Sec. 7. Field EMS quality

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To improve medical oversight of field EMS and ensure continuity and quality for such medical oversight, the Director of the Office of EMS and Trauma (in this section referred to as the Director ) shall— promote high-quality and comprehensive medical oversight of— all medical care provided by field EMS practitioners; and the education and training of field EMS practitioners; promote the development, adoption, and utilization of national guidelines for the roles of physicians who provide medical oversight for field EMS and other health care providers who support physicians in this role; support efforts of relevant physician stakeholders in developing and disseminating guidelines for use by EMS medical directors and field EMS practitioners on a national basis; and convene a Field EMS Medical Oversight Advisory Committee, comprised of representatives of relevant physician stakeholders, to advise the Director on ways and means to advance and support development and maintenance of quality medical oversight throughout the Nation's systems for field EMS.

In carrying out subparagraphs

(B)and

(C)of paragraph

(1)(relating to supporting guidelines), the Director shall take into consideration— existing guidelines developed by national professional physician associations, States, and other relevant governmental or nongovernmental entities; the input of other relevant stakeholders, including health care providers who support physicians who provide medical oversight for field EMS; and the unique needs associated with medical oversight of provision of field EMS in rural areas or by volunteers. The guidelines promoted under subparagraphs

(B)and

(C)of paragraph

(1)shall ensure high-quality training, credentialing, and direction in connection with medical oversight of field EMS at the State, regional, and local levels while providing sufficient flexibility to account for historical and legitimate differences in field EMS among States, regions, and localities. As a condition on receipt of a grant under section 5 or 6, the Director shall require the grant recipient to adopt and implement (to the extent applicable) the guidelines promoted under subparagraphs

(B)and

(C)of paragraph (1). The Comptroller General of the United States shall complete a study on— medical and administrative liability issues that may impede— medical direction provided by physicians directly regarding specific patients or medical oversight provided by physicians in establishing medical protocols, procedures, and other activities related to the provision of emergency medical care in field EMS; or the highest quality emergency medical care in field EMS provided by personnel other than physicians such as emergency medical technicians and paramedics; reimbursement for any component of medical oversight; and such other issues as the Comptroller General deems appropriate relating to improving the quality and medical oversight of emergency medical care in field EMS. Not later than 18 months after the date of the enactment of this Act, the Comptroller General shall complete the study under paragraph

