BILL ANALYSIS Ó
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CONCURRENCE IN SENATE AMENDMENTS
AB
1129 (Burke)
As Amended August 20, 2015
Majority vote
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|ASSEMBLY: | 77-0 | (May 7, 2015) |SENATE: |40-0 | (August 31, |
| | | | | |2015) |
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Original Committee Reference: HEALTH
SUMMARY: Requires an emergency medical services (EMS) provider,
when collecting and submitting data to with a local emergency
medical services agency (LEMSA), to use an electronic health
record (EHR) system compliant with California Emergency Medical
Services Information System (CEMSIS) and National Emergency
Medical Services Information System (NEMSIS) standards, as
specified, and includes those data elements that are required by
the LEMSA. Prohibits an LEMSA from mandating that an EMS
provider use a specific EHR system to collect and share this
data. Clarifies that the provisions of this bill do not affect
or modify existing written contracts or agreements executed
before January 1, 2016, between an LEMSA and an EMS provider.
The Senate amendments:
1)Specify an EMS provider is required to use an EHR system
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compliant instead of a system compatible with CEMSIS and
NEMSIS when collecting and submitting data to an LEMSA.
2)Clarify that the provisions of this bill do not affect or
modify existing written contracts or agreements executed
before January 1, 2016, between an LEMSA and an EMS provider.
FISCAL EFFECT: None
COMMENTS: According to the author, current law authorizes
LEMSAs to plan, implement, and oversee day-to-day EMS in
California. In order to monitor local EMS providers and
services, LEMSAs collect data from those providers. The author
further states, as local providers have shifted to electronic
patient records; the potential for better analysis of EMS has
increased. LEMSAs are able to provide the data they collect
from EMS providers to the Emergency Medical Services Authority
(EMSA) through CEMSIS compliant software. Although the software
and hardware must be compatible with CEMSIS, there are many
different systems in use and many more available. The author
explains that without guidelines in law, LEMSAs are able to
require EMS providers in their jurisdiction to purchase specific
software or hardware for data collection. Requiring providers
that cover multiple counties or contract with multiple LEMSAs to
purchase specific software and/or hardware can be an unnecessary
and costly burden. The author asserts existing law is silent on
whether or not an LEMSA can require a specific hardware or
software provider for EMS providers in their jurisdiction.
NEMSIS was formed in 2001 by the National Association of State
EMS Directors, in conjunction with the National Highway Traffic
Safety Administration and the Trauma/EMS Systems program of the
Health Resources and Services Administration's Maternal Child
Health Bureau, in order to develop a national EMS database.
NEMSIS is the national repository that will be used to
potentially store EMS data from every state in the nation, and
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was developed to help states collect more standardized elements
to allow submission to the national database.
According to EMSA, CEMSIS is a demonstration project for
improving EMS data analysis across California. CEMSIS offers a
secure, centralized data system for collecting data about
individual EMS requests, patients treated at hospitals, and EMS
provider organizations. EMSA states that at least 14 of
California's 33 LEMSAs currently send a variety of local data
collections to CEMSIS on a voluntary basis, and in return, these
local agencies gain access to digital tools for running
comprehensive reports on their own data at no cost.
EMSA states when fully operational with 100% local
participation, it is estimated that CEMSIS will catalogue more
than 3 million EMS events per year. According to EMSA, it will
use the data to develop and coordinate high quality emergency
medical care in California through activities such as healthcare
quality programs that monitor patient care outcomes, agency
collaboration across jurisdictional boundaries, and public
health surveillance.
On October 1, 2014, the NEMSIS Technical Advisory Committee
announced that California was the first state to successfully
transmit NEMSIS Version 3 EMS data to the national repository
using field and state level software "certified compliant".
NEMSIS Version 3, provides a set of tools that EMS professionals
can use to integrate EMS patient care data with electronic
medical records at hospitals, leading to better patient outcomes
and a smarter system of care.
The California Ambulance Association, the sponsor of this bill,
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along with the Los Angeles County Ambulance Association, and
several ambulance providers write in support of this bill.
Supporters state that the growing practice of LEMSAs to direct
or require EMS providers in their region to purchase and employ
specific software vendors undermines the purpose of a universal
standard allowing providers to use whatever system is most
efficient and effective for their area of operation, so long as
it complies with the universal standard. Supporters write that
there are numerous programs and vendors compatible with NEMSIS
standards that can facilitate the exchange of healthcare
information between the state and federal data repositories.
The California Association of Air Medical Services (CAL-AAMS) is
opposed to this bill. CAL-AAMS' air ambulance providers operate
helicopter and fixed wing aircraft flying emergency missions
within and between LEMSA jurisdictions. Because this bill has
no requirement for the 33 LEMSAs to use a standardized EMS
reporting system, air ambulance providers would have the burden
to pay for and report data compatible with each LEMSA they
serve. CAL-AAMS is strongly supportive of the development of a
single statewide data collection system and argues that this
bill would undermine the development of a consistent system with
information that will improve the safety and effectiveness of
care to patients.
The Emergency Medical Services Administrators Association of
California and the EMS Medical Directors Association of
California are both opposed to this bill, unless it is amended.
The opposition writes that although they are supportive of the
concept of the use of electronic EMS data, they are opposed to
the prohibition of LEMSAs mandating specific data collection
systems. According to the opposition, while it is uncommon for
a LEMSA to require a single system-wide patient care record
system, such an approach could be in the best interest of
patients to assure the transfer and continuity of patient care
data from prehospital providers, receiving hospitals, and
specialty care centers.
Analysis Prepared by:
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Patty Rodgers / HEALTH / (916) 319-2097 FN:
0001580