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Data missingness in the Michigan NEMSIS (MI-EMSIS) dataset: a mixed-methods study.

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High rates of missing data in Michigan's National Emergency Medical Services Information System (NEMSIS) persist, hindering prehospital care quality improvement. Addressing data quality issues is crucial for effective electronic health record utilization.

Keywords:
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Area of Science:

  • Emergency medicine
  • Health informatics
  • Data quality management

Background:

  • The National Emergency Medical Services Information System (NEMSIS) is vital for tracking prehospital care.
  • Electronic data collection aims to improve the quality of emergency medical services (EMS).
  • Data completeness is essential for leveraging electronic data for quality improvement initiatives.

Purpose of the Study:

  • To evaluate missing and invalid data values within the Michigan (MI) National Emergency Medical Services Information System (MI-NEMSIS).
  • To explore the root causes of data deficiencies in MI-NEMSIS.
  • To inform strategies for enhancing data reporting and prehospital care quality.

Main Methods:

  • A mixed-methods approach was employed to analyze data reporting trends.
  • Quantitative analysis assessed missing/invalid values for 18 key variables in MI-NEMSIS (2010-2015), stratified by EMS agency, software, and Medical Control Authorities (MCAs).
  • Qualitative data were gathered through 4 focus groups and 10 key-informant interviews with EMS personnel.

Main Results:

  • Only 5 out of 18 variables had <10% missingness; significant variation existed across strata.
  • No clear time-based trends in missing or invalid values were observed between 2010 and 2015.
  • Identified causes included data-mapping challenges, ambiguous variable definitions, and inadequate data collection infrastructure/training.

Conclusions:

  • High levels of missing data in MI-NEMSIS are prevalent among EMS agencies and MCAs and are not improving.
  • Incomplete electronic data collection limits its potential for supporting prehospital quality improvement.
  • Investment in data collection and reporting improvement efforts is urgently needed for effective NEMSIS utilization.