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TITLE 836 INDIANA EMERGENCY MEDICAL SERVICES COMMISSION

Final Rule
LSA Document #18-201(F)

DIGEST

Amends 836 IAC 1-1-5 to require the collection and next day reporting of updated (NEMSIS Version 3) data elements by all emergency medical services provider organizations. Effective 30 days after filing with the Publisher.



SECTION 1. 836 IAC 1-1-5 IS AMENDED TO READ AS FOLLOWS:

836 IAC 1-1-5 Reports and records

Authority: IC 16-31-2-7; IC 16-31-3
Affected: IC 4-21.5; IC 16-31-3

Sec. 5. (a) All emergency medical service provider organizations shall comply with this section.

(b) (a) All emergency medical service provider organizations shall participate in the emergency medical service system review by collecting and reporting data elements for all emergency medical service provider organization runs. The elements shall be submitted to the agency by the fifteenth 11:59 p.m. of the day following month the completion of the run by electronic format or submitted on disk in the format and manner specified by the commission. The data elements prescribed by the commission are 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 Version 3 data elements:
(1) EMS agency number.
(2) EMS agency state.
(3) EMS agency county.
(4) Level of service, for example, paramedic, ALS, BLS, etc.
(5) Organizational type, for example, county, hospital, fire department, etc.
(6) Organization status, for example, volunteer, paid, combination.
(7) Statistical year (current calendar year).
(8) Total service area (in square miles).
(9) Total service area population.
(10) 911 call volume per year.
(11) EMS dispatch volume per year.
(12) EMS transport per year.
(13) EMS patient contact volume per year.
(14) EMS agency time zone.
(15) National provider identifier (assigned by the National Plan and Provider Enumeration System).
(16) Agency contact zip code.
(17) Patient care report number.
(18) Software creator, that is, company name.
(19) Software name.
(20) Software version.
(21) EMS agency number (in patient record field).
(22) Incident number.
(23) EMS unit (vehicle) response number, that is, vehicle number.
(24) Type of service requested.
(25) Primary role of the unit.
(26) Type of dispatch delay.
(27) Type of response delay.
(28) Type of scene delay.
(29) Type of transport delay.
(30) Type of turn-around delay.
(31) EMS unit call sign, that is, radio number.
(32) Response mode to scene.
(33) Complaint reported by dispatch.
(34) EMD performed.
(35) EMD card number.
(36) Crew member ID (public safety identification number assigned by the Indiana department of homeland security).
(37) Incident on onset date and time, that is, the date and time the injury occurred or the symptoms or problem started.
(38) PSAP call date and time, for example, when call came into 911.
(39) Unit notified by dispatch date and time.
(40) Unit en route date and time.
(41) Unit arrived on scene date and time.
(42) Unit arrived at patient date and time.
(43) Unit left scene date and time.
(44) Patient arrived at destination date and time.
(45) Unit back in service date and time.
(46) Unit canceled date and time.
(47) Unit back at home location date and time.
(48) Patient last name.
(49) 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.
(1) Emergency medical services (EMS) agency unique state identification (ID) (dAgency.01).
(2) EMS agency number (dAgency.02).
(3) EMS agency name (dAgency.03).
(4) EMS agency state (dAgency.04).
(5) EMS agency service area states (dAgency.05).
(6) EMS agency service area counties (dAgency.06).
(7) EMS agency census tracts (dAgency.07).
