Mission Lifeline® Prehospital Recognition | Frequently Asked Questions

Mission: Lifeline EMS is the American Heart Association’s program that recognizes prehospital agencies for their quality of care for heart attack (STEMI), Acute Coronary Syndrome (ACS), and stroke patients. This recognition program focuses on transforming the quality of care by connecting all the components of heart attack and stroke care into a smoothly integrated system that reinforces the use of evidence-based guidelines, measures performance, identifies gaps, and engages in quality improvement at a systems level. 

2023 Mission: Lifeline EMS recognition (based on 2022 data) marks the addition of new required stroke measures and systems of care recognition components. The first tier of recognition is the prehospital award and the second tier of recognition is the Systems of Care award. 

1. What agencies are eligible for Mission: Lifeline EMS Recognition? 
For the Mission: Lifeline EMS Prehospital award, EMS (transporting) and first responding (non-transport) are eligible for recognition. For the Mission: Lifeline EMS Systems of Care award, only EMS transport agencies are eligible. 

2. What is the cost for EMS Agencies participating in Mission: Lifeline EMS Recognition? 
There is no cost to participate in Mission: Lifeline EMS recognition. 

3. How can agencies apply? 
Agencies can visit the website by clicking here.  

4. What is the application type options for 2023 recognition? 
Agencies may only submit individual applications. The joint and regional application types are retired.  

5. Can agencies still list “team member agencies” within their application? 
No, the optional team member portion of the application is retired. 

6. What are the two tiers of Mission: Lifeline EMS Recognition? 
2023 Mission: Lifeline EMS recognition (based on 2022 data) marks the addition of new required stroke measures and a new two-tiered recognition program. 

Mission: Lifeline Prehospital award 

The Prehospital Award focuses on the prehospital impression of the patient's primary problem or most significant condition, which led to the patient care management. 

Mission: Lifeline Systems of Care Target Heart Attack (STEMI) Award 

The Systems of Care award accounts for the patient's prehospital and hospital management. This award level is limited to EMS agencies that transport patients to acute care facilities and includes STEMI measures. For an agency to be eligible for the Systems of Care award, they must meet all required criteria for the Prehospital award. 

7. What are the award-level requirements? 
Mission: Lifeline Prehospital Award 

Mission: Lifeline EMS Systems of Care Target Heart Attack (STEMI) Award *Must meet Prehospital (Tier One) award criteria 

8. Can an EMS agency qualify for both tiers of awards?  
An agency must meet all required Prehospital award criteria to be eligible for the Systems of Care award. If an agency meets all required criteria for both, the agency will be issued the Mission: Lifeline EMS Systems of Care award with the appropriate award level based on time of compliance (i.e., 2023 Mission: Lifeline EMS Systems of Care Gold award). 

9. Can recognized agencies repeat the award level in consecutive years or must they advance to the next award level? 

• EMS agencies can repeat the bronze award level. 

• EMS agencies awarded the silver recognition award in the previous recognition year can achieve the bronze level in the current recognition year (if unable to achieve gold). 

• At this time, there is no limit on the number of years an agency can receive bronze recognition. 

• When silver level achievement is repeated, the agency advances to the gold  award level. 

• A current recognition year gold award can only be achieved if an agency reached Silver or Gold in the previous recognition year. 

10. What calendar year of data should agencies report? 
All agencies applying for 2023 recognition shall report the calendar year 2022 (January 2022 - December 2022) data. 

11. What is the volume requirement for each level of Mission: Lifeline EMS Recognition? 
Mission: Lifeline EMS Prehospital Award Volume Criteria:

At least 4 patients for the calendar year
≥1 STEMI patient
≥1 Stroke Patient

Mission: Lifeline EMS Systems of Care Award: 

At least 4 STEMI patients for the calendar year (STEMI receiving or referring). 

12. Can an EMS agency apply and be eligible for recognition if only one, two or three quarters of data is reported in the application? 
Yes, so long as the overall minimum annual volume of at least 4 STEMI patients is met. 

13. What is the deadline to submit a recognition application?  
March 31, 2023, at 11:59pm CST 

14. What is the review process for all Mission: Lifeline EMS Recognition application submissions? 
When an application is submitted for recognition analysis, each application’s data is reviewed by AHA staff for completeness, eligibility criteria, and measure adherence. Once the data analysis is complete, award-eligible agencies are assigned the appropriate award level. 

15. How are applicants notified when the application submission is complete and officially submitted?
Agencies can elect to receive confirmation of submission via email. Agency notifications will be sent in late Spring 2023.

16. Can corrections be made to an application after submission? 
Application corrections can be sent to the American Heart Association via email ([email protected]). The American Heart Association has ultimate discretion on accepting or denying proposed correction.  

17. How will EMS agencies be recognized? 
The American Heart Association will provide EMS agencies who achieve an award with a Mission: Lifeline EMS Recognition Kit. The kit will include local press release statements, web widgets and icons containing the AHA and Mission: Lifeline logo, and a certificate of achievement. Award agencies will also be listed on the Mission: Lifeline EMS webpage. 

18. How will EMS agencies be notified of their award? 
The primary contact listed within the award application will be notified via email. 

19. When will agencies by notified of any level of award achievement? 
Award notifications will be sent late Spring 2023. 

20. What tools and/or aids are available to assist agencies with collecting follow-up data from hospitals? 
Tools and resources can be found on the Mission: Lifeline EMS webpage at www.heart.org/missionlifelineems.  

21. Will the validity of the data be verified? 
All submitted data will be reviewed by AHA staff. Any data that seems to be inconsistent or inclusive of error may be flagged and sent back to the submitting agency for review and correction. All data should be submitted by a qualified and appropriately designated staff person of the EMS agency. At the time of the application submission, a representative of the EMS agency, with administrative authority will be asked to agree to a statement of truth attesting the application submission is complete, without omission, accurate, and truthful. Data entry in other repositories is also based on self-reported data and therefore limited by the same truth in reporting. 

22. What is EMS First Medical Contact (FMC) 
First Medical Contact (FMC) is broadly defined as the time of eye-to-eye contact between STEMI patient and caregiver. For the purposes of Mission: Lifeline EMS Recognition - First Medical Contact (FMC) is the time of eye-to-eye contact between the STEMI patient and the first caregiver (Medical First Responder, Physician at a clinic, or EMS personnel). When the Medical First Responder or physician at a clinic is the first caregiver at the patient’s side, and their time of initial contact with the patient is known, the eye-to-eye contact time between the patient and that first caregiver is preferred. 

23. If there are multiple agencies dispatched to a STEMI or stroke call, can all responding agencies include the patient in the data denominator for the award application? 
Yes. Agencies can utilize the same patient population in their application.  

24. Is there destination criteria to receive Mission: Lifeline System of Care Target Heart Attack Award? 
Yes. Agencies must transport patients to either a STEMI-receiving or STEMI-referring hospital (see below).  


Systems of Care Measures FMC to PCI within 90 minutes for patients with STEMI  Door to Thrombolytic within 30 minutes for patients with STEMI 
 STEMI Receiving Center  
 STEMI Referring Hospital   X

For additional questions or assistance, please email [email protected].  

Thank you for your participation in Mission: Lifeline EMS Recognition!