PLEASE DOWNLOAD LATEST DOCUMENTS AT https://mycares.net/cares_xml_upload_docs.jsp 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 eRecord.01 for N3.4.0 duplicate handling, see 3.4.0 XML Data Dictionary for details (page 2). -------------- 3.3.4.160316CP1_CARES_003 -------------- Multiple enhancements to the Schematron were added to improve file validity: - Removed invalid non-whitespace character "\" from Schematron file after "pattern_FirstDefibPatientValues" pattern declaration. - Duplicate assert ID "assert_CPRTimeReq" renamed to "assert_CPRTimeNotReq". - Duplicate assert ID "assert_FirstDefibPatient" renamed to "assert_FirstDefibPatientNoFRDisp". - Duplicate assert ID "assert_FirstDefibPatient" renamed to "assert_FirstDefibPatientROSC". - Duplicate assert ID "assert_DefibTimeReq" renamed to "assert_DefibTimeNotReq". - Duplicate rule ID "rule_PoliceAEDReq" renamed to "rule_PoliceDefibReq". - Duplicate assert ID "assert_SustainedROSCAndROSCStart" renamed to "assert_SustainedROSCAndROSCStart2". - Duplicate assert ID "assert_FirstRhythm" renamed to "assert_FirstRhythmShockable". - Duplicate rule ID "rule_PatientAgeOrDOBReq" renamed to "rule_PatientDOBorUnknownReq". - Duplicate assert ID "assert_PatientAgeOrDOBReq" renamed to "assert_PatientDOBorUnknownReq". - Duplicate pattern ID "pattern_WasAEDAppliedPriorReq" renamed to "pattern_WasAEDAppliedPriorWithOtherFields". - Duplicate rule ID "rule_WasAEDAppliedPriorReq" renamed to "rule_WasAEDAppliedPriorWithOtherFields". - Duplicate assert ID "assert_WasAEDAppliedPriorFirstDefibPatient" renamed to "assert_WasAEDAppliedPriorFirstDefibPatientEMSResp". - Duplicate assert ID "assert_WasAEDAppliedPriorFirstDefibPatient" renamed to "assert_WasAEDAppliedPriorFirstDefibPatientNoAED". - Duplicate assert ID "assert_WasAEDAppliedPriorFirstDefibPatient" renamed to "assert_WasAEDAppliedPriorFirstDefibPatientFirstApplied". - Duplicate pattern ID "pattern_EtiologyReq" renamed to "pattern_EtiologyOther". - Duplicate pattern ID "pattern_PoliceDefibReq" renamed to "pattern_911RespCPRReq". - Duplicate pattern with ID "pattern_FROnsceneFormat" removed from Schematron file. - Duplicate pattern with ID "pattern_FRDispatchedFormat" removed from Schematron file. - Duplicate pattern with ID "pattern_FREnrouteFormat" removed from Schematron file. - Invalid pattern ID "pattern_DOB_Unknown Value" renamed to "pattern_DOB_Unknown_Value". - Invalid rule ID "rule_DOB_Unknown Value" renamed to "rule_DOB_Unknown_Value". - Invalid role name "[WARNINGS]" in assert "assert_IncidentNumberLength" changed to "[WARNING]". - Element has been added to all rules where it was missing. -------------- 3.3.4.160316CP1_CARES_002 -------------- 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. -------------- 3.3.4.160316CP1_CARES_001 -------------- To improve tracking of CARES Schematron changes, the "schemaVersion" attribute for the CARES Schematron was updated from "3.3.4.160316CP1" to "3.3.4.160316CP1_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 "3.3.4.160316CP1_CARES_002"). -------------- September 2023 - 3.4.0 -------------- 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. -------------- May 2023 - 3.4.0 -------------- Form ID - now checks for empty value Agency ID - now checks for empty value Service Date - now checks for empty value eArrest.14 - now checks for empty value and for validity of date format Incident Number - now checks for empty value, also it should be less than 50 characters Incident Address - now checks for empty value Incident City - now checks for empty value Incident Zip - now checks for empty value Incident County - now checks for empty value Incident State - now checks for empty value. Also, it validates that the value corresponds to a valid state ID. 