(8) EMS agency service area ZIP codes (dAgency.08).
(9) Primary type of service (dAgency.09).
(10) Other types of service (dAgency.10).
(11) Level of service (dAgency.11).
(12) Organization status (dAgency.12).
(13) Organizational type (dAgency.13).
(14) EMS agency organizational tax status (dAgency.14).
(15) Statistical calendar year (dAgency.15).
(16) Total primary service area size (dAgency.16).
(17) Total service area population (dAgency.17).
(18) 911 EMS call center volume per year (dAgency.18).
(19) EMS dispatch volume per year (dAgency.19).
(20) EMS patient transport volume per year (dAgency.20).
(21) EMS patient contact volume per year (dAgency.21).
(22) National provider identifier (dAgency.25).
(23) Fire department ID number (dAgency.26).
(24) State associated with the certification/licensure levels (dConfiguration.01).
(25) State certification/licensure levels (dConfiguration.02).
(26) Procedures permitted by the state (dConfiguration.03).
(27) Medications permitted by the state (dConfiguration.04).
(28) Protocols permitted by the state (dConfiguration.05).
(29) EMS certification levels permitted to perform each procedure (dConfiguration.06).
(30) EMS agency procedures (dConfiguration.07).
(31) EMS certification levels permitted to administer each medication (dConfiguration.08).
(32) EMS agency medications (dConfiguration.09).
(33) EMS agency protocols (dConfiguration.10).
(34) EMS agency specialty service capability (dConfiguration.11).
(35) Emergency medical dispatch (EMD) provided to EMS agency service area (dConfiguration.13).
(36) Patient monitoring capabilities (dConfiguration.15).
(37) Crew call sign (dConfiguration.16).
(38) EMS personnel's state's licensure ID number (dPersonnel.23).
(39) EMS personnel's state EMS certification licensure level (dPersonnel.24).
(40) Indications for invasive airway (eAirway.01).
(41) Date and time airway device placement confirmation (eAirway.02).
(42) Airway device being confirmed (eAirway.03).
(43) Airway device placement confirmed method (eAirway.04).
(44) Type of individual confirming airway device placement (eAirway.06).
(45) Crew member ID (eAirway.07).
(46) Airway complications encountered (eAirway.08).
(47) Suspected reasons for failed airway procedure (eAirway.09).
(48) Cardiac arrest (eArrest.01).
(49) Cardiac arrest etiology (eArrest.02).
(50) Resuscitation attempted by EMS (eArrest.03).
(51) Arrest witnessed by (eArrest.04).
(52) Cardiopulmonary resuscitation (CPR) care provided prior to EMS arrival (eArrest.05).
(53) Who provided CPR prior to EMS arrival (eArrest.06).
(54) Automated external defibrillator (AED) use prior to EMS arrival (eArrest.07).
(55) Who used AED prior to EMS arrival (eArrest.08).
(56) Type of CPR provided (eArrest.09).
(57) First monitored arrest rhythm of the patient (eArrest.11).
(58) Any return of spontaneous circulation (eArrest.12).
(59) Date/time of cardiac arrest (eArrest.14).
(60) Date/time resuscitation discontinued (eArrest.15).
(61) Reason CPR/resuscitation discontinued (eArrest.16).
(62) Cardiac rhythm on arrival at destination (eArrest.17).
(63) End of EMS cardiac arrest event (eArrest.18).
(64) Crew member ID (eCrew.01).
(65) Crew member level (eCrew.02).
(66) Crew member response role (eCrew.03).
(67) Complaint reported by dispatch (eDispatch.01).
(68) EMD performed (eDispatch.02).
(69) Destination transferred to, name (eDisposition.01).
(70) Destination transferred to, code (eDisposition.02).
(71) Destination state (eDisposition.05).
(72) Destination county (eDisposition.06).
(73) Destination ZIP code (eDisposition.07).
