The Office of the State EMS Medical Director (OMD) provides leadership and coordination for state medical programs, protocols, and quality assurance in Maryland’s EMS system. In addition, the Aeromedical Director, Associate State EMS Medical Director for Pediatrics, and Regional EMS Medical Directors for each of the five regions collaborate with the State EMS Medical Director to update the Maryland Medical Protocols for Emergency Medical Services on an annual basis. Regional EMS Medical Directors also assist the Jurisdictional EMS Medical Directors in each of Maryland’s 28 jurisdictional EMS operational programs with protocol implementation and quality assurance initiatives. Fourteen of Maryland’s EMS Medical Directors are board-certified in EMS medicine. A network of 49 EMS base stations located in emergency departments provide online medical direction through Emergency Medical Resource Center and Systems Communications (EMRC/SYSCOM). The Office of the State EMS Medical Director ensures that patients who interact with the Maryland EMS system receive consistent, high-quality out-of-hospital medical care.

Maryland EMS Protocols

The Maryland Protocols for Emergency Medical Services In order to reflect best practices and evidence-based medicine, The Maryland Medical Protocols for Emergency Medical Services are updated annually by the Protocol Review Committee with multidisciplinary input from medical directors, emergency physicians, nurses, and EMS clinicians from across the state. State EMS Medical Director Timothy P. Chizmar, MD, FACEP, FAEMS, presented the changes for 2023 to the Statewide EMS Advisory Council and the Maryland EMS Board for approval.
Maryland EMS Protocol Page

Regional Medical Directors

MIEMSS coordinates a network of Regional EMS medical directors, who serve as the principal medical advisors for their respective regional councils, hospitals in the region, and jurisdictional medical directors. As members of the MIEMSS Protocol Review Committee, these physicians propose new protocols and revisions to existing protocols. They assist the jurisdictional medical directors with QA/QI and support educational efforts, with a particular focus on new protocol implementation. In conjunction with the MIEMSS Office of Clinical Integration and MIEMSS Regional Coordinators, the Regional EMS medical directors conduct hospital base station site surveys. They also assist the State EMS medical director with the development of base station education and credentialing of hospital base station instructors.
Regional Programs Page

EMS Medical Directors by Region:

Hospital Base Stations

EMS base stations are a critical component of Maryland EMS. Base stations provide real-time support and guidance to EMS clinicians in the field. There are 49 Maryland hospital base stations designated by the State EMS Board.

Physicians and nurses who answer base station calls are required to successfully complete the MIEMSS Base Station Communications Course for Emergency Department Personnel and the Maryland EMS Updates for Hospital Base Station Personnel training video to ensure they are prepared to communicate with EMS clinicians to provide real-time medical consultation. From July 2024 through June 2025, as a result to multiple hospitals facilitating the base station course and the addition of 11 instructors, MIEMSS issued 513 base station certificates to emergency physicians and nurses.
Hospital Base Station's Page

eMEDS® - electronic Maryland EMS Data System

The electronic Maryland EMS Data System (eMEDS®) is one of the few statewide comprehensive prehospital patient care reporting systems in the United States. eMEDS® relies on an ImageTrend® software product that complies with the latest standards set by the National Emergency Medical Services Information System (NEMSIS). MIEMSS holds a statewide site license for eMEDS®, offering it at no cost to local jurisdictions. All Maryland jurisdictional EMS operational programs (JEMSOPs) and approximately 20% of commercial ambulance companies submit patient care reports directly into eMEDS®, while most commercial service reports are automatically imported into eMEDS® from thirdparty electronic health platforms. All Maryland healthcare facilities have access to the prehospital patient care reports through the Hospital Hub online application. eMEDS® supports several key goals, including:

• Uniform Data Collection: Ensures consistent reporting of prehospital care by Maryland’s EMS clinicians.
• Performance Measurement: Provides a basis for evaluating patient care and compliance with protocols by local departments, EMSOPs, regional medical directors, and MIEMSS. • Standardized Reporting: Facilitates compliant data reporting to the National EMS Information System (NEMSIS).
• Data Integration: Supports integration with statewide systems such as Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE), Chesapeake Regional Information System for Patients (CRISP), Overdose Detection Mapping Application Program (ODMAP), Maryland Trauma Registry, Cardiac Arrest Registry to Enhance Survival (CARES), Emergency Department Advisory System (EDAS), and MIEMSS’ eLicensure System. • Local EMSOP Integration: Includes integration with 9-1-1 center computer-aided dispatch (CAD) systems, exports to third-party billing vendors for reimbursement, and data sharing with third-party vendors for local reporting, dashboard creation, and fire incident reporting.
• Maintaining and Updating EMS Systems: Updated to version 3.5 in 2023, eMEDS® 3.5.1 is under review for implementation to maintain NEMSIS compliance.

