Welcome to the NEMSIS 101 page. Here you will find various resources and links that will help you to understand various aspects of NEMSIS including development, implementation and support of the National EMS Data Standard.

If you have questions that are not reflected on this resource page, please reach out to the NEMSIS Technical Assistance Center at and we will be happy to connect you to the knowledge and support material you need.

This video provides a concise introduction to NEMSIS. Feel to use and share as needed!


Annual Meeting Resources

Annual Meeting (2023) – Find all of the documents, presentations, and links to recordings of the NEMSIS Annual Meeting from 2023.
Annual Meeting and Boot Camp (2022) – Find all of the documents, presentations, and links to recordings of the NEMSIS Annual Meeting and Boot Camp from 2022.
Annual Meeting and Boot Camp (2021) – Find all of the documents, presentations, and links to recordings of the NEMSIS Annual Meeting and Boot Camp from 2021.
Annual Meeting and Boot Camp (2020) – Find all of the documents, presentations, and links to recordings of the NEMSIS Annual Meeting and Boot Camp from 2020.

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Maintaining the Data Standard

The National EMS data standard is established as the universal standard for the collection, sharing, and assessment of pre-hospital patient encounter documentation throughout the United States and Territories. Regular revisions, updates, and critical patches are necessary to reflect the evolving needs of the broader EMS industry and developing standards for health information exchange.

NEMSIS Versioning Roadmap – Review the roadmap for version schedule, duration between releases, and version lifespan. (Updated 1-15-23)
Data Standard Revision Guide – Read about the process to maintain and update the data standard. (Updated 10-27-21)
NEMSIS NEMPUB Home – The public repository of requested features and updates to the NEMSIS standard.

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Data Consistency

Pertinent Negatives and Not Values – These are the different methods utilized when a data element is not applicable to a specific EMS activation.
Schematron Errors and Warnings – Learn about the distinction between errors (causing record failures) and warnings (impacting data quality).

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State Specific Tools

State/Territory EMS Data Managers are offered personal one-on-one training and assistance in developing and supporting EMS data collection. Additional resources include:

Submission Lag Best Practices Document – This document describes how NEMSIS dashboards can be used to track and document ePCR submission lag by agency. The document then details suggestions, recommendations and best practices for minimizing submission lag. (Posted 12-22-21)
Best Practices for State Resources Updates This document outlines recommendations on making and communicating changes to state/territory resources. (Posted 7-15-2022)
v3 Version Change Checklist for States and Territories – This checklist is for states and territories that have already implemented a version of NEMSIS V3 and need to implement a new version of NEMSIS V3 (for example, states that have implemented NEMSIS v3.4.0 and need to implement NEMSIS v3.5.0). (Updated 1/24/2022)
State/Territory Data Managers and Vendors – At the request of Data Managers, the TAC has compiled a list of State/Territory Data Managers and the state-level Receive & Process Software Vendor that they use. (For informational purposes only)
Access to State EMS MVC Dashboard NEMSIS – Flyer detailing how state traffic safety partners can request access to the State EMS MVC Dashboard.
Updated General Grant Application Information – This document is for Emergency Medical Services (EMS) Officials who are interested in learning more about possible opportunities for support through the new Bipartisan Infrastructure Law (BIL), Section 402 Highway Safety Programs, Section 405 National Priority Safety Programs, the Safe Streets and Road for All (SS4A) Grant Program, or other public funding opportunities.

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Understanding NEMSIS v3.5

A revision of the EMS data standard includes support tools and documentation.

ACS NASEMSO Joint Linkage Policy Statement – This policy statement has as its principal objective, outlining the foundation for linking pre-hospital EMS data to hospital trauma registry data for injured patients at the local, state, and national levels. (Posted 5/28/21)
Role and Scope of UUID in v3.5.0 – Read about the purpose of Universally Unique Identifiers to track ePCR’s and agency resources over time.
Patient and Incident Disposition in v3.5.0 – Learn about the adjustment of eDisposition.12 from one element to four elements to more accurately describe the EMS activation.
Harmonizing NEMSIS and CARES in v3.5.0 – Learn about the alignment of NEMSIS and CARES elements to strengthen out-of-hospital cardiac arrest data and reduce documentation redundancy.

Additional information about NEMSIS v3.5 is located here.