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 First Responder - now can be empty if there is also a NoFRDisp element with the value of 1 Patient Ethnicity (ePatient.14) - now checks for xsi:nil=true and presence of NV attribute LocationType - now checks for empty value Location Type Other - now checks for Location Type ID - 14 - with Location Type Other value Medical History - now checks for empty value Destination Hospital - now must be non-empty if End of Event is Pronounced Dead in ED or Ongoing Resuscitation in ED, must be empty/absent if End of Event is Pronounced in the Field or Effort Ceased Due to DNR Presumed Cardiac Arrest Etiology - now checks for empty value Presumed Cardiac Arrest Etiology Other - now checks for Etiology ID - 6 - with Etiology Other value CPR Time - now checks for Initiated CPR - 8 - with CPR Time value Defib Time - now checks for First Defib Patient - 8 - with Defib Time value Resus Attempt EMS - now checks for empty value, also it checks for: InitiatedCPRValue - 3, 4 - with ResusAttemptEMSValue - 2 EndOfEventValue - 2, 3 - with ResusAttemptEMSValue - 2 AEDUsedPriorEMS - 5 (3007005) - with ResusAttemptEMSValue - 2 FirstDefibPatient - 1, 2, 4, 5, 10, 11 - with ResusAttemptEMSValue - 2 911RespCPR - 1 - with ResusAttemptEMSValue - 2 NoFRDisp - if 1, then InitiatedCPR should not be 3, and WhoFirstAppliedAED/FirstDefibPatient should not be 10 Who Initiated CPR: - Can be empty string if ResusAttemptEMS is 2 - Should not be 3 if NoFRDisp is 1 - Requires confirmation if equals to 8 and ResusAttemptEMS is 1 - Requires confirmation if equals to 4 and eArrest.07 is 3007003 or 3007005 - Requires confirmation if equals to 4 and FirstDefibPatient is 1,2,3,5,10 or 11 Did Law Enforcement initiate CPR? - now checks for empty value if InitiatedCPR is 3 Bystander CPR Provided ID - schematron validation results gives the result with the [WARNING] if BystanderCPRProvidedID is 3. Was AED Applied Prior - now checks for empty value, also it checks for: FirstDefibPatient - 8 - with WasAEDAppliedPrior - 5 (3007005) FirstDefibPatient - 4 - with WasAEDAppliedPrior - 5 (3007005) FirstDefibPatient ID should match with WhoFirstAppliedAED ID - with WasAEDAppliedPrior - 5 (3007005) FirstDefibPatient - 1, 2, 5, 10, 11 - with WasAEDAppliedPrior - 6 (3007003) FirstRhythm - 0 (3011011), 1 (3011013), 6 (3011009) - with WasAEDAppliedPrior - 6 (3007003) First Defib Patient - now checks for empty value, also it checks for: NoFRDisp - 1 with FirstDefibPatient - 10 and WhoFirstAppliedAED - 11 ROSCStart - 3, 5 with FirstDefibPatient - 8 Police Defib - can`t be empty string. 911 Resp CPR - can`t be empty string, also it checks for ROSCStart - 4 - with 911RespCPR - 2 FirstRhythm - either eCustomConfiguration.firstRhythm or eArrest.11 is required when firstDefibPatient is not empty, also it checks for FirstDefibPatient - 8 with FirstRhythm - 0, 1, 6. Who First Applied the AED: - Now checks for empty string value if eArrest.07 is 3007003 or 3007005 - Requires confirmation if equals to 10 or 11 and NoFRDisp is 1 - Requires confirmation if equals to 10 or 11 and FirstDefibPatient is 1, 2, or 5 - Requires confirmation if equals to 1, 2 or 6 and LocationType is 1 PoliceAED - required if WhoFirstAppliedAED is 3 Sustained ROSC - can`t be empty string, also it checks for: EndOfEventValue - 1 - with SustainedROSC - 4 ROSCStart - 1 - with SustainedROSC - 3, 4 ROSCStart - 1, '' - with SustainedROSC - 2 Was hypothermia care provided in the field - now checks for empty value End of Event - now checks for empty value ROSCStart - requires confirmation if equals to 2 and ResusAttemptEMS is 1 FR Dispatched - it warn when NoFRDisp is true and FR_DISPATCHED has a value FR Enroute - it warn when NoFRDisp is true and FREnroute has a value FR Onscene - it warn when NoFRDisp is true and FROnscene has a value -------------- December 2020 - 3.4.0 -------------- eScene.15 - Street address now accepts 255 characters to align with NEMSIS. ePatient.16 - Age Units now accepts hours and minutes and calculates days. ePatient.14 - Race/ethnicity was a single select field in CARES and is now multi-select. "Arrest Witnessed