(74) Number of patients transported in this EMS unit (eDisposition.11).
(75) Incident/patient disposition (eDisposition.12).
(76) EMS transport method (eDisposition.16).
(77) Transport mode from scene (eDisposition.17).
(78) Additional transport mode descriptors (eDisposition.18).
(79) Final patient acuity (eDisposition.19).
(80) Reason for choosing destination (eDisposition.20).
(81) Type of destination (eDisposition.21).
(82) Hospital inpatient destination (eDisposition.22).
(83) Hospital capability (eDisposition.23).
(84) Destination team prearrival alert or activation (eDisposition.24).
(85) Date/time of destination prearrival alert or activation (eDisposition.25).
(86) Estimated body weight in kilograms (eExam.01).
(87) Barriers to patient care (eHistory.01).
(88) Advance directives (eHistory.05).
(89) Medication allergies (eHistory.06).
(90) Alcohol/drug use indicators (eHistory.17).
(91) Cause of injury (eInjury.01).
(92) Mechanism of injury (eInjury.02).
(93) Trauma center criteria (eInjury.03).
(94) Vehicular, pedestrian, or other injury risk factor (eInjury.04).
(95) Main area of the vehicle impacted by the collision (eInjury.05).
(96) Location of patient in vehicle (eInjury.06).
(97) Use of occupant safety equipment (eInjury.07).
(98) Airbag deployment (eInjury.08).
(99) Height of fall (feet) (eInjury.09).
(100) Date/time medication administered (eMedications.01).
(101) Medication administered prior to this unit's EMS care (eMedications.02).
(102) Medication given (eMedications.03).
(103) Medication administered route (eMedications.04).
(104) Medication dosage (eMedications.05).
(105) Medication dosage units (eMedications.06).
(106) Response to medication (eMedications.07).
(107) Medication complication (eMedications.08).
(108) Medication crew (healthcare professionals) ID (eMedications.09).
(109) Role/type of person administering medication (eMedications.10).
(110) Patient care report narrative (eNarrative.01).
(111) Personal protective equipment used (eOther.03).
(112) Suspected EMS work related exposure, injury, or death (eOther.05).
(113) Crew member completing this report (eOther.08).
(114) Emergency department disposition (eOutcome.01).
(115) Hospital disposition (eOutcome.02).
(116) Last name (ePatient.02).
(117) First name (ePatient.03).
(118) Middle initial/name (ePatient.04).
(119) Patient's home address (ePatient.05).
(120) Patient's home city (ePatient.06).
(121) Patient's home county (ePatient.07).
(122) Patient's home state (ePatient.08).
(123) Patient's home ZIP code (ePatient.09).
(124) Gender (ePatient.13).
(125) Race (ePatient.14).
(126) Age (ePatient.15).
(127) Age units (ePatient.16).
(128) Date of birth (ePatient.17).
(129) Primary method of payment (ePayment.01).
(130) Closest relative/guardian last name (ePayment.23).
(131) Closest relative/guardian first name (ePayment.24).
(132) Centers for Medicare and Medicaid Services (CMS) service level (ePayment.50).
(133) Date/time procedure performed (eProcedures.01).
(134) Procedure performed prior to this unit's EMS care (eProcedures.02).
(135) Procedure (eProcedures.03).
(136) Number of procedure attempts (eProcedures.05).
(137) Procedure successful (eProcedures.06).
(138) Procedure complication (eProcedures.07).
(139) Response to procedure (eProcedures.08).
(140) Procedure crew members ID (eProcedures.09).
(141) Role/type of person performing the procedure (eProcedures.10).
(142) Protocols used (eProtocols.01).
(143) Protocol age category (eProtocols.02).
(144) Patient care report number (eRecord.01).
(145) Software creator (eRecord.02).
(146) Software name (eRecord.03).
(147) Software version (eRecord.04).
