The North Central EMS Institute and its partners organized meetings to develop the EMS industry’s initial pilot set of clinical and operational performance indicators. The first meeting was held in Chicago in 2005. A follow up session was conducted in 2007 in Kansas City.

There is a lot of federal activity in the health arena surrounding performance improvement, quality improvement, benchmarking and indicator development. There is also some activity within EMS in these arenas with development of the National EMS Information System (NEMSIS), the Open Source EMS Initiative’s Performance Indicator Development Project, and the National EMS Performance Measures Project. However, EMS is behind the curve in relationship to other sectors of the healthcare community.

In March 2005, the Medicare Payment Advisory Commission (MedPAC) advised Congress that it needs to adopt “pay for performance” programs for hospitals and other specified care providers, stating “Medicare payment systems are neutral and sometimes negative toward quality.” It advises Congress to support methods that measure quality-enhancing activities that are supported by information technology.

It is a good thing MedPAC did not include the EMS industry within the list of providers to move to pay for performance, because EMS isn’t ready. We, as organizations representing the major facets of the EMS industry, need to lead this process ourselves in a pro-active manner rather than have it developed in haste under a future mandate that affects our federal funding and reimbursement.

The meeting in Chicago focused on identifying a limited set of performance measures for the EMS industry. We want to choose a pilot set of indicators that can be derived from the data elements included in the NEMSIS data set. The Kansas City meeting made updates to the measures.