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IL - Illinois

Contact Name: Dan Lee
  Lead, Information Management Systems
  Illinois Department of Public Health
  122 South Michigan Avenue
  Chicago IL  60603
Phone: (312) 814-0056
Email: Daniel.Lee@illinois.gov
EMS Website: IIllinois Department of Public Health, Division of Emergency Medical Services and Highway Safety (EMS)

This version of the State EMS Forms was posted on this site on 7/31/2007, and revised by the state on 7/26/2009. Last updated 08/19/2010.

Per Dan Lee:

The database is currently being transitioned to conform to the NEMSIS standard (April 2010). Additionally a web-based data submission option will be added to the state’s system during the summer of 2010.

Provider's have to be compliant with the new data elements by April 2011.

Illinois NEMSIS Specifications

 Illinois began accepting NEMSIS-compliant data from EMS agencies during the 2nd quarter of 2010 and is not currently submitting data to the National EMS Database.

Click on the thumbnails below to view a full sized image.

 Illinois Patient Care Report page 1     Illinois Patient Care Report page 2
 Patient Care Report Form 2001
   

      

Patient Care Report Form 2010

Select the following to view a printable Acrobat (.PDF) version.  pdf_acrobat_logo

Illinois EMS Report  2/2002(.PDF,1954.25k)

Illinois Prehospital Transport Dataset, Part I: EMS Dataset (EMS Event Information) 3/2010 (.PDF,172.92k)

Illinois Prehospital Transport Dataset, 1/2009 Part 2: Demographic Dataset (Information about the EMS Agency) (.PDF,83.39k)

Illinois Prehospital Care Report Form Instruction Manual – Version 1.1, 4/2010 (.PDF,512.4k)

NEMSIS-compliant Illinois OMR forms 4/2010 (.PDF,341.67k)

Data Validation Rules 4/2010 (.Doc,115.5k)

Instruction Manual for the Illinois EMS Prehospital Care Report Form - For form version dated 02/02 (.PDF,10093.2k)

Illinois Pre-Hospital Care Instruction Manual 7/2002(.PDF,12180.87k)

Click on the following links to view the corresponding files:

Resources for Converting from Paper-Based to Electronic Submission of EMS Pre-Hospital Data

Data Plan:  
Reporting Website: Illinois Department of Public Health EMS Reporting System
EMS Data Dictionary: Illinois Prehospital Transport Dataset, Part I: EMS Dataset (EMS Event Information) 3/2010

Illinois Prehospital Transport Dataset, 1/2009 Part 2: Demographic Dataset (Information about the EMS Agency)

Reporting Procedure Manual: Illinois Prehospital Care Report Form Instruction Manual – Version 1.1, 4/2010
EMS Run Statistics: Illinois Department of Public Health EMS Reporting System - Prehospital Query
Trauma System: Illinois Department of Public Health - Trauma Registry

NOTE:  You will need Acrobat Reader to view much of the catalogue content.  If you need the current version of Acrobat Reader, you may download it for free from: 
http://www.adobe.com/products/acrobat/readstep2.html

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Last edited:08/19/2010

 

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