(148) EMS agency number (eResponse.01).
(149) Incident number (eResponse.03).
(150) EMS response number (eResponse.04).
(151) Type of service requested (eResponse.05).
(152) Primary role of the unit (eResponse.07).
(153) Type of dispatch delay (eResponse.08).
(154) Type of response delay (eResponse.09).
(155) Type of scene delay (eResponse.10).
(156) Type of transport delay (eResponse.11).
(157) Type of turnaround delay (eResponse.12).
(158) EMS vehicle (unit) number (eResponse.13).
(159) EMS unit call sign (eResponse.14).
(160) Level of care of this unit (eResponse.15).
(161) Response mode to scene (eResponse.23).
(162) Additional response mode descriptors (eResponse.24).
(163) First EMS unit on scene (eScene.01).
(164) Other EMS or public safety agencies at scene (eScene.02).
(165) Type of other service at scene (eScene.04).
(166) Date/time initial responder arrived on scene (eScene.05).
(167) Number of patients at scene (eScene.06).
(168) Mass casualty incident (eScene.07).
(169) Triage classification for mild cognitive impairment (MCI) patient (eScene.08).
(170) Incident location type (eScene.09).
(171) Incident city (eScene.17).
(172) Incident state (eScene.18).
(173) Incident ZIP code (eScene.19).
(174) Incident county (eScene.21).
(175) Date/time of symptom onset (eSituation.01).
(176) Possible injury (eSituation.02).
(177) Complaint type (eSituation.03).
(178) Complaint (eSituation.04).
(179) Duration of complaint (eSituation.05).
(180) Time units of duration of complaint (eSituation.06).
(181) Chief complaint anatomic location (eSituation.07).
(182) Chief complaint organ system (eSituation.08).
(183) Primary symptom (eSituation.09).
(184) Other associated symptoms (eSituation.10).
(185) Provider's primary impression (eSituation.11).
(186) Provider's secondary impressions (eSituation.12).
(187) Initial patient acuity (eSituation.13).
(188) Public safety answering point (PSAP) call date/time (eTimes.01).
(189) Dispatch notified date/time (eTimes.02).
(190) Unit notified by dispatch date/time (eTimes.03).
(191) Unit en route date/time (eTimes.05).
(192) Unit arrived on scene date/time (eTimes.06).
(193) Arrived at patient date/time (eTimes.07).
(194) Transfer of EMS patient care date/time (eTimes.08).
(195) Unit left scene date/time (eTimes.09).
(196) Patient arrived at destination date/time (eTimes.11).
(197) Destination patient transfer of care date/time (eTimes.12).
(198) Unit back in service date/time (eTimes.13).
(199) Unit canceled date/time (eTimes.14).
(200) Date/time vital signs taken (eVitals.01).
(201) Obtained prior to this unit's EMS care (eVitals.02).
(202) Cardiac rhythm/electrocardiography (ECG) (eVitals.03).
(203) ECG type (eVitals.04).
(204) Method of ECG interpretation (eVitals.05).
(205) Systolic blood pressure (eVitals.06).
(206) Diastolic blood pressure (eVitals.07).
(207) Method of blood pressure measurement (eVitals.08).
(208) Heart rate (eVitals.10).
(209) Pulse oximetry (eVitals.12).
(210) Respiratory rate (eVitals.14).
(211) End tidal carbon dioxide (ETCO2) (eVitals.16).
(212) Blood glucose level (eVitals.18).
(213) Glasgow coma score-eye (eVitals.19).
(214) Glasgow coma score-verbal (eVitals.20).
(215) Glasgow coma score-motor (eVitals.21).
(216) Glasgow coma score-qualifier (eVitals.22).
(217) Total Glasgow coma score (eVitals.23).
(218) Temperature (eVitals.24).
(219) Level of responsiveness (AVPU) (eVitals.26).
(220) Pain scale score (eVitals.27).
(221) Stroke scale score (eVitals.29).
(222) Stroke scale type (eVitals.30).
(223) Reperfusion checklist (eVitals.31).
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.

