Some states have mandated that agencies switch to NEMSIS Version 3, but have found it difficult to enforce those mandates. For example, in California, the state legislature set a deadline of January 1, 2017, for local EMS providers to submit data using NEMSIS V3. However, the legislation did not establish penalties for EMS services that do not meet that deadline, and state regulators have said they do not feel that they have an effective or practical method of enforcing the law.
In Virginia, however, agencies have felt pressure to comply with the state’s timeline, even though it was not mandated by legislation. The incentive has come from fear that failing to meet deadlines could make an agency ineligible for the state’s Rescue Squad Assistance Fund (RSAF) grants.
In New Jersey, the state offered $3,000 “mini-grants” to help local EMS systems purchase ePCR hardware.
States that administer grant programs have an effective method of ensuring NEMSIS Version 3 use, both by awarding grants to help agencies make the upgrade and by denying grants to those that do not.
Numerous states have found that putting together a data dictionary and deciding on custom elements has taken much longer than anticipated. In Michigan, for example, the move to NEMSIS Version 3 has been delayed because of the effort to define custom elements.
Several states have decided to add custom elements or make changes to the state dataset only after they have begun successfully receiving NEMSIS Version 3 data from agencies across the state. Using this method, the state not only avoids prolonged discussions about which custom elements to use and how to design them, but it is also easier for software vendors to help agencies make the transition.
Several states have faced challenges simply because local EMS providers don’t always see the benefit of collecting and submitting EMS data. Even those that do may not always make it a priority, meaning they don’t allocate sufficient funding to maintain the data systems or to upgrade to Version 3. In California, for example, state data officials reported that many fire-based EMS agencies won’t move to NEMSIS v3.4 until their software vendors can offer the ability to do both NEMSIS-compliant reporting and National Fire Incident Reporting System (NFIRS) reports, because they don’t want to have to use two separate reporting platforms.
Various states have also reported that some EMS provider agencies simply don’t understand the value of electronic reporting, and choose to focus on other items with perceived higher priority. In such cases, outreach is essential, and resources such as this Toolkit — particularly the sections containing answers to frequently asked questions about NEMSIS Version 3 for fire chiefs, leaders and data managers of local EMS services and for EMTs and paramedics.
Another helpful idea is to share success stories from agencies within your state via newsletters, your state EMS office website, state conference presentations, webinars and similar channels. When doing so, be sure to focus on “success” as more than simply fulfilling a mandate — rather, highlight the benefits that EMS agencies are capitalizing on following the transition, such as richer data, enhanced ability to do research and improved patient care.
A PHASED APPROACH
Converting an entire state to a new data platform can be challenging — trying to do it with the resources available to most state EMS offices can be truly daunting. While most states have allotted a transition period of anywhere from one to two years to allow agencies time to make the adjustment, some have taken an additional step of phasing in those organizations on a more formal schedule. Virginia, for example, divided its local EMS agencies into four groups:
Group I – Agencies that use the state-provided ePCR and do not bill for service and agencies that enter data manually into the state website
Group II – Agencies that use the state-provided ePCR and bill for service
Group III – Agencies that only provide EMS services and agencies that provide Fire and EMS but use the same software platform for NFIRS and EMS reporting
Group IV – Agencies that provide Fire and EMS service and use a single software platform
Each group had a different deadline for making the switch to NEMSIS Version 3, with Group IV’s transition happening 10 months after Group I. This not only extended the rollout period to make things easier for state officials, but also provided more time for organizations with sophisticated data-collection systems to prepare for the transition.