CARES Annual Report 2018 | 13 Reporting Capability The CARES software includes functionality to automate data analysis for participating EMS agencies. The reports include 911 response intervals, delivery rates of critical interventions (i.e. bystander CPR, dispatcher CPR, public access defibrillation [PAD]), and community rates of survival using the Utstein template. An EMS agency has continuous access to their data and can generate reports by date range at their convenience. The software is also capable of aggregate reporting such that CARES staff can generate custom reports for benchmarking and surveillance purposes. In addition, hospitals have access to facility-specific reports, allowing users to view pre-hospital and in-hospital characteristics of their patient population with benchmarking capability. A robust query feature also allows agencies and hospitals to create customized searches of their data. These search results can be easily exported to Microsoft Excel for further analysis. Data Validation The CARES quality assurance process is one of the strengths of the registry, as a number of measures are taken to ensure the integrity and accuracy of the data. These measures include standardized training of all CARES users, built-in software logic, an audit algorithm ensuring consistent data validation across the registry, and a bi-annual assessment of population coverage and case ascertainment. Training, Education, and Support Training, education, and ongoing technical and operations support are key components of CARES that contribute to the registry’s success and enhance the experience for participating sites. During the enrollment process, EMS and hospital users receive extensive training from CARES staff on the data elements, data collection process, and features of the CARES website. This training includes a one-on-one session with a CARES Program or State Coordinator prior to being granted access to the software. EMS and hospital users are also provided with numerous resources, including a detailed CARES data dictionary and a CARES user guide. Once a community has been participating in the registry for an extended period of time, CARES provides ongoing support in the form of answering questions as needed, providing updated training documents, and responding to individual reporting requests. Software Logic and Auditing In order to provide consistent data validation across the registry, each CARES record is reviewed for completeness and accuracy through an automated audit algorithm. Once the record is processed by the algorithm, data entry errors are flagged for review by EMS and hospital users (as appropriate) and CARES staff. Logic and error messages are also incorporated into the data-entry form to minimize the number of incomplete fields and implausible answer choices during the data entry process. Finally, aggregate data is analyzed on a regular basis to identify agency-specific anomalies. CARES staff utilize site-by-site comparison tools to detect outliers and compare each agency’s data with the national average. Case Ascertainment Each EMS agency is asked to confirm their non- traumatic call volume to ensure capture of all arrests in a defined geographic area. The volume of OHCA per month is compared with historic monthly volumes by CARES staff; when a substantial drop in the number of events occurs, the EMS contact is notified to determine if the variation was real or the result of a lag in the data- entry process. In addition, CARES conducts a bi-annual assessment of population coverage and case ascertainment. CARES staff and State Coordinators provide each EMS agency’s geographic coverage, census population, and start date via a standardized template. This information is then linked with record volume to identify outliers across the entire registry. In the event that an outlier is found, CARES staff or the State Coordinator works closely with the EMS agency to identify any issues in the data collection process and resolve as needed.