eMEDS® Mobile Integrated Health (MIH) Module
MIEMSS continues to support enhancements to the eMEDS® Mobile Integrated Health (MIH) module, developed in 2020, to improve data collection and guide future MIH efforts. As of the end of FY 2025, over 12,100 reports have been recorded using the MIH module. Starting in FY 2024, MIEMSS began working with CRISP to export MIH data to the state’s designated health information exchange.

eMEDS® Support Desk (emeds-support@miemss.org) The eMEDS® application includes a MIEMSS support desk that handles requests from EMS clinicians, EMS Operational Program (EMSOP) administrators, and healthcare facility personnel across the state. Common issues include password resets, login problems, access level questions, report writer functionality, EMSOP integrations, and general application inquiries. During FY 2025, the support desk processed over 1,500 support tickets.

eMEDS® Statewide Steering Committee Jurisdictional, commercial, and hospital stakeholders continue to meet on a quarterly basis to discuss topics for eMEDS® improvement. Topics include system-wide integrations, enhancements, and change requests. To address continual improvement, change requests for the eMEDS® application can be submitted by any stakeholder who uses or interacts with the system. The committee reviews requests and supports actions for implementation.

eMEDS® Page  |  ImageTrend®,

Cares Program

MIEMSS works with the Cardiac Arrest Registry to Enhance Survival (CARES) in order to measure and ultimately improve emergency cardiac care in Maryland. CARES is an out-ofhospital cardiac arrest registry for the United States, facilitating uniform data collection and quality improvement in each state and nationally.

With the updated and consolidated Cardiac Arrest tab in eMEDS®, the statewide prehospital patient care reporting system, EMS clinicians can readily enter comprehensive prehospital cardiac arrest information. MIEMSS can then export the prehospital information directly to CARES when it is first entered, saving time for clinicians and EMS CARES coordinators. Using a single patient care record for CARES submission makes Maryland one of the first states to incorporate this process within their electronic patient care reporting documentation. Maryland hospitals then enter outcome data into the CARES report for those cardiac patients who receive ongoing care in the ED.
Cares Program Page

EMS Medical Directors’ Symposium

The 30th EMS Medical Directors’ Symposium is designed to increase statewide collaboration and the promotion of state-of-the-art techniques in the field for Emergency Services. The 30th Annual EMS Medical Directors’ Symposium, held April 9, 2025, at the James Robey Public Safety Training Center in Marriottsville, MD, was attended by regional, jurisdictional, and commercial ambulance services medical directors, highest jurisdictional EMS officials, quality assurance officers, and MIEMSS personnel.

Cardiac Arrest Steering Commitee

The Cardiac Arrest Steering Committee (CASC), as authorized by the State EMS Board, provides guidance to MIEMSS’ medical and executive leadership teams on matters related to sudden cardiac arrest in Maryland. The committee actively works on matters related to public health and safety by sharing best MEDICAL DIRECTION 8 practices regarding telecommunicator CPR, prehospital cardiac arrest management performance improvement, and further development of a comprehensive statewide system for the treatment of sudden cardiac arrest. In FY 2025, CASC introduced several new members to its roster, including emergency clinicians, 9-1-1 administrators, and pediatric champions, and empowered four subcommittees to continue efforts to improve cardiac arrest survival through 9-1-1 and EMS synergy and community engagement.

County EMS Assessment / SWOT Analysis

The Office of the Medical Director and the MIEMSS Regional Offices, upon request from the leading County Official(s), will facilitate a SWOT (Strengths, Weaknesses, Opportunities, and Threats) process though a broad constituency County task force to address selective EMS issues to improve the delivery of prehospital medical care. The SWOT process has been instrumental in addressing individual EMS Operational Program issues such as rising ambulance scratch rates, financial solvency, timely delivery of quality BLS/ALS services, establishing countywide standards for the County's EMS service, and developing sustainable and adaptive strategies to maintain a robust EMS system and an accountable EMS service.

The Somerset County Commissioners requested the assistance of State EMS Medical Director Timothy P. Chizmar, MD, FACEP, FAEMS, and the MIEMSS Region IV office to facilitate a SWOT analysis. The Somerset County EMS Task Force included representation from Somerset’s fire and EMS companies, Somerset County Emergency Services (9-1-1 Center), Somerset County Health Department, TidalHealth, mutual aid fire and EMS companies, and the Maryland Fire and Rescue Institute. A detailed geographic analysis of EMS calls was prepared with technical assistance from the Eastern Shore Regional GIS Cooperative. The SWOT report was presented to the Somerset County Commissioners on May 2, 2023. 

Updated 10-1-2025