Please see the following message from the NYS Bureau of Emergency Medical Services and Trauma Systems:
With special thanks to the Regional Elite Site administrators, the program agency directors, and software vendors, we have fixed the high volume errors resulting from the implementation of NYS Schematron 2019 – 01. The Schematron, generated from validation rules establishing a documentation standard, have been extensively tested by multiple Program Agency directors, EMS agency ePCR contacts, ImageTrend and Bureau staff.
The implementation of Schematron 2019 – 01 resulted in many significant challenges for some responding crews across NYS resulting in an inability to close charts and advance them to the NYS Elite Site. The dialogue and effort extended to resolve these issues has been extensive and comprehensive. The full implementation plan for 2019 – 01 (Revision 1) will be released as soon as the Schematron revision is sent to the NEMSIS TAC and software vendors with a planned implementation as soon as possible; however, the affected rule changes are included on the attached document. We ask that every recipient of this email read the full contents of the email and the attachments and raise any questions as quickly as possible so we can answer them directly.
- The attached spreadsheet outlines the rules that were modified slightly to correct chart closure and submission data errors that occurred after the implementation of 2019 – 01 on July 15, 2019. The rules were selected after an analysis of the chart rejections at the Regional Elite Sites and the NYS Elite Site. It is our expectation that software vendors will evaluate the rules and implement them directly as written and report any issues immediately to me directly here at the Bureau.
- The ePCR software vendors should be working with their client EMS agencies to ensure the providers are empowered to utilize their ePCR software platform and comply with the standards established in the Schematron. EMS agencies should be cautioned against workarounds or fixes that bypass the standards outlined in the Schematron.
- The revisions in this release (2019 – 01 (Revision 1)) are meant to correct the large scale issues and we expect that 2019 – 01 (Revision 2) to be released by the end of August if the transition team deems revisions to be more urgent or if the revisions can wait for release in January 2020.
The addition of Pertinent Negative values to be documented as an attribute of an element. The Pertinent Negative values allow the documentation of a pertinent negative value in addition to a real value:
Aspirin Administration — if the medication Aspirin is part of the agency protocol for Chest pain but was not administered by the responding crew, the reason why should be documented. This is done through the use of Pertinent Negative values. If the patient took Aspiring prior to the EMS arrival on scene, the value “Medication Already Taken” should be documented in addition to “Aspirin.”
Additionally, if a value is not able to be obtained, the Pertinent Negative will provide a valid rationale for an inability to obtain a real value.
Medication Allergies — if the patient’s condition or location do not allow for data to be entered into the ePCR, the responding crew may document one of the following Pertinent Negatives that fits the scenario:
- Unable to Complete
The ePCR software vendors should be able to provide background materials on how to document a Pertinent Negative on their platform. The responding crews should be comfortable and confident documenting with clinical accuracy to match the care provided to and for the patient. If there are any issues completing a chart or documentation standards challenge the completion of a chart, please ask the responding crews to discussion with agency leadership; if leadership is not able to resolve the issue, please complete the survey and a member of the Data and Informatics team will investigate and reply back to the inquiring EMT, the agency leadership, the agency ePCR contact, the Program Agency and the Software Vendor.
Each program agency is requested to add the survey link to their website so the responding crews and EMS agencies have easy access through the regional sites.
Please advise if you have any questions.
Peter L. Brodie, BS, AEMT
EMS Data Coordinator
Bureau of Emergency Medical Services and Trauma Systems