PLEASE DOWNLOAD LATEST DOCUMENTS AT https://vendors.mycares.net 3.5.0.250403CP5_CARES_016_Required ------------- + Update to NEMSIS 3.5.0 CP5 (XSDs and NEMSIS National Schematron) + Update CARES importer to utilize Patient Sex in CP5+ - Required pattern_PatientGenderReq Removed (ePatient.13) + Required pattern_PatientSexReq Added (ePatient.25) + Added Required Schematron Disposition Rules to assist with CARES case identification + pattern_PatientEvaluationReq Added to Required Elements Schematron + pattern_CrewDispositionReq Added to Required Elements Schematron + Updated Data Dictionary with ePatient.25 changes Importer Only Changes - No Schematron Changes - v1.93 -------------- - Improved capture of eMedications.03 (Normal Saline) - Per U.S. Department of Health and Human Services guidance, ePatient.13 mapping has been updated to reflect Sex as "Male" and "Female". Importer Only Changes - No Schematron Changes - v1.90 -------------- - Importer updated to use UUID for N3.5.0 duplicate handling, see 3.5.0 XML Data Dictionary for details (page 2). - Custom Element DrugAdministration removed and derived from eMedications.03 in all cases. - Improved capture of Were Drugs Administered - Improved capture of Mechanical CPR Device - Improved capture of ITD Used - Improved capture of Were Dispatcher CPR Instructions Provided - Improved capture of Type of Bystander CPR Provided - Improved capture of Medical History 3.5.0.230317CP4_CARES_015_Required eCustomConfiguration.FROnscene removed, replaced with standard element eScene.05. assert_ResusAttemptRespReq updated to improve capture of eArrest.22/CARES #27. 3.5.0.230317CP4_CARES_014_Required -------------- Updated rule syntax to improve data qualification in the following patterns (no logic changes in this version): - pattern_AgeReq - pattern_AgeUnitsReq - pattern_ArrestWitnessStatusReq - pattern_CardiacArrestCprReq - pattern_CardiacArrestDefibrillationReq - pattern_CardiacArrestEpiReq - pattern_DOBReq - pattern_DestinationHospitalReq - pattern_EndOfEventReq - pattern_EtiologyReq - pattern_FirstRhythmReq - pattern_IncidentAddressReq - pattern_IncidentCityReq - pattern_IncidentCountyReq - pattern_IncidentNumberReq - pattern_IncidentStateReq - pattern_IncidentZipReq - pattern_WhoInitiatedCPRReq - pattern_LocationTypeReq - pattern_PatientEthnicityReq - pattern_PatientFirstNameReq - pattern_PatientGenderReq - pattern_PatientLastNameReq - pattern_ResusAttemptRespReq - pattern_ResuscitationAttemptedReq - pattern_SustainedROSC - pattern_WasAEDAppliedPriorReq - pattern_arrestdateReq - pattern_FirstResponderAppliedAED - pattern_FirstResponderDefibrillatedPatient - pattern_FirstResponderInitiatedCPR - pattern_FirstResponderProvidedCare 3.5.0.230317CP4_CARES_014_Supplemental -------------- Updated rule syntax to improve data qualification in the following patterns (no logic changes in this version): - pattern_WasAEDAppliedPriorSupplemental - pattern_WhoFirstDefibSupplemental NEMSIS 3.5.0: XML Import & Data Dictionary Update v1.84: - Custom Element VascularAccessID removed, IV/IO will be derived from eProcedures.03. - Custom Element BookletID removed. - eMedications.03 Import improved to support Oxygen instead of requiring a custom element. -------------- 3.5.0.230317CP4_CARES_013_Required -------------- pattern_ResusAttemptRespReq corrected pattern_CardiacArrestReq title changed pattern_WhoFirstAppliedAED removed pattern_WhoFirstDefib removed -------------- 3.5.0.230317CP4_CARES_012_Required -------------- pattern_DestinationHospitalReq corrected -------------- 3.5.0.230317CP4_CARES_011_Required -------------- New 'required' schematron file published for vendors and states to utilize, contains only CARES required element validations. -------------- 3.5.0.230317CP4_CARES_011_Supplemental -------------- New 'supplemental' schematron file published for use when an agency or vendor would like to see supplemental element rules and additional audit validations in their ePCR. -------------- 3.5.0.230317CP4_CARES_011_Combined -------------- Updated 'combined' schematron file available if a vendor would like to replicate all CARES import