(1)and submit a report to the Congress on the results of such study, including any recommendations. The Administrator of NHTSA may maintain, improve, and expand the National EMS Information System, including the National EMS Database. The Administrator of NHTSA shall carry out this paragraph in consultation with the Director. In carrying out subparagraph (A), the Administrator of NHTSA shall promote the collection and reporting of data on field EMS in a standardized manner. The Administrator of NHTSA shall ensure that information in the National EMS Database (other than individually identifiable information) is available to Federal and State policymakers, EMS stakeholders, and researchers. In carrying out subparagraph (A), the Administrator of NHTSA may provide technical assistance to State and local agencies, field EMS agencies, and other entities deemed appropriate by the Administrator to assist in the collection, analysis, and reporting of data. Not later than 12 months after the date of the enactment of this Act, the Secretary of Health and Human Services, acting through the Director, in consultation with the Administrator of NHTSA, shall submit to the Congress a report that— identifies gaps in the collection of data related to the provision of field EMS; and includes recommendations for improving the collection, reporting, and analysis of such data. The recommendations required by subparagraph (A)(ii) shall— take into consideration the recommendations of FICEMS and NEMSAC and relevant stakeholders; recommend methods for improving data collection and reporting and analysis without unduly burdening reporting entities and without duplicating existing data sources (such as data collected by the National Trauma Data Bank); address the quality and availability of data, and linkages with existing patient registries, related to the provision of field EMS and utilization of field EMS with respect to a variety of illnesses and injuries (in both the everyday provision of field EMS and catastrophic or disaster response) including— cardiac events such as chest pain, sudden cardiac arrest, and STEMI; stroke; trauma; disaster and catastrophic incidents, such as incidents related to terrorism or natural or manmade disasters; and ambulance diversion and patient parking; and include an analysis of the variety of services provided by field EMS agencies. Not later than 18 months after the date of the enactment of this Act, the Secretary of Health and Human Services, acting through the head of the Office of the National Coordinator for Health Information Technology, in collaboration with the Director of the Office of EMS and Trauma, FICEMS, and the Administrator of NHTSA as appropriate, and taking into consideration input from relevant stakeholders, shall submit a report (including recommendations) on issues, impediments, and potential solutions pertaining to the following objectives: Incorporation of field EMS patient care reports into patient electronic health records, taking into consideration— the extent to which field EMS patient care reports are presently created in electronic format and the potential for elements of such reports to be incorporated into patient electronic health records; the data elements of field EMS patient care reports that would promote quality and efficiency of care if incorporated into patient electronic health records; potential modifications to the Medicare and Medicaid programs under titles XVIII and XIX, respectively, of the Social Security Act or other Federal health programs (including potential modifications to the HITECH Act (title XIII of division A of Public Law 111–5 ) including modifications to the entities included as eligible for incentive payments under section 1848(o), 1853(l) (to the extent that such section 1848(o) is applied), or 1903(t) of the Social Security Act, criteria for certified EHR technology for purposes of such sections, and objectives and measures for determining meaningful use of such technology for purposes of such sections) to provide appropriate reimbursement and financial incentives for EMS agencies— to maintain field EMS patient care reports in a structured electronic format; and to otherwise adopt and use electronic health records; and potential modifications to the HITECH Act to provide incentives to eligible hospitals under section 1886(n), 1853(m) (to the extent that such section 1886(n) is applied), or section 1814(l)(3) of the Social Security Act to incorporate appropriate data elements of field EMS patient care reports into patient electronic health records. Incorporation of patient health information created subsequent to the receipt of field EMS emergency care into NEMSIS, taking into consideration— what types of medical information created subsequent to the receipt of field EMS emergency care (such as outcomes information or information regarding subsequent care and treatment) would, if included in NEMSIS, be potentially useful in evaluating and improving the quality of EMS care; how best to integrate such information into NEMSIS; potential modifications to the HITECH Act to require eligible hospitals, as defined in section 1886(n)(6)(B) of the Social Security Act, for purposes of incentive payments under 1886(b)(3)(B)(ix) and 1886(n) of such Act, to develop or report relevant data to NEMSIS or other appropriate State or private registries; and potential modifications to the Medicare and Medicaid programs under titles XVIII and XIX, respectively, of the Social Security Act or other Federal health programs to provide appropriate reimbursement and financial incentives for field EMS agencies to develop or report relevant data to NEMSIS or other appropriate State or private registries. Nothing in HIPAA privacy and security law (as defined in section 3009(a)(2) of the Public Health Service Act ( 42 U.S.C. 300jj–19(a)(2) ) shall be construed as prohibiting the exchange of information between field EMS practitioners treating an individual and personnel of a hospital to which the individual is transported for the purposes of relating information on the medical history, treatment, care, and outcome of such individual (including any health care personnel safety issues such as infectious disease). The Secretary of Health and Human Services shall establish guidelines for exchanges of information between field EMS practitioners treating an individual and personnel of a hospital to which the individual is transported to protect the privacy of the individual while ensuring the ability of such EMS practitioners and hospital personnel to communicate effectively to further the continuity and quality of emergency medical care provided to such individual. Nothing in HIPAA privacy and security law (as defined in section 3009(a)(2) of the Public Health Service Act ( 42 U.S.C. 300jj–19(a)(2) ) shall be construed as prohibiting— a field EMS agency from submitting EMS data to the State EMS Office for the purpose of quality improvement and data collection by the State for submission to NEMSIS; or the State EMS Office from submitting aggregated nonindividually identifiable EMS data to the National EMS Database maintained by NHTSA.

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Pub. L. 111-5
42 USC 300jj–19(a)(2)

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Sec. 7

Field EMS quality

Pub. L.Pub. L. 111-5

Cite42 USC 300jj–19(a)(2)

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