Status" field has been added to CARES form. "Arrest After Arrival of EMS Responder" and "Arrest Witnessed" fields have been removed and now map to "Arrest Witnessed Status" field "Who Initiated CPR" field selections have been relabeled. Sub-question "Did Law Enforcement initiate CPR" has been added to "Who Initiated CPR". New answer choice "Unknown" added to "Type of Bystander CPR Provided". "Who First Applied the AED" field selections have been relabeled. "Did police first apply the AED" has been removed from the CARES form, but is still in the XML to map to new answer choices. "Who first defibrillated the patient" field selections have been relabeled. "Did police first defibrillate the patient" has been removed from the CARES form, but is still in the XML to map to new answer choices. Added "Time of Sustained ROSC" custom field. Mapping "Time Resuscitation Terminated" from eArrest.15. Added new selection, "Used existing tracheostomy" to "Advanced airway successfully placed in the field". Mapped from eAirway.03 = 4003015. Removed "Endotracheal Tube" from "ITD Used" and mapping this choice to Oral/Nasal ET. "Were drugs Administered" - "Narcan" relabeled to "Naloxone". Added "Calcium Chloride" and "Magnesium Sulfate". "Vascular Access" - removed "No IV" and added "None" to selections. "STEMI" locations Anterior/Inferior removed. "ER Outcome" Relabeled "Resuscitation Terminated in ED" to "Died in the ED". "Hospital Medical Record Number" is now mapped from eOutcome.03/eOutcome.04 instead of custom element. Now saving data in eResponse.04, "EMS Response Number", for improving searches with unique identification of records. -------------- June 2020 -------------- dAgency.01, dAgency.02, and dAgency.04 will now be checked against the custom element AgencyID when saving each PatientCareReport. The files must now contain the proper header with matching agency information that will be part of the agency setup. -------------- September 2019 -------------- New hospital fields added to XML and schematron DischargeDeathDateTime - Date and time of Discharge/Death (format checked in schematron) HypoNotInitiatedHosp - Why was hypothermia care not initiated or continued in the hospital (value checked in schematron) HospMedicalRecordNo - Hospital Medical Record Number (not added to schematron) -------------- December 2018 -------------- We will map eTimes.03 to Date of Arrest if the custom element servicedate and eArrest.14 are both nil. In this case, the CARES Schematron will produce a WARNING message. -------------- December 2017 -------------- We will now map Not Values 7701001 Not Applicable and 7701003 Not Recorded to the "Unknown" value in myCARES. There is no need to use the custom element "EthnicityUnknown" if you are mapping it using not values in your system. However, we will leave the element there for the time being to accommodate anyone using it. -------------- November 2017 -------------- ---- Was hypothermia care provided in the field ---- Some vendors who submit 3.4.0 files cannot pass a Pertinent Negative in this field (for eProcedure.03) and some states do not collect the data. There is now an agency setting which will default all records to "No" if there is no value passed in the XML or selected and saved in the form. "Yes" can still be passed in a file/saved in the Rev 4 form. ----------- July 2017 ----------- Added Narcan as an answer choice in CARES Rev 4 form. No action needed on part of vendors. Several RXNorm codes will automatically map to this answer choice from eMedications.03. ----------- February 2017 ----------- Presumed Cardiac Etiology, eArrest.02 has been updated in myCARES to reflect all values in NEMSIS, mapping to new values in the myCARES form. If already passing all values in eArrest.02, no action on the part of vendors is necessary. Added FATAL CARES Schematron rules: If NULL or null is passed as a value in the following elements, the file will be rejected: FirstResponder