The History of NEMSIS
Since the 1970s, the need for EMS information systems and databases has been well established.
NEMSIS was originally funded by the National Highway Traffic Safety Administration NHTSA, the Health Resources and Services Administration HRSA, and the Centers for Disease Control and Prevention CDC to support each state’s efforts to collect, retain, and send data to the national database.
Prior to NEMSIS, state and local EMS systems varied in their ability to collect patient and systems data.
Over the years, there have been many individuals, groups, organizations and federal partners that have made the NEMSIS project possible.
In October of 2003, a Memorandum of Understanding (MOU) was created by the National Association of State EMS Officials (NASEMSO) in response to the need for EMS data collection at the national level. The MOU was signed by 52 state and territory members in agreement to promote and support all EMS data initiatives within their states and to conform to future national dataset definitions.
Follow the timeline of major events in the evolution of the National EMS Information System
Emergency Medical Service System Act
State EMS directors realize that they could not compare data from one state to another in any way or in any standard format or process. The Department of Health, Education and Welfare indentifies 15 essential components of an EMS system. The first legislation to require data or documentation of EMS services.
Utstein Style for Uniform Reporting of Data
First major document is published that specifically addresses EMS systems and their impact on patient outcome.
NHTSA’s Uniform PreHospital EMS Dataset Version 1.0
Realization that different data fields (across all EMS systems) exist for the same issue or event - there is a need for standardization. The National Highway Safety Administration (NHTSA) develops a national consensus document that defines 81 elements important to an EMS information system.
EMS Agenda for the Future
After widespread national input, NHTSA publishes the EMS Agenda for the Future...A Vision for the Nation's EMS System outlining five recommendations for EMS information systems.
Data Elements for Emergency Department Systems
The National Center for Injury Prevention and Control publishes Data Elements for Emergency Department Systems which extends the concept of an information system to the emergency department by providing standards for data collection and linkages back to EMS.
EMS Agenda Implementation Guide
NHTSA produces a follow-up document to EMS Agenda for the Future called EMS Agenda for the Future: Implementation Guide. The document gives suggestions or approaches for the development of 14 components of the EMS Agenda for the future - a comprehensive EMS information system is the backbone for future EMS development.
NEMSIS Inception
The National Association of State EMS Directors in conjunction with its federal partners at the National Highway Traffic Safety Administration (NHTSA) and the Trauma/EMS Systems program of the Health Resources and Services Administration's (HRSA) Maternal Child Health Bureau work to develop a national EMS database—known as NEMSIS, the National EMS Information System.
Memorandum of Understanding Signed
The Memorandum of Understanding The MOU "recognized the need for EMS data collection at the national level" as well as the assignment of "specific definitions to a set of data elements indentified as desirable to be collected on a national level." Fifty-two states and territories sign the memorandum.
EMS Reason for Encounter
A two-year project funded by NHTSA is established to develop a coding system for EMS as well as a uniform description for the reason for an EMS encounter. It is based on EMS curricula and the NHTSA dataset.
Creation of a National Data Dictionary (dataset)
After 18 months a 400 page detailed and complex data dictionary is completed. Information about each of the data elements, the variables, and the definitions associated with that data element as well as how to deploy the element in a database are described. See the Data Dictionary's latest release.
Development of Schemas
Physical database schemas or models as well as scripts to automatically create the database are made available in different platforms.
XML Choosen Standard
XML defined as the standard to move EMS data between local and state level or state and national database level. XML's open format provides and easy way to pass data between different software formats.
EMS Uniform PreHospital Dataset Version 2.2
A solid dataset is released and shemas published on the website for integration. The Version 2.2 dataset was created through a national consensus process to update and revise the standard.
Funding for the Technical Assistance Center
NHTSA, HRSA (EMSC), and the CDC see the value from the pilot phase of the project. They provide funding to create the NEMSIS Technical Assistance Center. The contract is given to the University of Utah School of Medicine (Utah) to operate the NEMSIS Technical Assistance Center. Utah partners with the University of North Carolina to handle all of the customer service needs.
The first public release of NEMSIS data are made available for research. Included 300,000 EMS activations from 3 states.
A formal process for the electronic submission of NEMSIS data was developed and implemented. State data are submitted quarterly.
NEMSIS begins the process of formally testing EMS software for compliance to the NEMSIS standard.
Twenty-one states are now compliant with the NEMSIS standard and 8 million EMS activations are submitted to the National EMS registry.
The first peer-reviewed research paper using NEMSIS data is published.
The NEMSIS/NHTSA Version 3 EMS Data Standard is released in beta form!
The first nationally approved export standard to move EMS patient care information from the field to the hospital emergency department is released.
The NEMSIS Version 3 standard is finalized and released for adoption by states and territories.
NEMSIS develops a revised data exchange process allowing or near real-time data sharing among local, state and national registries.
Over 50 peer-reviewed research studies are now published using the NEMSIS standard.
The National EMS registry includes 30,206,450 EMS activations submitted by 10,137 EMS agencies serving 49 states and territories.
The NEMSIS Version 2 standard is officially closed and State migration to Version 3 increases.
The number of Version 3 EMS activations submitted to the NEMSIS National Repository tops 20 million.
The NEMSIS v3.5.0 Data Standard is completed and released to the public.
Over 900 scholarly reports, peer-reviewed papers and other publications using NEMSIS data are available online.
In response to the COVID-19 pandemic, the NEMSIS Technical Assistance Center (TAC) generates a weekly report detailing the impact of COVID-19 on EMS response.
The TAC collaborates with the CMMI ET3 Model group to develop and implement their innovative EMS payment model.
Emergency Medical Service System Act
State EMS directors realize that they could not compare data from one state to another in any way or in any standard format or process. The Department of Health, Education and Welfare indentifies 15 essential components of an EMS system. The first legislation to require data or documentation of EMS services.
