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Medical Examiner Requirements

Reporting Requirements

What are medical examiners required to report?
Medical examiners are to report all traumatic brain injuries (TBIs), spinal cord injuries (SCIs), and submersions to the EMS and Trauma Registries (EMSTR).

Requirements Flyer


What are the reportable data elements?

The applicable data dictionary lists all required fields for TBIs, SCIs, and submersions.

Data Dictionaries
2024 Submersion Data Dictionary
2024 Traumatic Brain Injury (TBI) /Spinal Cord Injury (SCI) Data Dictionary

Note: EMSTR does not accept paper records.


How does a medical examiner send data?
Send data electronically for TBIs, SCIs, and submersions. Establish an account with EMSTR and use the online system for submitting data. A medical examiner can use the free online system for entering data.

Justice of the Peace / Medical Examiner User Guide


How often does a medical examiner send data?
Submit data within 90 days from the identification of a required reportable event. A medical examiner should submit data monthly.


If a medical examiner has just started submitting data, should they send records from previous months?
Texas Administrative Code, Title 25, Part 1, Chapter 103, Rule 103.1-103.8 requires medical examiners to submit all data. The amount and quality of data sent will affect EMSTR data reports.  


May a medical examiner submit data through a business associate, e.g., local health department, RAC, billing agency, etc.?
Yes, a medical examiner may submit through a business associate. However, individual medical examiners are responsible to check for data accuracy and acceptance into the EMSTR platform. A medical examiner must have a signed Business Associate Agreement (BAA) on file with EMSTR before EMSTR will accept records from a third-party associate. 

NOTE: EMSTR will not accept BAAs with an effective date over 5 years old as the system needs to verify and track organization and vendor changes. 

Sample BAA

This is a sample BAA only. Each 3rd party/billing company should have their own BAA forms to provide customers. BAAs must include the effective date and be signed and dated by both parties.


The Texas Department of State Health Services does not endorse external links to other websites or documents created by other agencies. These links and documents are informational and may not be accessible to persons with disabilities.

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