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HITS Committee Meeting Materials

July 31, 2009

Original request for comments on the Traffic Records Performance Measures white paper:

The National Highway Traffic Safety Administration (NHTSA) has funded a project to develop performance measures that should be used by states in their traffic records strategic plans and 408 data improvement grant applications. The measures cover six data systems: crash, vehicle, driver, injury, roadway, and citation/adjudication and address six data-related issues (accuracy, timeliness, completeness, uniformity, integration and accessibility). Since the members of your respective associations may be responsible for one or more of these data systems and may be participants in state Traffic Records Coordinating Committees, I want to bring you up to speed on this project and ask that you share this information with them.

Preusser Research Group (a firm that does a lot of evaluation work for NHTSA) is the contractor for the project. Jim Hedlund (a former NHTSA senior staffer known to many of you) is the principal investigator for the project, and GHSA is a subcontractor. NHTSA has funded this project partly to respond to recommendations of the Government Accountability Office (GAO) and partly in anticipation of the next reauthorization (which, as we already know from the House bill, will heavily emphasize performance and performance measures).
A panel of data experts was formed to identify the initial set of measures. That panel met in February. A white paper has been developed that summarizes the panel’s recommendations. It is posted on the GHSA home page under “What’s New” or it can be accessed by clicking on: http://www.ghsa.org/html/projects/perf_msrs/pdf/2009.07.01.recordsPerfMsrs.pdf

The white paper solicits comments on the recommendations at several points throughout the paper. Comments can be submitted on the specific questions that have been raised as well as on any other aspects of the recommendations. GHSA is accepting comments on the paper until September 4. Comments may be submitted to headquarters@ghsa.org. In addition, there will be a listening session on the proposed measures at the upcoming Traffic Records Forum, http://www.atsip.org/index.php?/atsip/, in Phoenix and at the GHSA Annual Meeting in Savannah, http://www.ghsa.org/html/meetings/index.html.

The panel will reconvene at the end of September to consider the comments that have been submitted either online or at the listening sessions. A final report will be issued by the end of the year, and states will be expected to use these traffic records performance measures thereafter.

I hope you will share this information with your members, encourage them to carefully review the white paper and, if possible, attend one of the listening sessions and submit comments before the Sept. 4 deadline. Many thanks.

Barbara L. Harsha, Executive Director
Governors Highway Safety Association

Email request for State EMS Data Manager comments on the Traffic Records Performance Measures white paper:

Dear State EMS Data Manager:
 
NASEMSO was represented on the expert panel that drafted the referenced Traffic Records Performance Measures white paper, and now we have the opportunity as an association to review and provide any additional thoughts prior to finalization.  NASEMSO’s Highway Incident & Traffic Safety (HITS) Committee Chair Dia Gainor asks that you take a look at the drafted performance measures with particular emphasis on the “Injury” data system and provide any feedback, comments or proposed revisions by Friday, July 24. Hit “reply” or send an email to Sharon Kelly at info@nasemso.org. 
 
The HITS Committee will formulate NASEMSO’s response for Executive Committee approval by their August 13 call.  Their next teleconference/webinar will be announced in the next week or so.
 
Thanks,
Beth
Elizabeth B. Armstrong, MAM, CAE
Executive Director
National Association of State EMS Officials

Comments Received:

  • Dr. David James Harden's comments: Thank you for allowing Arizona the opportunity to review and provide comments and recommendations to the July 1, 2009, Model Performance Measures for State Traffic Record Systems White Paper. Please find attached Arizona’s comments/recommendations concerning the Model Performance Measures for State Traffic Record Systems White Paper. The Arizona comments/recommendations apply to all of the six Data Systems and not just the Injury Surveillance Data System. attached comments
     
  • Mark Nelson's comments: The Indiana EMS Data Registry is represented on the Indiana Governor's Dangerous and Impaired Drivers Council and on the Indiana Traffic Records Committee.  Both committees are sponsored by the Indiana Criminal Justice Institute (ICJI) TRCC.  The EMS program has received funding from the NHTSA 408 grant program, and Indiana is upgrading its EMS reporting system to an on-line web server NEMSIS data set (85 required and 18 additional elements).  We plan the switch-over to the NEMSIS data set and the web server on October 1, 2009.
     
    Indiana has a mandatory EMS reporting statute for EMS providers to submit emergency run data by the 15th of the following month.  With the new NEMSIS data set in place, the departments reporting should increase significantly -- from 72% to 95++%.  The data system will be locked to only receive NEMSIS compliant and completed reports, thus higher quality in the run data leading to more accurate summary statistical reports.
     
    I agree with the alignment of all data bases on the common linking data points / elements. I also highly agree with the deadline / cutoff date for data transmissions to NHTSA, NEMSIS TAC, and to CODES programs.
     
    Here are some recommended NEMSIS code changes and new elements for linking databases:
     
    The Zone / Area of the incident and the Zone / Area of the destination (hospital, clinic, etc.) to include the state's Homeland Security Districts.  Indiana has 10 districts that the TRCC member state agencies use for standardization of location besides townships and counties data elements.
     
    Add  the NFIRS (National Fire Incident Reporting System) fire department identification code (FDID) issued by each state.  This will link First Responder Fire Department agencies into the NEMSIS code set.  The fire services have significantly expanded their first responder service into on-scene patient care prior to EMS arrival.  This is an important data set that can close the information loop in the crash data system.
     
  • Dr. Greg Mears' comments: I just scanned the Traffic Records Performance Measures document.  I like the idea and am hopeful it will promote more timeline data collection and ultimately application.  I don’t have any real concerns with the document with the exception of the National Information Exchange Model (NIEM).  I am really trying hard to make it work with NEMSIS Version 3 but this is not the model for healthcare.  HL7 is the exchange standard that all 4 of the injury data systems mentioned (EMS, ED, Trauma, and Hospital Discharge) are or will be based upon.
     
    Again, it know who the funder is and this is their data model and they have invested heavily in the standard just as healthcare has in HL7.  We seem to be pushing to tear down walls at the top through linkage as we continue to reinforce the base.
     
    One thought would be to recommend a project to model and identify how information can be exchanged between the NIEM and HL7 exchange standards.  If this could be accomplished, it would be a win win for all.  Otherwise someone is always going to trip or fall off of the wall.
     
  • Tim Erskine's comments: Care should be taken on this issue to avoid sweeping generalizations.  Each element needs to be examined individually for the null status.  There are times when a null value means there was no response to a question, or that the field was left blank.  However, there are times when the right null value is an affirmative answer.  Example: A field that asks the question "Did airbags deploy?" that elicits the response "Not applicable" is a non-responsive null valuvalue when the vehicle is a modern passenger vehicle and therefore can and should be considered along with missing values.  However, it is an actual responsive value when the vehicle was an antique that predates airbag technology or is a motorcycle.  In these cases, it would indicate that the question was inappropriate to the situation, not that the question was ignored or that the value was missing.