DOB_Unknown Starting in February, the value for WhoFirstAppliedAED Lay Person Medical Provider is changing from "5" to "6". There was an issue in the code and it got copied as the wrong value in the import documentation. The documentation will be updated for vendors that have not yet developed their XML. For existing vendors, we will map the value of "5" to "6" in the myCARES application. No action necessary for vendors already sending data. ----------- January 2017 ----------- Added Other text field in CARES form for Advanced Airway. Does not require any intervention from vendors. We will simply map the following to the Other field: 4003001 Maps to Other radio and Cricothyrotomy Tube to other text field in CARES 4003013 Maps to Other radio and SAD-Other to other text field in CARES 4003015 Maps to Other radio and Tracheostomy Tube to other text field in CARES 4003005 Maps to Other radio and Other-Invasive Airway to other text field in CARES To cut down on FATAL errors, we made the following changes to the schematron: - Allow date or dateTime format for custom element servicedate. - FirstRhythm missing and eArrest.11 nil was causing a fatal error. This condition will now only produce a warning. - Allow missing PoliceAED and PoliceDefib - produce warning. ------------ October 2016 ------------ Added a custom element (to 3.3.4 only) to accommodate vendors who cannot send the GNIS code. Use IncidentCityStr to pass the name of the city. ------- August 2016 ------ Changed all documentation, web pages, and parsing to remap EMS times to NEMSIS elements and create 3 new custom elements for First Responder times. EMS times mapped to eTimes (Previously First Responder times were mapped to eTimes): Time Ambulance dispatched custom element removed (AmbDispatched) and now mapped to eTimes.03 Time Ambulance en route custom element removed (AmbEnRoute) and now mapped to eTimes.05 Time Ambulance arrived at scene custom element removed (AmbArrivedAtScene) and now mapped to eTimes.06 Time Ambulance left scene custom element removed (AmbLeftScene) and now mapped to eTimes.09 Time Ambulance arrived at ED custom element(AmbArrivedAtED) removed and now mapped to eTimes.11 Mappings for eTimes.01 and eTimes.07 stay as is. New custom elements created and FR times remapped: Time First Responder dispatched remapped to new custom element FRDispatched Time First Responder en route remapped to new custom element FREnroute Time First Responder arrived at scene remapped to new custom element FROnscene June 2016 ------ Revamped the XML Data Dictionary Added SOAP web service and file validation to Beta site only Web pages containing information updated and items still in work Feedback welcome eScene.17 must be populated with correct GNIS feature_id, not a string. We will be using GNIS going forward, not FIPS. eScene.18 must be populated with the proper state ANSI code. Incident number has been expanded to maxLength = 32. First Arrest Rhythm will be accepted in eArrest.11 (3.4.0) or the custom FirstRhythm (3.3.4) element. Was Hypothermia Care Provided in the field will be accepted in eArrest.10 (3.3.4) or if eProcedure.03 = 430189000 with a PN mapping to "No" in myCARES. Mechanical CPR Device Used will be accepted in custom element MechCPRDevice or if eProcedure.03 = 429283006 with a PN mapping to "No" in myCARES. ITD Used will be will be accepted in custom element ITD or if eProcedure.03 = 441893003 with a PN mapping to "No" in myCARES. 