validations including Required and Supplemental rules. -------------- 3.5.0.230317CP4_CARES_011 -------------- pattern_AgencyInfoReq removed pattern_PatientFirstNameReq updated with context, so it only applies to CARES-eligible cases pattern_PatientLastNameReq updated with context, so it only applies to CARES-eligible cases pattern_FirstResponderAppliedAED updated to reduce complexity and add CARES criteria pattern_FirstResponderDefibrillatedPatient updated to reduce complexity and add CARES criteria pattern_FirstResponderInitiatedCPR updated to reduce complexity and add CARES criteria pattern_FirstResponderProvidedCare updated with CARES criteria pattern_WasAEDAppliedPriorReq updated with context, so it only applies to CARES eligible cases pattern_LocationTypeReq updated with CARES context pattern_ArrestWitnessStatusReq updated with CARES criteria and to reduce complexity. pattern_EndOfEventReq updated with CARES criteria and to reduce complexity. pattern_WhoFirstAppliedAEDReq updated with CARES criteria and to reduce complexity. pattern_WhoFirstDefibReq updated with CARES criteria and to reduce complexity. pattern_WhoInitiatedCPRReq updated with CARES criteria and to reduce complexity. pattern_FirstRhythmReq updated with CARES criteria and to reduce complexity. pattern_SustainedROSC updated with CARES criteria pattern_AgeReq added to require Patient Age. pattern_AgeUnitsReq added to require Patient Age Units. pattern_DestinationHospitalReq eDisposition02nil criteria improved pattern_ResusAttemptRespReq updated with CARES criteria and to reduce complexity. pattern_DOBReq added to require Patient DOB or PN. pattern_CardiacArrestReq added to 3.5.0 Schematron pattern_ResuscitationAttemptedReq added to 3.5.0 Schematron pattern_CardiacArrestEtiologyReq added to 3.5.0 Schematron pattern_CardiacArrestCprReq added to 3.5.0 Schematron pattern_CardiacArrestDefibrillationReq added to 3.5.0 Schematron pattern_CardiacArrestEpiReq added to 3.5.0 Schematron pattern_ResusAttemptEMSReq moved to supplemental Schematron -------------- 3.5.0.230317CP4_CARES_010 -------------- pattern_arrestdateReq updated with context so it only applies to CARES eligible cases pattern_IncidentNumberReq updated with context so it only applies to CARES eligible cases asssert_IncidentNumberLength removed pattern_IncidentAddressReq updated with context so it only applies to CARES eligible cases pattern_IncidentZipReq updated with context so it only applies to CARES eligible cases Removed pattern_DateOfArrestFormat as it duplicates NEMSIS XSD validation pattern_IncidentCityReq updated with context so it only applies to CARES eligible cases pattern_IncidentCountyReq updated with context so it only applies to CARES eligible cases pattern_IncidentStateReq updated with context so it only applies to CARES eligible cases pattern_IncidentStateReq assert messages updated pattern_EtiologyReq updated with context so it only applies to CARES eligible cases pattern_DestinationHospitalReq updated with CARES criteria pattern_PatientEthnicityReq updated with CARES context pattern_PatientGenderReq updated with CARES context -------------- 3.5.0.211008CP3_CARES_009 -------------- eArrest.10 rule removed ePatient.15 rule removed ePatient.16 rule removed ePatient.17 rule removed -------------- 3.5.0.211008CP3_CARES_008 -------------- Fix eDisposition.02 Rules - if eArrest.18 = 3018001 OR 3018005 OR 3018009 AND eDispostion.02 DOES NOT EXIST -> ERROR: You must document a destination facility (w/ code) on arrests that end in an ED. - if eArrest.18 = 3018003 AND eDispostion.02 EXISTS -> WARNING: You should not document a destination facility on arrests which expire in the field. - if eArrest.18 = 3018007 AND eDisposition.30 = 4230001 OR 4230003 AND eDispostion.02 DOES NOT EXIST -> ERROR: You must document a destination facility on arrests w/ ROSC that were transported. Patient Name rules relaxed in severity to allow more cases to enter CARES. -------------- 3.5.0.211008CP3_CARES_007 -------------- New eDisposition.02 Rule - if eArrest.18 = 3018001 OR 3018005 OR 3018009 AND eDispostion.02 DOES NOT EXIST -> ERROR: You must