# Title 23 — Health and Safety

## Chapter 23-47 — Acute Cardiovascular Emergency Medical System

### § 23-47-01. Definitions.

As used in this chapter:
1. "Department" means the department of health and human services.
2. "STEMI" means ST-elevation myocardial infarction.
### § 23-47-02. Acute cardiovascular emergency medical system - Duties of department.

1. Following consultation with and receipt of a recommendation of the acute
cardiovascular emergency medical system of care advisory committee, the department
shall establish and maintain a comprehensive emergency cardiovascular medical
system for the state. The system must include standards for the following components:
a. A system plan.
b. Prehospital emergency medical services.
c. Hospitals, for which the standards must include:
(1) Standards for designation, redesignation, and dedesignation of receiving
and referring centers.
(2) Standards for evaluation and quality improvement programs for designated
centers.
(3) Recognition of a hospital as a STEMI receiving center or as a STEMI
referring center. In making such recognition, the standards must include
consideration of whether the hospital is:
(a) Accredited as a mission: lifeline STEMI receiving center or mission:
lifeline STEMI referring center by the society of cardiovascular patient
care and the American heart association accreditation process; or
(b) Accredited by a department-approved, nationally recognized
organization that provides mission: lifeline STEMI receiving center and
mission: lifeline STEMI referring center accreditation or a substantive
equivalent.
d. System registries, for which the components must include a plan for achieving
continuous quality improvement in the quality of care provided under the
statewide system, including for STEMI response and treatment.
(1) In implementing this plan, the department shall maintain a statewide STEMI
heart attack database that aggregates information and statistics on heart
attack care.
(2) To the extent possible, the department shall coordinate with national
voluntary health organizations involved in STEMI heart attack quality
improvement to avoid duplication and redundancy.
(3) Designated receiving centers shall participate in the registry.
2. The proceedings and records of the program are not subject to subpoena, discovery,
or introduction into evidence in any civil action arising out of any matter that is the
subject of consideration by the program.
### § 23-47-03. Acute cardiovascular emergency medical system of care advisory

committee.
1. The commissioner of the department of health and human services or designee shall
appoint the members of the acute cardiovascular emergency medical system of care
advisory committee. The state health officer, or the officer's designee, is an ex officio
member of the advisory committee. The commissioner of the department of health and
human services or designee shall appoint to the committee members who represent
referring and receiving hospitals, physicians who treat patients, and members who
represent emergency medical services operations that provide services in rural and
urban areas of the state. Members of the acute cardiovascular emergency medical

system of care advisory committee serve at the pleasure of the commissioner of the
department of health and human services.
2. The purpose of the acute cardiovascular emergency medical system of care advisory
committee is to advise the department on the establishment of an effective system of
acute cardiovascular emergency care throughout the state and to take steps to ensure
and facilitate the implementation of the system of acute cardiovascular emergency
care. The advisory committee shall:
a. Encourage sharing of information and data among health care providers on ways
to improve the quality of care of acute cardiovascular patients in this state.
b. Facilitate the communication and analysis of health information and aggregate
data among health care professionals providing care for acute cardiovascular
events.
c. Advise the department on how best to require the application of evidence-based
treatment guidelines regarding the transitioning of patients to community-based
followup care in hospital outpatient, physician office, and ambulatory clinic
settings for ongoing care after hospital discharge following acute treatments.
d. Develop and advise the department to adopt a data oversight process and plan
for achieving continuous quality improvement in the quality of care provided
under the system of acute cardiovascular emergency care. The plan must be
based on aggregate data analysis and the identification of potential interventions
to improve heart attack care in geographic areas or regions of the state.
e. Recommend improvements for acute cardiovascular emergency medical system
response.
3. A physician serving as a member of the acute cardiovascular emergency medical
system of care advisory committee is immune from professional liability in providing
the advisory committee with voluntary medical direction.
4. Except for a member of the acute cardiovascular emergency medical system of care
advisory committee serving on the advisory committee in the member's capacity as a
department employee and who is therefore entitled to receive reimbursement of
mileage and expenses from the department, a member of the advisory committee
serves without compensation or reimbursement of mileage and expenses from the
department but may receive compensation and reimbursement from the advisory
committee member's employer or sponsoring entity.
### § 23-47-04. Standard of care.

This chapter is not a medical practice guideline and may not be used to restrict the authority
of a hospital to provide services for which the hospital has been licensed. This chapter must be
interpreted to recognize that all patients should be treated individually based on each patient's
needs and circumstances.