Utstein Style for Uniform Reporting of Data
First major document is published that specifically addresses EMS systems and their impact on patient outcome.
NHTSA’s Uniform PreHospital EMS Dataset Version 1.0
Realization that different data fields (across all EMS systems) exist for the same issue or event - there is a need for standardization. The National Highway Safety Administration (NHTSA) develops a national consensus document that defines 81 elements important to an EMS information system.
EMS Agenda for the Future
After widespread national input, NHTSA publishes the EMS Agenda for the Future...A Vision for the Nation's EMS System outlining five recommendations for EMS information systems.
Data Elements for Emergency Department Systems
The National Center for Injury Prevention and Control publishes Data Elements for Emergency Department Systems which extends the concept of an information system to the emergency department by providing standards for data collection and linkages back to EMS.
EMS Agenda Implementation Guide
NHTSA produces a follow-up document to EMS Agenda for the Future called EMS Agenda for the Future: Implementation Guide. The document gives suggestions or approaches for the development of 14 components of the EMS Agenda for the future - a comprehensive EMS information system is the backbone for future EMS development.
NEMSIS Inception
The National Association of State EMS Directors in conjunction with its federal partners at the National Highway Traffic Safety Administration (NHTSA) and the Trauma/EMS Systems program of the Health Resources and Services Administration's (HRSA) Maternal Child Health Bureau work to develop a national EMS database—known as NEMSIS, the National EMS Information System.
Memorandum of Understanding Signed
The Memorandum of Understanding The MOU "recognized the need for EMS data collection at the national level" as well as the assignment of "specific definitions to a set of data elements indentified as desirable to be collected on a national level." Fifty-two states and territories sign the memorandum.
EMS Reason for Encounter
A two-year project funded by NHTSA is established to develop a coding system for EMS as well as a uniform description for the reason for an EMS encounter. It is based on EMS curricula and the NHTSA dataset.
Creation of a National Data Dictionary (dataset)
After 18 months a 400 page detailed and complex data dictionary is completed. Information about each of the data elements, the variables, and the definitions associated with that data element as well as how to deploy the element in a database are described. See the Data Dictionary's latest release.
Development of Schemas
Physical database schemas or models as well as scripts to automatically create the database are made available in different platforms.
XML Choosen Standard
XML defined as the standard to move EMS data between local and state level or state and national database level. XML's open format provides and easy way to pass data between different software formats.
EMS Uniform PreHospital Dataset Version 2.2
A solid dataset is released and shemas published on the website for integration. The Version 2.2 dataset was created through a national consensus process to update and revise the standard.
Funding for the Technical Assistance Center
NHTSA, HRSA (EMSC), and the CDC see the value from the pilot phase of the project. They provide funding to create the NEMSIS Technical Assistance Center. The contract is given to the University of Utah School of Medicine (Utah) to operate the NEMSIS Technical Assistance Center. Utah partners with the University of North Carolina to handle all of the customer service needs.
The first public release of NEMSIS data are made available for research. Included 300,000 EMS activations from 3 states.
A formal process for the electronic submission of NEMSIS data was developed and implemented. State data are submitted quarterly.
NEMSIS begins the process of formally testing EMS software for compliance to the NEMSIS standard.
Twenty-one states are now compliant with the NEMSIS standard and 8 million EMS activations are submitted to the National EMS registry.
The first peer-reviewed research paper using NEMSIS data is published.
The NEMSIS/NHTSA Version 3 EMS Data Standard is released in beta form!
The first nationally approved export standard to move EMS patient care information from the field to the hospital emergency department is released.
The NEMSIS Version 3 standard is finalized and released for adoption by states and territories.
NEMSIS develops a revised data exchange process allowing or near real-time data sharing among local, state and national registries.
Over 50 peer-reviewed research studies are now published using the NEMSIS standard.
The National EMS registry includes 30,206,450 EMS activations submitted by 10,137 EMS agencies serving 49 states and territories.
The NEMSIS Version 2 standard is officially closed and State migration to Version 3 increases.
The number of Version 3 EMS activations submitted to the NEMSIS National Repository tops 20 million.
The NEMSIS v3.5.0 Data Standard is completed and released to the public.
Over 900 scholarly reports, peer-reviewed papers and other publications using NEMSIS data are available online.
In response to the COVID-19 pandemic, the NEMSIS Technical Assistance Center (TAC) generates a weekly report detailing the impact of COVID-19 on EMS response.
The TAC collaborates with the CMMI ET3 Model group to develop and implement their innovative EMS payment model.
The following organizations have given their support and/or involvement to NEMSIS.
- American Ambulance Association (AAA)
- American College of Emergency Physicians (ACEP)
- American College of Surgeons: Committee on Trauma (ASC-COT)
- American Heart Association (AHA)
- Center for Disease control and Prevention (CDC)
- Emergency Medical Services for Children (EMSC)
- EMSC national Resource Center (NRC)
- EMSC National Data Analysis Resource Center (NEDARC)
- Emergency Medical Services Outcomes Project (EMSOP)
- Federal Emergency Management Administra on (FEMA)
- National EMS Quality Alliance (NEMSQA)
- International Association of Fire Chiefs (IAFC)
- National Academy of Emergency of Emergency Medical Dispatch (NAEMD)
- National Association of Emergency Medical Technicians (NAEMT)
- National Association of EMS Physicians (NAEMSP)
- National Association of State EMS Officers (NASEMSO)
- National EMS Management Association (NEMSMA, formerly NAEMSQP)
- National Emergency Number Association (NENA)
- National Highway Traffic Safety Administration (NHTSA)
- HRSA's Office of Rural Health Policy (ORHP)
- Department of Health and Human Services (HHS)