(c) (b) Each emergency medical services provider organization shall retain all records required by this title for a minimum of three (3) years, except for the following records that shall be retained for a minimum of seven (7) years:
(1) Audit and review records.
(2) Run Patient care reports.
(3) Training records.
(4) Maintenance records.

(d) (c) 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.

(e) (d) Each provider organization, except basic life support nontransport provider organization, shall maintain accurate records concerning the assessment, treatment, or transportation of each emergency patient, including a run patient care report form in an electronic or written format as prescribed by the commission as follows:
(1) A run patient care report form shall include, at a minimum, the following:
(A) Name.
(B) Identification number.
(C) Age.
(D) Sex.
(E) Date of birth.
(F) Race.
(G) Address, including ZIP code.
(H) Location of incident.
(I) Chief complaint.
(J) History, including the following:
(i) Current medical condition and medications.
(ii) Past pertinent medical conditions and allergies.
(K) Physical examination section.
(L) Treatment given section.
(M) Vital signs, including the following:
(i) Blood pressure.
(ii) Pulse.
(iii) Respirations.
(iv) Level of consciousness.
(v) Skin temperature and color.
(vi) Pupillary reactions.
(vii) Ability to move.
(viii) Presence or absence of breath sounds.
(ix) The time of observation and a notation of the quality for each vital sign.
(N) Responsible guardian.
(O) Hospital destination.
(P) Radio contact via UHF or VHF.
(Q) Name of patient attendants, including emergency medical service certification numbers and signatures.
(R) Vehicle certification number.
(S) Safety equipment used by patient.
(T) Date of service.
(U) Service delivery times, including the following:
(i) Time of receipt of call.
(ii) Time dispatched.
(iii) Time arrived on scene.
(iv) Time of departure from scene.
(v) Time arrived at hospital.
(vi) Time departed from hospital.
(vii) Time vehicle available for next response.
(viii) Time vehicle returned to station.
(2) The run patient care report form shall be designed in a manner to provide space for narrative notation of additional medical information.
(3) A copy of the completed run patient care report form shall be provided to the receiving facility when the patient is delivered unless it is not feasible; however, the form shall be provided to the receiving facility not later than twenty-four (24) hours after the patient is delivered.
(4) When a patient has signed a statement for refusal of treatment or transportation services, or both, that signed statement shall be maintained as part of the run patient care documentation.

(f) (e) Each basic life support nontransport provider organization shall maintain, in a manner prescribed by the commission, accurate records, including a run patient care report form, concerning the assessment and treatment of each emergency patient as follows:
(1) A run patient care report form shall be required by all basic life support nontransport provider organizations, including, at a minimum, the following:
(A) Name.
(B) Identification number.
(C) Age.
(D) Sex.
(E) Race.
(F) Physician of the patient.
(G) Date of birth.
(H) Address, including ZIP code.
(I) Location of incident.
(J) Chief complaint.
(K) History, including the following:
(i) Current medical condition and medications.
(ii) Past pertinent medical conditions and allergies.
(L) Physical examination section.
(M) Treatment given section.
(N) Vital signs, including the following:
(i) Pulse.
(ii) Blood pressure.
(iii) Respirations.
(iv) Level of consciousness.
(v) Skin temperature and color.
(vi) Pupillary reactions.
(vii) Ability to move.
(viii) Presence or absence of breath sounds.
(ix) The time of observation and a notation of the quality for each vital sign.
(O) Responsible guardian.
(P) Name of patient attendants, including emergency medical services certification numbers and signatures.
(Q) Vehicle emergency medical services certification number.
(R) Responding service delivery times, including the following:
(i) Time of receipt of call.
(ii) Time dispatched.
(iii) Time arrived on scene.
(iv) Time of patient released to transporting emergency medical services.
(v) Time vehicle available for next response.
(S) Date of service.
(T) Safety equipment used by patient.
(2) The report form shall provide space for narrative description of the situation and the care rendered by the nontransport unit.
(3) A signed statement for refusal of treatment or transportation services, or both, shall be maintained as part of the run patient care documentation.
(Indiana Emergency Medical Services Commission; 836 IAC 1-1-5; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3512; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; filed Oct 6, 2009, 4:19 p.m.: 20091104-IR-836080879FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; filed Feb 13, 2019, 10:10 a.m.: 20190313-IR-836180201FRA)


LSA Document #18-201(F)
Notice of Intent: 20180425-IR-836180201NIA
Proposed Rule: 20181017-IR-836180201PRA
Hearing Held: November 13, 2018
Approved by Attorney General: January 28, 2019
Approved by Governor: February 11, 2019
Filed with Publisher: February 13, 2019, 10:10 a.m.
Documents Incorporated by Reference: None Received by Publisher
Small Business Regulatory Coordinator: Justin K. Guedel, Indiana Department of Homeland Security, Indiana Government Center South, 302 West Washington Street, W246, Indianapolis, IN 46204, (317) 233-6926, jguedel@dhs.in.gov

Posted: 03/13/2019 by Legislative Services Agency

DIN: 20190313-IR-836180201FRA
Composed: Apr 27,2024 3:55:12PM EDT
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