Sec. 5. (a) All emergency medical service provider organizations shall comply with this section.
(b) All emergency medical service provider organizations shall participate in the emergency medical service system review by collecting and reporting data elements. The elements shall be submitted to the agency by the fifteenth of the following month by electronic format or submitted on disk in the format and manner specified by the commission. The data elements prescribed by the commission are
as follows: the following National Emergency Medical Service Information System (NEMSIS), created by the National Association of EMS Directors in partnership with the federal National Highway Traffic Safety Administration data elements:
(1) Provider organization EMS agency number.
(2) Date of incident. EMS agency state.
(3) Time call received. EMS agency county.
(4) Incident number. Level of service, for example, paramedic, ALS, BLS, etc.
(5) Service Organizational type, for example, county, hospital, fire department, etc.
(6) Time of dispatch. Organization status, for example, volunteer, paid, combination.
(7) Location type. Statistical year (current calendar year).
(8) Patient name. Total service area (in square miles).
(9) Response number. Total service area population.
(10) Patient care record number. 911 call volume per year.
(11) Patient zip code. EMS dispatch volume per year.
(12) Gender. EMS transport per year.
(13) Race. EMS patient contact volume per year.
(14) EMS agency time unit responding. zone.
(15) Time of arrival at scene. National provider identifier (assigned by the National Plan and Provider Enumeration System).
(16) Time unit left scene. Agency contact zip code.
(17) Time available for service. Patient care report number.
(18) Lights and siren to scene. Software creator, that is, company name.
(19) Lights and siren used from scene. Software name.
(20) Level of care provided. Software version.
(21) Provider impression. EMS agency number (in patient record field).
(22) Mode of injury. Incident number.
(23) Incident/patient disposition. EMS unit (vehicle) response number, that is, vehicle number.
(24) Vehicle Type of service requested.
(25) Destination/transferred to. Primary role of the unit.
(26) Destination determination. Type of dispatch delay.
(27) Time of arrival at destination. Type of response delay.
(28) Incident location. Type of scene delay.
(29) Date Type of birth. transport delay.
(30) Medical history. Type of turn-around delay.
(31) Signs and symptoms. EMS unit call sign, that is, radio number.
(32) Injury description. Response mode to scene.
(33) Safety equipment. Complaint reported by dispatch.
(34) Suspected drug/alcohol use. EMD performed.
(35) Pulse rate. EMD card number.
(36) Respiratory rate. Crew member ID (public safety identification number assigned by the Indiana department of homeland security).
(37) Respiratory effort. Incident on onset date and time, that is, the date and time the injury occurred or the symptoms or problem started.
(38) Systolic blood pressure. PSAP call date and time, for example, when call came into 911.
(39) Skin perfusion. Unit notified by dispatch date and time.
(40) Glascow eye opening. Unit en route date and time.
(41) Glascow verbal component. Unit arrived on scene date and time.
(42) Glascow motor component. Unit arrived at patient date and time.
(43) Airway treatment. Unit left scene date and time.
(44) Stabilization treatment. Patient arrived at destination date and time.
(45) Miscellaneous treatment. Unit back in service date and time.
(46) Medication name. Unit canceled date and time.
(47) Research code. Unit back at home location date and time.
(48) Crew member one number. Patient last name.
(49) Crew member two number. Patient's home zip code.
(50) Gender.
(51) Race.
(52) Ethnicity.
(53) Age.
(54) Age units, for example, hours, days, months, or years.
(55) Date of birth (mmddyyyy).
(56) Primary method of payment.
(57) CMS service level.
(58) Condition code number.
(59) Number of patients at scene.
(60) Mass casualty incident (yes or no).
(61) Incident location type, for example, work, residence, retail establishment.
(62) Scene zone number (Indiana homeland security district number).
(63) Incident county.
(64) Incident state of Indiana.
(65) Incident zip code.
(66) Prior aid, that is, aid rendered prior to arrival of unit.
(67) Prior aid performed by.
(68) Outcome of prior aid.
(69) Possible injury.
(70) Chief complaint.
(71) Chief complaint anatomic location.
(72) Chief complaint organ system.
(73) Primary symptom.
(74) Other associated symptoms.
(75) Providers primary impression.
(76) Providers secondary impression.
(77) Cause of injury.
(78) Intent of the injury, for example, self-inflicted.
(79) Mechanism of injury.
(80) Use of occupant safety equipment.
(81) Cardiac arrest.
(82) Cardiac arrest etiology.
(83) Resuscitation attempted.
(84) Barriers to patient care.
(85) Medical and surgical history.
(86) Alcohol and drug use indicators.
(87) Medication given.
(88) Procedure.
(89) Number of procedure attempts.
(90) Procedure successful.
(91) Procedure complication.
(92) Destination/transferred to, name.
(93) Destination/transferred to, code.
(94) Destination zip code.
(95) Destination zone code (Indiana homeland security district number).
(96) Incident/patient disposition.
(97) Transport mode from scene.
(98) Reason for choosing destination.
(99) Type of destination.
(100) Emergency department disposition.
(101) Hospital disposition.
(102) Research survey field.
(103) Medication complication.
Basic life support nontransport provider organizations that are paid or volunteer fire departments that render fire prevention or fire protection services to a political subdivision are not required to submit data under this rule.
(d) An emergency medical service provider organization that has any certified vehicles involved in any traffic accident investigated by a law enforcement agency shall report that accident to the agency within ten (10) working days on a form provided by the agency.