Canonical definitions for the NEMSIS v3.5 → IHE-conformant FHIR R4 translation engine at github.com/fhirEMS/emsinterop. Everything here is authored by this project; nothing here redefines an identifier owned by HL7, IHE, SNOMED or LOINC.
The IHE EMS profiles leave much of a working translator undecided, so this project decides — and says so. Those decisions are not conformance, and the difference is declared rather than blurred:
urn:emsinterop:resource-id name no document and stay URNs deliberately.Each entry records what the IHE profiles leave open, what this project does instead, and — the part usually missing — what makes the local decision go away. A decision with no retirement trigger is a permanent fork wearing a temporary label.
| Gap | What is open | What we do | Retires when |
|---|---|---|---|
mapping-table-emptyverified 2026-08-07 | NEMSIS-Mapping.html leaves the FHIR-path column empty on ~90-95% of rows; only scattered entries such as Organization.identifier are populated. source | Author the complete field-level mapping for all NEMSIS 3.5 national elements (ADR-005), dispositioning every element as Mapped/Seeded/Deferred rather than dropping any. | IHE populates the FHIR-path column. Ours then becomes a conformance test against theirs rather than the source. |
composition-sectionsverified 2026-08-07 | The Medical Summary Composition profile defines three mandatory sections (Problems, Allergies, Medications) with open slicing, and no section for vitals, procedures, EMS course or narrative. source | Emit additional LOINC-coded sections (Vital Signs 8716-3, Procedures 47519-4, EMS Narrative 28568-4, EMS Course 46240-8). The profile's slicing is OPEN, so these are conformant, not a deviation — most clinical panels would otherwise have no home in the document at all. | mPSC defines its own clinical sections. Ours align to the codes it picks; where they differ, theirs win. |
nemsis-codesystem-placeholdersverified 2026-08-07 | CodeSystem-NEMSIS contains 18 placeholder concepts with 'TODO: JFM' displays, including malformed codes 99270235, C7 and todo1. source | Keep REFERENCING the mPSC canonical in coding.system so our data is conformant the day the IG is fixed, but publish our registry-derived CodeSystem (2,321 concepts, content=fragment) under our OWN canonical. Publishing ours at theirs would be two conflicting definitions of one identifier. | IHE publishes a usable NEMSIS CodeSystem. We then drop ours and rely on theirs; no coding.system changes, because we never stopped pointing at it. |
outcome-delegated-to-qoreverified 2026-08-07 | eOutcome is delegated to the QRPH 'QORE' profile, which is named but not linked, bound or profiled anywhere in the IG. source | Use the FHIR-native representation rather than inventing a shape: discharge disposition rides on Encounter.hospitalization.dischargeDisposition (NUBC-coded, the vocabulary eOutcome.01/.02 already speak) with hospitalization.destination for the receiving facility. The inbound loop (ADT^A03 / FHIR discharge summary) writes eOutcome back into NEMSIS for the state registry rather than modelling it a second time in FHIR. Nothing bespoke is emitted; what is missing is an IHE-blessed PROFILE to claim, not a place to put the data. | QORE is published with a binding. We then claim it; the underlying elements are already the FHIR-native ones, so this is a claim to add rather than a model to replace. |
prior-care-vitals-flagverified 2026-08-07 | NEMSIS eVitals.02 records whether a reading was obtained before this unit's care began. FHIR has no element for it and the IG proposes none, so the distinction is lost on every vital sign. source | Carry it in a project extension. A reading taken by a prior crew is a materially different clinical claim from one this crew took, and silently flattening the two is the kind of loss this project exists to prevent. | IHE or US Core defines an equivalent. Dual-carry for one minor release, then drop ours — the pattern ADR-006 already uses for US Core vs pcc-uv race/ethnicity. |
no-source-version-pinverified 2026-08-07 | No NEMSIS version is declared anywhere on the mapping page, so the source scope is ambiguous between 3.4, 3.5.0 and 3.5.1. source | Pin explicitly to NEMSIS 3.5.0 and handle 3.5.1 as declared deltas (ADR-007), rather than guessing what the table means. | IHE pins a version. If it differs from 3.5.0, that is a scope change for this project, not a mapping tweak. |
transport-binding-looseverified 2026-08-07 | EMS-Overall names no ITI transaction numbers; the transport binding is described narratively. source | Treat transport as a pluggable interface with ITI-65 (MHD Provide Document Bundle) as the default binding (ADR-008), so a different binding is configuration rather than a rewrite. | EMS-Overall names its transactions. The default changes to whatever it names; the interface does not. |