Ana səhifə

Massachusetts ambulance trip record information system (matris) Effective October 7, 2013 matris version 6


Yüklə 1.08 Mb.
səhifə6/13
tarix27.06.2016
ölçüsü1.08 Mb.
1   2   3   4   5   6   7   8   9   ...   13

Allows data to be sorted based on gender

Allows data to describe the gender of the EMS patient population

Data Collector

EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database

Other Associated Elements

E00 Common Null Values E01_01 Patient Care Report Number

E06_01 Last Name

References in NHTSA Version 1

Essential Element 42 Gender



References to Other Databases

● NFIRS 5.0 EMS Module; Title: Gender; Pick-List: Male = 1, Female = 2



Section E06 Patient

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

RACE

E06_12

Data Format [combo] single-choice National Element

Definition

The patient's race as defined by the OMB (US Office of Management and Budget)



XSD Data Type xs:integer XSD Domain (Simple Type) Race

Multiple Entry Configuration No Accepts Null Yes

Required in XSD Yes

Field Values

-25 Not Applicable -20 Not Recorded

-15 Not Reporting

660 American Indian or Alaska Native 665 Asian

670 Black or African American 675 Native Hawaiian or Other Pacific Islander

680 White 685 Other Race

Uses

A component of the EMS Medical Record: Patient Care Report

Allows data to be sorted based on race as required from a state and federal government reporting perspective

Allows data to describe the race of the EMS patient population

Data Collector

EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database

Other Associated Elements

E00 Common Null Values E01_01 Patient Care Report Number

E06_01 Last Name

References in NHTSA Version 1

Essential Element 43 Race/Ethnicity



References to Other Databases

● NFIRS 5.0 EMS Module; Title: Race; Pick-List: White = 1, Black = 2, American Indian, Eskimo, Aleut = 3, Asian = 4,

Other, Multi-racial = 0, Race Undetermined = U


Section E06 Patient

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

ETHNICITY

E06_13

Data Format [combo] single-choice National Element

Definition

The patient's ethnicity as defined by the OMB (US Office of Management and Budget)



XSD Data Type xs:integer XSD Domain (Simple Type) Ethnicity

Multiple Entry Configuration No Accepts Null Yes

Required in XSD Yes

Field Values

-25 Not Applicable -15 Not Reporting

-20 Not Recorded

690 Hispanic or Latino 695 Not Hispanic or Latino

Uses

A component of the EMS Medical Record: Patient Care Report

Allows data to be sorted based on ethnicity as required from a state and federal government reporting perspective

Allows data to describe the ethnicity of the EMS patient population

Data Collector

EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database

Other Associated Elements

E00 Common Null Values E01_01 Patient Care Report Number

E06_01 Last Name

References in NHTSA Version 1

Essential Element 43 Race/Ethnicity



References to Other Databases

● NFIRS 5.0 EMS Module; Title: Ethnicity; Check-Box: Hispanic = Yes or No



Section E06 Patient

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

AGE

E06_14

Data Format [number] National Element

Definition

The patient's age (either calculated from date of birth or best approximation)



XSD Data Type xs:integer XSD Domain (Simple Type) Age

Multiple Entry Configuration No Accepts Null Yes, but null value is blank or empty

Required in XSD Yes Minimum Constraint 1 Maximum Constraint 120

XSD Structure: E06_14 and E06_15 are members of the E06_14_0 Patient's Age Structure



Field Values

Relevant Value for Data Element & Patient Care

Additional Information

Could be calculated from Date of Birth (E06_16)

Uses

A component of the EMS Medical Record: Patient Care Report

Allows data to be sorted based on age

Allows data to describe the age of the EMS patient population

Data Collector

EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database

Other Associated Elements

E01_01 Patient Care Report Number E06_01 Last Name

E06_15 Age Units

References in NHTSA Version 1

Desirable Element 41 Age



References to Other Databases

● NFIRS 5.0 EMS Module; Title: Age; The age of the patient or best approximation. If less than one year then enter the

number of months.