document a destination facility (w/ code) on arrests that end in an ED. - if eArrest.18 = 3018003 AND eDispostion.02 EXISTS -> WARNING: You should not document a destination facility on arrests which expire in the field. - if eArrest.18 = 3018007 AND eDisposition.30 = 4230001 OR 4230003 AND eDispostion.02 DOES NOT EXIST -> ERROR: You must document a destination facility on arrests w/ ROSC that were transported. -------------- 3.5.0.211008CP3_CARES_006 -------------- CARES End-of-event-related rules were improved to streamline import and match standard provider documentation. - If End of Event is documented as DNR in eArrest.16 and a conflicting choice in eArrest.18 a Warning (for eTimes.03 < 1/1/24) or Error (for eTimes.03 >= 1/1/24) will be produced. -------------- 3.5.0.211008CP3_CARES_005 -------------- Multiple enhancements to the Schematron were added to improve file validity: - Removed invalid non-whitespace character sequence ">" from Schematron file after variable declaration in rule "rule_IncidentCityReq". - Duplicate rule ID "rule_PatientAgeOrDOBReq" renamed to "rule_PatientDOBorUnknownReq". - Duplicate assert ID "assert_PatientAgeOrDOBReq" renamed to "assert_PatientDOBorUnknownReq". - Duplicate pattern ID "pattern_EtiologyReq" renamed to "pattern_EtiologyOther". - Duplicate rule ID "rule_WhoFirstAppliedAEDReq" renamed to "rule_WhoFirstAppliedAEDWithOtherValues". - Duplicate assert ID "assert_ResusAttemptRespReq" renamed to "assert_ResusAttemptRespReqInitiatedCPR". - Duplicate pattern ID "pattern_ResusAttemptRespReq" renamed to "pattern_ResusAttemptEMSReq". - Duplicate rule ID "rule_ResusAttemptRespReq" renamed to "rule_ResusAttemptEMSReq". - Duplicate pattern ID "pattern_DischargeDeathDateTimeFormat" renamed to "pattern_DischargeDeathDateTime". - Duplicate rule ID "rule_DischargeDeathDateTimeFormat" renamed to "rule_DischargeDeathDateTime". - Element has been added to all rules where it was missing. - Added UUID output into nemsisDiagnostic section. -------------- 3.5.0.211008CP3_CARES_004 -------------- New validation rules for Sustained ROSC added: - If Sustained ROSC is documented as "No" and "Yes" at the same time (multiple eArrest.12 elements with 3012003, 3012005, or 3012007 and at least one 3012001), a warning (for eTimes.03 < 1/1/24) or error (for eTimes.03 >= 1/1/24) will be issued. - If Sustained ROSC is documented as "Yes, Prior to Arrival at the ED" (eArrest.12 is 3012005), then another choice should also be documented using additional eArrest.12 with "Yes, At Arrival at the ED" (3012003) or "Yes, Sustained for 20 consecutive minutes". Otherwise, a warning will be issued. - If Sustained ROSC is documented as "Yes, Sustained for 20 consecutive minutes" (eArrest.12 is 3012007), then you must also document when ROSC occurred, using additional eArrest.12: at arrival at the ED (3012003) or prior to arrival at the ED (3012005). Otherwise, a warning (for eTimes.03 < 1/1/24) or error (for eTimes.03 >= 1/1/24) will be issued. Some obsolete validation rules related to Sustained ROSC were removed. For others, assertion messages have been updated to make them more compliant with NEMSIS Assertion Text guidelines. To improve the ability for vendors to integrate with CARES the Custom Configuration AgencyID has been removed. Agency will be determined from the incident dAgency.01, dAgency.02, and dAgency.04 values in myCARES on import. The associated schematron requirement for AgencyID has also been removed. -------------- 3.5.0.211008CP3_CARES_003 -------------- New validation rule for Arrest Witness Status added: - If Cardiac Arrest is documented but Arrest Witnessed By is not, a warning (for eTimes.03 < 1/1/24) or error (for eTimes.03 >= 1/1/24) will be issued. Assertion messages for validation rules related to Cardiac Arrest and Arrest Witnessed By elements were updated. -------------- 3.5.0.211008CP3_CARES_002 -------------- New validation rules for First Responders added: - If any eScene.ResponderGroup contains eScene.03 but none of eScene.ResponderGroup elements contain eScene.24 = Yes (9923003), a warning will be issued. - If CPR was initiated by