The Commonwealth of Massachusetts. Executive Office of Health and Human Services Department of Public Health Office of Emergency Medical Services 99 Chauncy Street, Boston, MA 02111 ADVISORY 15-09-02 ‘AILMA Ambulance Services EMCAB Members, ePCR Software Vendors Eric Shechan, JD, Interim Ditestor, Bureau of Heal fey and Quality Michael Kass, MS, JD, EMT, Director, OEMS, ‘September 10,2015 ‘Opioid Incident Data Submission to MATRIS ‘On June 22,2015, Governor Baker released his action plan to address the opioid epidemic in the ‘Commonwealth. The action plan requires the Department of Public Health to analyze a number of datasets to assess the opiotd problem and inform preventative and intervention measures. Appropriate collection of EMS data serial inorder forthe Department to conduct these analyses, ‘The Statewide EMS Minimum Dataset, Administrative Requirement (AR) 5-403, requires embulance services to enter responses to opioid and suspected opioid incidents accurately and uniformly ino ePCR software for upload to Massachusets Ambulance Trip Record Information System (MATRIS) or directly ino MATRIS. Its important tht data pertaining to al incidents is submited within the 14 days, a= required by AR 5-403. ‘The following data elements and values must be entered forall suspected opiold incidents according tothe guidance below and utilizing the codes/values where applieable. The table is using the current [NEMSIS V2 element and value names: While your sofware may use slightly diferent terminology, it should map to these values upon export from your ePCR to MATRIS, You may contact your vendor if you do not know which elementvalues are associated in your ePCR. All values accepted by MATRIS fare NEMSIS V2 standard values only. Ifyou have addtional values in your ePCR, they need 1 be ‘mapped ta valid NEMSIS V2 value. Element Name(Element | {Code|Value(s for | Guidance Code) Opioid overdoses Providers Bimary 11690] Poisoning/ diag | Weally tis cement should be populncd wih ie Impression (E0905) | ingestion Poisoning/drug ingestion value but there ae times when multiple impressions apply to a patients presentation. When the overdose i @ secondary impresion this element ean be populated by another value, (-, {1640} Cardiac ‘Arrest as long asthe Provider's Secondary Impression contains Posoning/drug ingestion. Provider's Secondary | [1925] Poisoning/ drug | I the Provider's Primary Impression is populated Impression (E09 06) | ingest with Poisoning/drug ingestion then this elementnay be empty or hold another impression, butt the Provider’ Primary Impression is not Poisoning/Drug Ingestion then Secondary Impression should be populated with this value. ‘Medieation Given THOT] Naloxone TE Naloxone was administered by the EMTS (Narcan) providing car, this must be populated using the ‘Medication Given element. We have found that frequently the Narative notes Naloxone was ‘administered, but there is no corresponding Medication Given value. Ifmuliple doses were ‘administered, each should be marked with a separate Medication Given entry and corresponding Date/Time Medication ‘Administered. ‘Date/Time Medication | Enter appropriate time | This should be corded each time Naloxone was ‘Administered (E18_01) administered by the EMTs on this cll Tis is tet to be used for First Recponder administration “for tha, use Prior Aid fields rior ATSCEDO_O1) TloT Naloxone TENaloxone wes administered prior to EMS (areas) arrival this fel should be recorded withthe value Naloxone (Narcan). rior Aid Performed T1195] EMS Provider | Any of te values can be used and should be ‘By(E09_02) [1200] Law ‘documented, more than one person Enforcement ‘administered Naloxone prior tothe EMTS! [1205] Lay Person | arival, record all that apply. This will help 11210} Other Inform the Department if M.G.L c. 94C, §34, the Healthcare Provider | “Good Samaritan law” with respect to immunity 11215} Patient from prosecution in connection with drug-related ‘overdose, is leeding to more people calling 911 in these cases. ‘Guteome of Prior Ald [1220] improved ‘Record te oulome of each administration of (£09.03) [1225] Unchanged | Naloxone prior to the EMT arsival at patient [1230] Worse side. Possible Ijury(E09_04) | [1]¥es Poisoning isa ijury and should be documented ‘Cause oF Taju5(E10_01) | 19530] Drug poisoning | Document the Cause of injury as «drug poisoning whes applicable. A cause is always quired when Possible Injury (E09 04) = Ves. “AlcchoVDrug Use Indicators (E12_19) [2995] Patient Adis to Drug Use [000] Alcohol andlor Drug Paraphernalia at Scene “Ths shouldbe populated tothe best ofthe EMTs ability if elter ofthe options is applicable. This could be prescribed opioids or iit drugs. “ge(E06_TAyVAge Units ‘Age: Numer value “This field should always be populated forall cals (€06_15) ‘Age Units: 8 accurately as possible using available {700} Hours resources. Many EMTs enter a DOB which the [705] Days software will calculate to age and age units for[710] Months [715] Years ‘plead to MATRIS, TrcidenPationt [4815] Cancelled Disposition (E20_10) | [4820] Obvious Signs of Death [4825{ No Patient Found [4830] No Treatment Required [4835] Patient Refused Care 4840) Treated and Released [4845] Treated, “Transferred Care {4850} Treated, ‘Transported by EMS 4855} Treated, ‘Transported by Law Enforcement (4860) Treated, ‘Transported by Private Vehicle “The disposition ofthe calls extremely important and in general it is are that a record willbe missing ths value. Please eneure that your ePCR is mapping to these codesvalues accurately. ‘Chief Complainw(E09_05) | Suggested: Opioid ‘overdose, Heroin ‘overdose “This sa shor text eld that has boon typieally ‘populated with clear information that the call ‘drug overdose or opioid overdase. Please {encourage the continued use of this which will also hep differentiate when a poisoningfoverdose sls drug vs. alcohol related. arrative(E13_O1) Historically in MATRIS, Narratives the main ‘eid indicating an incident was related to opioid overdose. It is very important that hi information is documented in the above elements {o support statewide analysis. However the narrative may provide addtional information about the scene and patient presentation. ‘We require your assistance in educating EMS personnel onthe value and use ofthis data for larger public health surveillance, ad to guide improvement as well as standard definitions and instructions for completing specific fields. We appreciate your intemal evaluation ofthe data quality and mapping of values into MATRIS. The value of our analyses i i submited ately ted to the accuracy and quality of data ‘Thank you for your continued contributions towards fulflin our collective goal of providing high ‘quality EMS and supporting evidence-based solutions to this complex problem. Ifyou have any ‘question, please feel ee to contact Ridgely icks, MATRIS Data Manager, at Fidaelfehaits