Section E06 Patient

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

AGE UNITS

E06_15

Data Format [combo] single-choice National Element

Definition

The units which the age is documented in (Hours, Days, Months, Years)



XSD Data Type xs:integer XSD Domain (Simple Type) AgeUnits

Multiple Entry Configuration No Accepts Null Yes

Required in XSD Yes

XSD Structure: E06_14 and E06_15 are members of the E06_14_0 Patient's Age Structure



Field Values

-25 Not Applicable -15 Not Reporting

-20 Not Recorded

700 Hours 705 Days

710 Months 715 Years

Uses

A component of the EMS Medical Record: Patient Care Report

Allows data to be sorted based on age

Allows data to describe the age of the EMS patient population

Data Collector

EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database

Other Associated Elements

E00 Common Null Values E01_01 Patient Care Report Number

E06_14 Age

References in NHTSA Version 1

Desirable Element 41 Age



Section E06 Patient

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

DATE OF BIRTH

E06_16

Data Format [date]

Definition

The patient's date of birth



XSD Data Type xs:date XSD Domain (Simple Type) DateOfBirth

Multiple Entry Configuration No Accepts Null No

Required in XSD No Minimum Constraint 1,890 Maximum Constraint 2,030

Field Values

Relevant Value for Data Element & Patient Care

Uses

Key component of an EMS Medical Record

Provides important information which will allow EMS data to be sorted, grouped and evaluated by age demographics

Data Collector

EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database

Other Associated Elements

E01_01 Patient Care Report Number E06_01 Last Name

References in NHTSA Version 1

Essential Element 40 Date of Birth



References to Other Databases

● NFIRS 5.0 EMS Module; Title: Date of Birth; The date of birth of the patient in MMDDYYYY format.



Section E06 Patient

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

Section E07

Billing



Section E07 Billing

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

PRIMARY METHOD OF PAYMENT

E07_01

Data Format [combo] single-choice National Element

Definition

The primary method of payment or type of insurance associated with this EMS encounter



XSD Data Type xs:integer XSD Domain (Simple Type) PrimaryMethodOfPayment

Multiple Entry Configuration No Accepts Null Yes

Required in XSD Yes

Field Values

-25 Not Applicable -15 Not Reporting

-20 Not Recorded 720 Insurance

725 Medicaid 730 Medicare

735 Not Billed (for any reason) 740 Other Government

745 Self Pay 750 Workers Compensation

Uses

A component of the EMS Medical Record: Patient Care Report

Allows data to be sorted based on the payer mix

Allows data to describe the EMS patient population's payer mix

Data Collector

EMS personnel or electronically through linkage with a pre-existing Patient Care Report or hospital database

Other Associated Elements

E00 Common Null Values E01_01 Patient Care Report Number

E06_01 Last Name


Section E07 Billing

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

CMS SERVICE LEVEL

E07_34

Data Format [combo] single-choice National Element

Definition

The CMS service level for this EMS encounter.



XSD Data Type xs:integer XSD Domain (Simple Type) CMSServiceLevel

Multiple Entry Configuration No Accepts Null Yes

Required in XSD Yes

Field Values

-25 Not Applicable -15 Not Reporting

-20 Not Recorded 990 BLS

995 BLS, Emergency

1000 ALS, Level 1 1005 ALS, Level 1 Emergency

1010 ALS, Level 2 1015 Paramedic Intercept

1020 Specialty Care Transport 1025 Fixed Wing (Airplane)

1030 Rotary Wing (Helicopter)

Uses

Allows data to be quantified and described based on the CMS Service Level

Allows data to be sorted based on the CMS Service Level

Important for EMS billing

Data Collector

EMS personnel unless the EMS Agency has professional billing personnel to provide this function

Other Associated Elements

E00 Common Null Values E01_01 Patient Care Report Number

Section E07 Billing

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

CONDITION CODE NUMBER

E07_35

Data Format [combo] multiple-choice National Element

Definition

The condition codes are used to better describe the service and patient care delivery by an EMS service. Please consult CMS

documentation for detailed descriptions of these condition codes and their use.