first responder (eArrest.20 is 3020007, 3020009, or 3020011), there must be a eScene.ResponderGroup with eScene.03 and eScene.24 = Yes (9923003), otherwise warning (for eTimes.03 < 1/1/24) or error (for eTimes.03 >= 1/1/24) will be issued. - If AED was first applied by first responder (eArrest.21 is 3021007, 3021009, or 3021011), there must be a eScene.ResponderGroup with eScene.03 and eScene.24 = Yes (9923003), otherwise warning (for eTimes.03 < 1/1/24) or error (for eTimes.03 >= 1/1/24) will be issued. - If the patient was first defibrillated by first responder (eArrest.22 is 3022007, 3022009, or 3022011), there must be a eScene.ResponderGroup with eScene.03 and eScene.24 = Yes (9923003), otherwise warning (for eTimes.03 < 1/1/24) or error (for eTimes.03 >= 1/1/24) will be issued. - Multiple eScene.ResponderGroup elements containing eScene.03 and eScene.24 = Yes (9923003) will produce a warning. Some obsolete validation rules related to First Responders were removed. For others, assertion messages have been updated to make them more compliant with NEMSIS Assertion Text guidelines. -------------- 3.5.0.211008CP3_CARES_001 -------------- To improve tracking of CARES Schematron changes, the "schemaVersion" attribute for the CARES Schematron was updated from "3.#.#.######_###### (see Schematron Guide for recommended values)" to "3.5.0.211008CP3_CARES_001". This follows the format "_CARES_", where the CARES_VERSION is incremented every time new changes are introduced (e.g. the next CARES Schematron version after this will be "3.5.0.211008CP3_CARES_002"). -------------- September 2023 - 3.5.0 -------------- To improve the ability for vendors to integrate with CARES the Custom Configuration FormID has been removed and the proper value will be derived from the incident by myCARES on import. The associated schematron requirement for FormID has also been removed. -------------- July 2023 - 3.5.0 -------------- Who First Defibrillated the Patient (eArrest.22): - schematron validation results gives the [ERROR] message if the 'PN' attribute is present for eArrest.22 ResusAttemptResponder: - requires values in eArrest.22 when eArrest.03 (Resuscitation Attempted By EMS) is 3003001 (Attempted Defibrillation) - requires values in eArrest.20 when eArrest.03 (Resuscitation Attempted By EMS) is 3003003 (Attempted Ventilation) or 3003005 (Initiated Chest Compressions) -------------- May 2023 - 3.5.0 -------------- Form ID - now checks for empty value Agency ID - now checks for empty value Incident Number - now checks for empty value, also it should be less than 50 characters Service Date - now checks for empty value eArrest.14 - now checks for empty value and for validity of date format Incident Address - now checks for empty value Incident City - now checks for empty value Incident State - now checks for empty value. Also, it validates that the value corresponds to a valid state ID. Incident Zip - now checks for empty value Incident County - now checks for empty value Person First Name - now checks for empty value Person Last Name - now checks for empty value Patient Age - now checks for empty value and numeric range (1-99) Patient Date of Birth - now checks for empty value (can't be empty unless there is a DOB_Unknown element with the value of 1) Patient Gender - now checks for empty value Patient Ethnicity (ePatient.14) - now checks for empty value First Responder - now can be empty if there is also a NoFRDisp element with the value of 9923001 If NoFRDisp(eScene.24) is 1(9923001), InitiatedCPR(eArrest.20) should not be 3('3020007','3020009','3020011'), and FirstDefibPatient(eArrest.22) should not be 10(3022009), and WhoFirstAppliedAED(eArrest.21) should not be 10(3021009) Destination Hospital - now must be non-empty if End of Event is Pronounced Dead in ED, must be empty/absent if End of Event is Pronounced in the Field or Effort Ceased Due to DNR Who Initiated CPR: - Value is required unless resuscitation was not attempted - Requires confirmation if equals to 7701001 (Not Applicable) and resuscitation was attempted - Requires confirmation if equals to 3020013 and eArrest.07 