No. 34358 (5-year Review): Rule R426-7. Emergency Medical Services Prehospital Data System Rules

DAR File No.: 34358
Filed: 01/12/2011 07:53:05 AM

NOTICE OF REVIEW AND STATEMENT OF CONTINUATION

Concise explanation of the particular statutory provisions under which the rule is enacted and how these provisions authorize or require the rule:

Section 26-8a-203 (Data collection) authorizes the state Emergency Medical Services (EMS) committee to specify the information that must be collected for the EMS data system, and it authorizes the Department to implement the system.

Summary of written comments received during and since the last five-year review of the rule from interested persons supporting or opposing the rule:

The rule was amended in 2007. Three commenters submitted comments at that time. All three commenters addressed Subsection R426-7-3(10), the requirement of EMS to give a report to the receiving facility. They stated that if the requirement means giving a complete patient care report to the hospital within one hour, compliance will not always be possible. One commenter additionally stated the following claims: 1) the rule revision will cause lost productivity, due to personnel taking 15 minutes longer to fill out reports, amounting to an additional personnel cost of $30 per EMS response; and 2) the rule revision will cause new infrastructure costs, due to buying laptop computers for field data entry, amounting to an additional infrastructure cost of $2,800 per ambulance, with a 1218 month replacement cycle. The commenter recommended the following actions: 1) attach a fiscal note to the rule change; 2) provide a new revenue stream for EMS agencies; 3) give sufficient thought initially to the dataset; and 4) delay or postpone NEMSIS compliance.

Reasoned justification for continuation of the rule, including reasons why the agency disagrees with comments in opposition to the rule, if any:

Over the ensuing years, many EMS agencies have implemented electronic reporting for reasons above and beyond the requirements of this rule. Recent federal initiatives underscore the importance of electronic medical records. Since the time that the rule was amended to adopt a national data standard, compliance with the rule has increased from 35% to 85% of EMS agencies. Data collected through the system has been utilized in dozens of data requests and research projects at the state level, and de-identified data is publicly available for analysis at both the state and national levels. Therefore, this rule should be continued. The rule was amended again in 2008 to address the concern regarding Subsection R426-7-3(10). The amended rule requires a report of critical information to be provided to the receiving hospital, rather than a full patient care report. In response to concerns about lost productivity and increased costs, the Bureau of EMS provided the following response to the commenter: 1) any increased time required to report the more extensive information required in the rule change is largely offset by efficiencies that are made possible by using the national standard for data transfer (for example, improving the efficiency and timeliness of the billing process, which improves collection rates); 2) the rule change did not specifically require an agency to make substantial changes to its field operations, if an agency did not currently use laptops for field data entry, it was not required to begin doing so. However, the Bureau of EMS made laptops available to agencies free of charge; 3) a majority of EMS agencies in Utah had already completed the transition to the NEMSIS standard; and 4) at the next ambulance rate review, the Bureau of EMS would take into consideration any data documenting claimed increased costs caused by Rule R426-7 and consider possible rate adjustments. An additional consideration regarding personnel costs is that a typical high performance EMS system has a "unit hour utilization" ratio (the proportion of time that a unit on shift spends responding to calls) of 0.3 - 0.5. In other words, for every hour that a unit spends responding to a call, it spends 1 to 2 hours providing coverage for the next call. Patient care reports can be completed during the time in between calls.

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Health Systems Improvement, Emergency Medical Services
3760 S HIGHLAND DR
SALT LAKE CITY, UT 84106

Direct questions regarding this rule to:

• Joshua Legler at the above address, by phone at 801-273-6668, by FAX at 801-273-4165, or by Internet E-mail at [e-mail]

Authorized by:

David Sundwall, Executive Director

Effective:

01/12/2011

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