XSD Data Type xs:string XSD Domain (Simple Type) ConditionCodeNumber

Multiple Entry Configuration Yes, via structure Accepts Null Yes

Required in XSD Yes Minimum Constraint 2 Maximum Constraint 30

XSD Structure: E07_35, E07_36 are members of E07_35_0 Condition Codes Structure



Field Values

-25 Not Applicable -15 Not Reporting

-20 Not Recorded

8001 Severe Abdominal Pain (ALS-789.00) 8002 Abdominal Pain (ALS-789.00)

8003 Abnormal Cardiac Rhythm/Cardiac Dysrhythmia (ALS- 8004 Abnormal Skin Signs (ALS-780.8)

427.9)


8005 Abnormal Vital Signs (ALS-796.4) 8006 Allergic Reaction (ALS-995.0)

8007 Allergic Reaction (BLS-692.9) 8008 Blood Glucose (ALS-790.21)

8009 Respiratory Arrest (ALS-799.1) 8010 Difficulty Breathing (ALS-786.05)

8011 Cardiac Arrest-Resuscitation in Progress (ALS-427.5) 8012 Chest Pain (non-traumatic) (ALS-786.50)

8013 Choking Episode (ALS-784.9) 8014 Cold Exposure (ALS-991.6)

8015 Cold Exposure (BLS-991.9) 8016 Altered Level of Consciousness (non-traumatic) (ALS-

780.01)


8017 Convulsions/Seizures (ALS-780.39) 8018 Eye Symptoms (non-traumatic) (BLS-379.90)

8019 Non Traumatic Headache (ALS-437.9) 8020 Cardiac Symptoms other than Chest Pain (palpitations)

(ALS-785.1)



8021 Cardiac Symptoms other than Chest Pain (atypical pain) 8022 Heat Exposure (ALS-992.5)

(ALS-536.2)



8023 Heat Exposure (BLS-992.2) 8024 Hemorrhage (ALS-459.0)

8025 Infectious Diseases requiring Isolation/Public Health Risk 8026 Hazmat Exposure (ALS-987.9)

(BLS-038.9)



8027 Medical Device Failure (ALS-996.0) 8028 Medical Device Failure (BLS-996.3)

8029 Neurologic Distress (ALS-436.0) 8030 Pain (Severe) (ALS-780.99)

8031 Back Pain (non-traumatic possible cardiac or vascular) 8032 Back Pain (non-traumatic with neurologic symptoms) (ALS-

(ALS-724.5) 724.9)



8033 Poisons (all routes) (ALS-977.9) 8034 Alcohol Intoxication or Drug Overdose (BLS-305.0)

8035 Severe Alcohol Intoxication (ALS-977.3) 8036 Post-Operative Procedure Complications (BLS-998.9)

8037 Pregnancy Complication/Childbirth/Labor (ALS-650.0) 8038 Psychiatric/Behavioral (abnormal mental status) (ALS-

292.9)


8039 Psychiatric/Behavioral (threat to self or others) (BLS-298.9) 8040 Sick Person-Fever (BLS-036.9)

8041 Severe Dehydration (ALS-787.01) 8042 Unconscious/Syncope/Dizziness (ALS-780.02)

8043 Major Trauma (ALS-959.8) 8044 Other Trauma (need for monitor or airway) (ALS-518.5)

8045 Other Trauma (major bleeding) (ALS-958.2) 8046 Other Trauma (fracture/dislocation) (BLS-829.0)

8047 Other Trauma (penetrating extremity) (BLS-880.0) 8048 Other Trauma (amputation digits) (BLS-886.0)

8049 Other Trauma (amputation other) (ALS-887.4) 8050 Other Trauma (suspected internal injuries) (ALS-869.0)

8051 Burns-Major (ALS-949.3) 8052 Burns-Minor (BLS-949.2)

8053 Animal Bites/Sting/Envenomation (ALS-989.5) 8054 Animal Bites/Sting/Envenomation (BLS-879.8)

8055 Lightning (ALS-994.0) 8056 Electrocution (ALS-994.8)

Section E07 Billing

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

8057 Near Drowning (ALS-994.1) 8058 Eye Injuries (BLS-921.9)

8059 Sexual Assault (major injuries) (ALS-995.83) 8060 Sexual Assault (minor injuries) (BLS-995.8)

8061 Cardiac/Hemodynamic Monitoring Required (ALS-428.9) 8062 Advanced Airway Management (ALS-518.81)

8063 IV Meds Required (ALS-No ICD code provided)) 8064 Chemical Restraint (ALS-293.0)

8065 Suctioning/Oxygen/IV fluids required (BLS-496.0) 8066 Airway Control/Positioning Required (BLS-786.09)

8067 Third Party Assistance/Attendant Required (BLS-496.0) 8068 Patient Safety (restraints required) (BLS-298.9)

8069 Patient Safety (monitoring required) (BLS-293.1) 8070 Patient Safety (seclusion required) (BLS-298.8)

8071 Patient Safety (risk of falling off stretcher) (BLS-781.3) 8072 Special Handling (Isolation) (BLS-041.9)

8073 Special Handling (orthopedic device required) (BLS-907.2) 8074 Special Handling (positioning required) (BLS-719.45)

Additional Information

A list of 95 Condition Codes which are mapped to ICD-9 Codes. At this time the Condition Code List is still in draft. The

