Inter-system care delivery is designed to include all the data fields related to EMS and transfers from outside facilities to streamline data entry. It is completed for the pre-admit STEMI, end STEMI, unstable angina, or low-risk chest pain patient types. Sequence 15464, call to 911, date and time, seeks to capture the date and time the call was placed to a 911 operator. This data field is optional for all those facilities not seeking chest pain center accreditation or chest pain center certification. Sequence 15593, emergency medical services agency NPI, seeks to capture the national provider identifier number, or NPI, specific to the responding EMS agency. It can be obtained from the National Plan and Provider Enumeration System, for which we have provided a link. If a volunteer EMS agency does not have an NPI number assigned, leave sequence 15593 blank. Sequence 15465, STEMI alert, date, time, seeks to capture the date and time the STEMI alert was activated on arrival to this facility, meaning what time did EMS alert the facility of their arrival with a STEMI patient, which should occur prior to the EMS unit arriving at the facility with the patient. Sequence 15468, patient-centered reason for delay to transfer, seeks to capture a patient-centered reason that occurred at the transferring facility and delayed the patient's departure within the first 30 minutes after arrival at the transferring facility, or within 30 minutes after a STEMI diagnosis. A patient-centered reason for delay is an issue or condition understood and specifically documented to originate with the patient. It is not associated with the healthcare system, such as staffing or process issues. To warrant coding yes, the patient-centered reason must be identified within the first 30 minutes of the patient's arrival at the transferring facility, or after the diagnosis of STEMI, and be responsible for affecting the patient's departure time. Some examples of this may include patient's delay in providing consent for transfer, the patient has a cardiac arrest and or requires intubation prior to being transferred, an emergency CT was needed to rule out CVA, or the patient was too unstable for transport. Some examples of this are cardiovascular instability, acute heart failure, or cardiogenic shock. There are times when the freestanding ED or transferring facility has the same AHA number as the parent facility. In those instances, sequence 15466, same ID as parent facility, is selected.

inter-system care delivery

data entry

patients

sequences

data fields