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Training Opportunities

In addition to twice monthly v3 Implementation Calls and regular State and Public Trainings, NEMSIS offers an Annual Boot Camp and the Annual v3 Implementation Meeting.

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Data Ownership and Utilization Guidance

EMS agencies nationwide still widely report that hospitals and other healthcare providers refuse to share patient information with them, citing Health Insurance Portability and Accountability Act (HIPAA) concerns. Misconceptions about HIPAA create artificial barriers to legitimate, approved bidirectional data exchange between EMS and other providers. As a result, many healthcare systems are missing a critical opportunity to improve patient outcomes and advance evidence-based practices in prehospital care.

To conclusively answer this question, the NEMSIS Technical Assistance Center collaborated with Page, Wolfberg & Wirth to provide an expert legal opinion regarding the bidirectional sharing of patient information between EMS and other healthcare providers.

HIPAA: An Imaginary Barrier to Data Exchange – Please share and use this White Paper as needed.
PCR Data QuickGuide – FAQs on Owning, Amending, Retaining and Sharing Patient Care Report Data.
Legal Opinion: Sharing Patient Data Bidirectionally Under HIPAA – This brief Legal Opinion describes how bidirectional data sharing of patient information is not only allowed but encouraged under HIPAA. It is developed specifically for healthcare administrators, legal counsel, and risk management.
HIPAA Basics for EMS Practitioners – This poster provides guidance on HIPAA for EMS practitioners. EMS agencies are welcome to print or share this and distribute it as needed. (Posted 05/24/2021)
EMS Body-worn Camera Quickstart Guide: Legal Considerations for EMS Agencies – This document identifies and generally outlines threshold legal considerations for EMS agencies contemplating the use of body-worn cameras. (Posted 6-16-21)

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Custom Data Elements

Custom Elements are utilized to enhance national/state/territory data collection when the existing NEMSIS standard does not have elements/values present to collect the necessary information. In an effort to assist with identifying the need for a custom element, the NEMSIS TAC has developed a Best Practices Guide, Checklist and Flowchart toolkit for use in determining the best process to follow for customization. The National Custom Element
contains the National Custom Element, Specific Project Custom Elements such as ET3 Custom Elements, and a link to each of the states that utilize State Specific Custom Elements . The NEMSIS TAC will collaborate with EMS Stakeholders to identify the need for National Custom Elements when necessary. Whenever considering the use of custom elements the NEMSIS TAC highly recommends reaching out to the DMC at NASEMSO, other State Data Managers, other ePCR vendors, and your State Repository Vendor. As always, the NEMSIS TAC will strive to assist in the process to identify the need for additional custom elements. Also available for developers is a more technical guide to using Custom Elements, the Approaches to Using NEMSIS V3 Custom Elements

Creating Custom Element Best Practices Guide
Creating Custom Element Best Practices Checklist
Creating Custom Element Best Practices Flowchart
Approaches to using NEMSIS V3 Custom Elements

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Defined Lists

The transition from suggested to Defined Lists is implemented in NEMSIS v3.5. It does not impact previous versions.

Suggested to Defined Lists General Overview – This PowerPoint presentation is a general overview of the transition from suggested to Defined Lists for v3.5.0. (Updated 04/16/2021)
Suggested to Defined Lists Info-Sheet – This info-sheet addresses many frequently asked questions about the purpose and impact of Defined Lists. (Updated 04/22/2021)
Outline of the Process Moving NEMSIS Suggested Lists to Defined Lists – This is the updated PowerPoint presentation detailing the finalized approach to Defined Lists.
Use of Defined Lists for Specific NEMSIS Elements – This fact sheet identifies the history, related issues and potential solutions for Suggested Lists.

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ET3: Emergency Triage, Treat and Transport Model Click Here

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EMS Legislative Database

National Conference of State Legislatures Database – The NCSL conducts unbiased policy research in various areas and provides comprehensive information to answer more than 20,000 requests for information a year.
Backing the First Responders: Recent Bills Empower EMS Systems – In 2022, several US states enacted legislation related to EMS administration, funding, rules and regulations, systems of care, and workforce. The legislation aimed to address challenges related to providing EMS care, including funding gaps, workforce shortages, and regulations related to data collection, air ambulance services, emergency services for children, and liability protections for EMS clinicians.

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