number of the Condition Code should be stored in this field



From the Center for Medicare and Medicaid Services (CMS) Ambulance Fee Schedule Condition Based Coding

Uses

Allows data to be quantified and described based on the Condition Code

Allows data to be sorted based on the Condition Code

Important for EMS billing

Data Collector

EMS personnel unless the EMS Agency has professional billing personnel to provide this function

Other Associated Elements

E00 Common Null Values E01_01 Patient Care Report Number

E07_36 ICD-9 Code for the Condition Code Number E07_37 Condition Code Modifier


Section E07 Billing

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

Section E08

Scene




Section E08 Scene

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

NUMBER OF PATIENTS AT SCENE

E08_05

Data Format [combo] single-choice National Element

Definition

Indicator of how many total patients were at the scene



XSD Data Type xs:integer XSD Domain (Simple Type) NumberOfPatientsAtScene

Multiple Entry Configuration No Accepts Null Yes

Required in XSD Yes

Field Values

-25 Not Applicable -15 Not Reporting

-20 Not Recorded

1120 None 1125 Single

1130 Multiple

Uses

A component of the EMS Medical Record: Patient Care Report

Allows data to be sorted based on the number of patients associated with the event and resources required

Allows data to describe the number of EMS events with multiple patient encounters

Data Collector

EMS personnel

Other Associated Elements

E00 Common Null Values E01_01 Patient Care Report Number

References to Other Databases

● NFIRS 5.0 EMS Module; Title: Number of Patients; The total number of patients.




Section E08 Scene

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

MASS CASUALTY INCIDENT

E08_06

Data Format [combo] single-choice National Element

Definition

Indicator if this event would be considered a mass casualty incident (overwhelmed existing EMS resources)



XSD Data Type xs:integer XSD Domain (Simple Type) YesNoValues

Multiple Entry Configuration No Accepts Null Yes

Required in XSD Yes

Field Values

-25 Not Applicable -15 Not Reporting

-20 Not Recorded 0 No

1 Yes

Uses

A component of the EMS Medical Record: Patient Care Report

Allows data to be sorted based on a Mass Casualty Event

Allows data to describe the number of EMS events which were declared a mass casualty event and is connected with

disaster and domestic preparedness



Data Collector

EMS personnel

Other Associated Elements

E00 Common Null Values E01_01 Patient Care Report Number

Section E08 Scene

MATRIS Version 1.6 (based on 2006 NHTSA Uniform PreHospital Dataset V.2.2.1)

INCIDENT LOCATION TYPE

E08_07

Data Format [combo] single-choice National Element

Definition

The kind of location where the incident happened



XSD Data Type xs:integer XSD Domain (Simple Type) IncidentLocationType

Multiple Entry Configuration No Accepts Null Yes

Required in XSD Yes

Field Values

-25 Not Applicable -15 Not Reporting

-20 Not Recorded 1135 Home/Residence

1140 Farm

1145 Mine or Quarry 1150 Industrial Place and Premises

1155 Place of Recreation or Sport 1160 Street or Highway

1165 Public Building (schools, gov. offices) 1170 Trade or service (business, bars, restaurants, etc)

1175 Health Care Facility (clinic, hospital, nursing home) 1180 Residential Institution (Nursing Home, jail/prison)

1185 Lake, River, Ocean 1190 Other Location

Additional Information

Based on ICD-9

Uses

A component of the EMS Medical Record: Patient Care Report

Allows data to be sorted based on the Incident Location and Type

Allows data to describe the Incident Location and the distribution of EMS events

Data Collector

EMS personnel
1   2   3   4   5   6   7   8   9   ...   13


Verilənlər bazası müəlliflik hüququ ilə müdafiə olunur ©atelim.com 2016
rəhbərliyinə müraciət