is 3007003 or 3007005 - Requires confirmation if equals to 3020007 or 3020009 or 3020011 (first responder codes) and eScene.24 is 9923001 or 7701001 (Not Value) - Requires confirmation if equals to 3020013 and eArrest.22 is 3022001, 3022003, 3022005, 3022009, 3022007 or 3022011 Location Type (eScene.09) - now checks for empty value Location Type Other - now checks for Location Type (eScene.09) with Other (Y92.89) value. Bystander CPR Provided ID - schematron validation results gives the result with the [WARNING] if BystanderCPRProvidedID is 3. Was AED Applied Prior: - Can't be empty string - Requires confirmation if equals to 3007005 and eArrest.22 is 7701001 (Not Applicable) - Requires confirmation if equals to 3007005 and eArrest.22 is 3022013 - Requires confirmation if equals to 3007003 and eArrest.22 is 3022001, 3022003, 3022005, 3022009, 3022007 or 3022011 - Requires review if equals to 3007003 and eArrest.11 is 3011011, 3011013 or 3011009 - If equals to 3007005 then eArrest.21 and eArrest.22 must match Presumed Cardiac Arrest Etiology (eArrest.02) - now checks for empty value Presumed Cardiac Arrest Etiology Other - now checks for Presumed Cardiac Arrest Etiology ID - 6 (3002011) Resuscitation Attempted EMS (eArrest.03): - requires confirmation if equals to 2 - '3003007', '3003009', '3003011' and eArrest.18 is 2 or 3 - '3018001', '3018005', '3018007', '3018009', '3018011' - requires confirmation if equals to 2 - '3003007', '3003009', '3003011' and eArrest.07 is 5 - '3007005' - requires confirmation if equals to 2 - '3003007', '3003009', '3003011' and custom element 911RespCPR is '1' Who First Applied the AED: - now checks for empty string value if eArrest.07 is 3007003 or 3007005 - requires confirmation if equals to 10('3021009') or 11('3021007', '3021011') and NoFRDisp(eScene.24) is 1('9923001') - requires confirmation if equals to 10('3021009') or 11('3021007', '3021011') and FirstDefibPatient(eArrest.22) is 1('3021009'), 2('3021007'), 5('3021011') - requires confirmation if equals to 1('3021001') or 2('3021003') or 6('3021005') and LocationType(eScene.09) is 1('Y92.01') Who First Defibrillated the Patient (eArrest.22): - can`t be empty string - requires confirmation if equals to 10 ('3022009') and NoFRDisp(eScene.24) is 1('9923001') and WhoFirstAppliedAED(eArrest.21) is 11('3022007', '3022011') - requires confirmation if equals to 8 ('7701001') and custom element ROSCStart is 3 or 5 911RespCPR: - can`t be empty string - requires confirmation if equals to 2 and ROSCStart is 4 First Arrest Rhythm of Patient (eArrest.11): - requires confirmation if equals to 0('3011011') or 1('3011013') or 6('3011009') and FirstDefibPatient(eArrest.22) is 8('7701001') Sustained ROSC: - can`t be empty string - requires confirmation if equals to 4('3012003', '3012005', '3012007', '3012003', '3012007', '3012003') and eArrest.18 is 1('3018003') - requires confirmation if equals to 3('3012005', '3012007') or 4('3012003', '3012005', '3012007', '3012003', '3012007', '3012003') and the custom element ROSCStart is 1 - requires confirmation if equals to 2('3012001') and the custom element ROSCStart is not 1 and is not empty Was Hypothermia provided in the field (eArrest.10) - now checks for empty value End Of Event - now checks for empty value ROSCStart: - requires confirmation if equals to 2 and ResusAttemptEMS(eArrest.03) is 1('3003001', '3003003', '3003005') DischargeDeathDateTime - now checks for empty value NoFRDisp(eScene.24) - If the field is present, please verify that it is set to 1(9923001) FRDispatched - it warn when NoFRDisp(eScene.24) is true and FR_DISPATCHED has a value FREnroute - it warn when NoFRDisp(eScene.24) is true and FREnroute has a value FROnscene - it warn when NoFRDisp(eScene.24) is true and FROnscene has a value ResusAttemptResponder: - requires values in eArrest.07, eArrest.20, and eArrest.22 when eArrest.03 is 3003001 (Attempted Defibrillation), 3003003 (Attempted Ventilation), or 3003005 (Initiated Chest Compressions) -------------- December 2020 - 3.5.0 -------------- 3.5.0 Introduced. Please see CARES XML Import Data Dictionary for 3.5.0 for details