12 Lead will be will be accepted in custom element 12Lead or if eProcedure.03 = 268400002 with a PN mapping to "No" in myCARES. Time of 1st CPR will be accepted in custom element CPRTime(3.3.4) or eArrest.19 (3.4.0). Custom element servicedate OR eArrest.14 will be accepted for the Date of Arrest. ---------- Changes 12/4/2014 - Updated Data Dictionary - improved descriptions for several elements ("Other" custom elements, Incident County, etc). Changes 08/22/2014 Added optional string element "CardiacEtiologyOther" to pass an etiology (string) other than what is listed in the NEMSIS element eArrest.02. See XML Data Dictionary for more details. Changes 7/3/2013 Clarification on eHistory.08- In order to fix an XML validation issue, use Pertinent Negative value 8801023 for "Unknown" value we have confirmed that the 3.3.2 XSD allows the value of I10 for Hypertension, so please use this value. Changes 6/27/2013 GNIS codes have been updated for IL,CA,MN,TX,GA,PA and WA in the db. Please see XML Data Dictionary for details on eScene.17 Changes 6/06/2013 Clarification on eAirway.02- Advanced Airway successfully placed in the field The logic for the answer choice "No" really means the airway attempt was "Unsuccessful" and that the airway placement was attempted. It does NOT mean that the question was not applicable, not documented, etc. Not Values for this field will not be mapped. eAirway.02 (Was advanced airway placed successfully in the field) is of datetime type. If you pass a date for this greater than the minInclusive value for this element, we will record this as a "Yes" answer. If you pass the minInclusive value of 1950-01-01T00:00:00-00:00 we will record a "No". You must pass a datetime value for eAirway.02 if you are passing any real value for eAirway.03, as it is a followup question (If yes, please specify). The data dictionary has been updated to reflect this. Example: Pass a "No" value: 1950-01-01T00:00:00-00:00 Pass a yes with Combitube value 2013-06-04T00:00:00-08:00 4003007 Changes 5/13/2013 Clarification on eHistory.08- Medical history Use R69 for "Unknown" and 8801015 for "No". Previously, R69 was mapped to both values. Changes 5/10/2013 ****ALL VENDORS*** We improperly had vendors map the incident number to eRecord.01. The Incident Number should be mapped to eResponse.03. This element is already in the XML. We apologize for any inconvenience. **FOR THE BELOW 5/10/13 CHANGES, THIS ONLY AFFECTS VENDORS PASSING HOSPITAL FIELDS (OTHER VENDORS NOT AFFECTED)** The hospital elements were redesigned to permit outcome data from a destination hospital OR a transfer hospital. New elements were added to accommodate transfer hospital data. These elements will be mapped appropriately to the existing hospital fields in the CARES application. The new elements are all custom: - EROutcomeTrans - Hypothermia_Provided_Hosp_Trans - HospOutcomeTrans - HospOutcomeDNRTrans - HospDispositionTrans - NeuroOutcomeTrans To pass data accurately, you must use specific combinations of the existing destination hospital elements plus the transfer elements (if applicable). Please refer to the Hospital section of the XML Data Dictionary for more details. Changes to Documentation (03/19/2013) - For eTimes.02, since this element is optional, is not nillable, and does not except NV- please pass min value for NOT value as follows: 1950-01-01T00:00:0000:00 Changes to XML (03/07/2013) - eDisposition.01 was changed to eDisposition.02. The value passed for this is the CARES defined import value set up for the destination hospital - Medical History (eHistory.08) field was listed as xs:integer in the dictionary, changed to xs:string - Various descriptions in documentation in response to questions/to make things more clear. - Note: found documentation error in data dictionary- Date of Arrest maps to custom element servicedate and not eTimes.02 (which is CAD service date) - First Responder moved to custom element - we will not use eResponse.01 for this field. See FirstResponder custom configuration. - eArrest.08 moved to custom element WhoFirstAppliedAED and made into a required field Changes to XML (12/17/2012) - Incident City redefined from Custom element to NEMSIS eScene.17. - Removed nemsisCode incidences from custom configuration (codes remain the same). - Updated descriptions - "Unknown" answer removed from MyocardialInfarction - Updated Data Dictionary with descriptions - Updated CARES_NEMSISDetails spreadsheet