakout Sessions.

2020 Implementation Meeting Facilitation Slides – This includes the facilitated discussion slides throughout all three days.
The Evolution of NEMSIS – The opening day presentation by Dr. Jon Krohmer and Mr. Eric Chaney, NHTSA’s Office of EMS, which describes the critical nature of accurate, timely, and actionable National EMS data.
EMS & Federal Regulation: Facilitating Bi-Directional Data Exchange – The presentation provided by Ryan Stark, of Page, Wolfberg & Wirth, concerning HIPAA and pre-hospital data exchange.
ET3 Model Presentation – The presentation provided by Neil Milan, CMMI, CMS, describing the implementation of ET3 and addressing frequently asked questions.

Annual Meeting Boot Camp

A Boot Camp is offered in conjunction with the Annual v3 Implementation Meeting. It is designed for new and learning State/Territory EMS Data Managers and EMS Directors. This interactive training creates and develops an increased understanding of and proficiency with the NEMSIS Data Standard, State/Territory specific tools, State/Territory support, and additional resources.

Boot Camp Resource Binder: This binder offers support material for the topics addressed during Boot Camp.
2020 Boot Camp Agenda

Maintaining the Data Standard

The National EMS data standard is established as the universal standard for the collection, sharing, and assessment of pre-hospital patient encounter documentation throughout the United States and Territories. Regular revisions, updates, and critical patches are necessary to reflect the evolving needs of the broader EMS industry and developing standards for health information exchange.

Data Standard Revision Guide 2020 – Read about the process to maintain and update the data standard.
NEMSIS Versioning Schedule v8 – Review the timeline for version schedule, duration between releases, and version lifespan.

Data Consistency

Pertinent Negatives and Not Values – These are the different methods utilized when a data element is not applicable to a specific EMS activation.
Schematron Errors and Warnings – Learn about the distinction between errors (causing record failures) and warnings (impacting data quality).

State Specific Tools

State/Territory EMS Data Managers are offered personal one-on-one training and assistance in developing and supporting EMS data collection. Additional resources include:

NEMSIS TAC Version 3 On-Boarding Process for States and Territories – Dec 2017 – Review the necessary steps for successful web service submission of data to the NEMSIS TAC.
v3 Version Change Checklist for States and Territories – This checklist is for states and territories that have already implemented a version of NEMSIS V3 and need to implement a new version of NEMSIS V3 (for example, states that have implemented NEMSIS v3.4.0 and need to implement NEMSIS v3.5.0).
State/Territory Data Managers and Vendors – At the request of Data Managers, the TAC has compiled a list of State/Territory Data Managers and the state-level Receive & Process Software Vendor that they use. (For informational purposes only.)

Understanding NEMSIS v3.5

A revision of the EMS data standard includes support tools and documentation.

Role and Scope of UUID in v3.5.0 – Read about the purpose of Universally Unique Identifiers to track ePCR’s and agency resources over time.
Patient and Incident Disposition in v3.5.0 – Learn about the adjustment of eDisposition.12 from one element to four elements to more accurately describe the EMS activation.
Harmonizing NEMSIS and CARES in v3.5.0 – Learn about the alignment of NEMSIS and CARES elements to strengthen of out-of-hospital cardiac arrest data and reduce documentation redundancy.

Additional information about NEMSIS v3.5 is located here.

Training Opportunities

In addition to twice monthly v3 Implementation Calls and regular State and Public Trainings, NEMSIS offers an Annual Boot Camp and the Annual v3 Implementation Meeting.

2020 NEMSIS Boot Camp – The Annual Boot Camp is designed specifically for State/Territory and National Offices of EMS. The Boot Camp teaches and reviews specific requirements and resources that require access to restricted data. (August 25, 2020)
2020 NEMSIS Annual Meeting – The Annual NEMSIS v3 Implementation Meeting brings together State/Territory Offices of EMS,  EMS Software Vendors and Developers, and National EMS Partners to discuss and collaborate on issues affecting EMS data. (September 15-17, 2020)

Bidirectional Data Exchange

EMS agencies nationwide still widely report that hospitals and other healthcare providers refuse to share patient information with them, citing Health Insurance Portability and Accountability Act (HIPAA) concerns.  Misconceptions about HIPAA create artificial barriers to legitimate, approved bidirectional data exchange between EMS and other providers.  As a result, many healthcare systems are missing a critical opportunity to improve patient outcomes and advance evidence-based practices in prehospital care.

To conclusively answer this question, the NEMSIS Technical Assistance Center collaborated with Page, Wolfberg & Wirth to provide an expert legal opinion regarding the bidirectional sharing of patient information between EMS and other healthcare providers.

HIPAA: An Imaginary Barrier to Data Exchange – Please share and use this White Paper as needed.
Legal Opinion: Sharing Patient Data Bidirectionally Under HIPAA – This brief Legal Opinion describes how bidirectional data sharing of patient information is not only allowed but encouraged under HIPAA. It is developed specifically for healthcare administrators, legal counsel, and risk management.

Custom Data Elements

The NEMSIS TAC collaborates with EMS stakeholders to identify needed National Custom Elements to respond to the COVID-19 pandemic. These custom elements are made available to EMS agencies and States in an effort to standardize the documentation and coding of recent travel and potential exposures related to an infectious disease, like COVID-19.

Infectious Disease National Custom Elements

Defined Lists

Outline of the Process Moving NEMSIS Suggested Lists to Defined Lists – This is the updated PowerPoint presentation detailing the finalized approach to Defined Lists.
Use of Defined Lists for Specific NEMSIS Elements – This fact sheet identifies the history, related issues and potential solutions for Suggested Lists.

New Software Developer

Data Dictionaries and XSD


Web Service

ET3: Emergency Triage, Treat and Transport Model

ET3 Data Flow Diagram – The diagram illustrates the flow of data from an EMS ePCR to the CMS Data Center. Updated 09.18.2020

ET3-NEMSIS Testing Schedule – This is the first opportunity to on-board and/or submit test data to the ET3 Data Exchange Platform.

ET3 Participation Agreement – Attached is the October release of the ET3 Participation Agreement. We provide this document to stakeholders because of the valuable information included regarding ET3 definitions, general model requirements, and an extensive overview of the ET3 interventions under evaluation.

ET3 Questions and Answers with States – This document addresses questions raised regarding the implementation of ET3 in States and will be updated as more questions arise.

ET3 Q and A with State Officials (10-13-2020) – ET3 representatives facilitated a discussion concerning the impact to State Offices of EMS related to local EMS agencies participating in the ET3 Model.

NEMSIS v3 Custom Elements for the ET3 Model: There are several custom values added to eDisposition.12 and eDisposition.21 to adequately document transport to alternate destinations and treatment in place.

ET3 StateDataSet: These documents highlight the elements that will be collected from ePCRs to evaluate the ET3 model. Included are StateDataSets and Schematron pertinent to ET3.