Purpose Statement

This article explains how to configure Default Value and Error Validation workflows on the NEMSIS-defined Authorized by (eMedications.12) field so EMS agencies can support documentation requirements for controlled substance administration.

Effective March 9, 2026, the DEA final rule implementing the Protecting Patient Access to Emergency Medications Act of 2017 (PPAEMA) requires that any EMS agency administering controlled substances (e.g., fentanyl, morphine, midazolam, ketamine, buprenorphine) document a Medication Authorizing Physician on every applicable record. 

Background Information

The Authorized by (eMedications.12) field captures the physician responsible for authorizing a medication. For agencies that administer controlled substances, this field becomes especially important when medications are given under a Protocol (Standing Order) or when the authorizing physician must be manually documented.

Configuring both a Default Value Workflow and an Error Validation Workflow helps agencies:

• Automatically populate the Medical Director or authorizing physician when appropriate

• Prevent incomplete medication documentation for controlled substances

• Improve chart accuracy for field personnel

• Support agency-level compliance workflows and audit readiness

This setup is most useful for EMS agencies that carry and administer controlled medications and want to standardize documentation across all crews.

Required Permissions

Users will need access to:

• Incident Documentation

• EMS Setup

• Workflows

At minimum, this task should be completed by a user with administrative or configuration-level access to EMS setup and workflow management. If your agency uses role-based permissions, confirm the user can view and edit workflow rules for treatment and medication fields.

Video

Step-by-Step Guide

1. Open EMS Workflow Configuration

Navigate to:

Incident Documentation > EMS Setup > Workflows

This is where field-level Default Value and Error Validation workflows are managed.

2. Locate the Authorized by (eMedications.12) Field

Search for:

Authorized by (eMedications.12)

Review whether workflows already exist on this field.

• If workflows already exist, select Edit

• If no workflows are configured, select Add

3. Create the Default Value Workflow

Select the Default Value Workflows tab, then click the + button to add a new workflow.

Complete the workflow with the following values:

• Description: Medical Director Default for Protocol (Standing Order)

• Default Value: Enter your EMS Medical Director’s initials or last name

Then add the following condition:

• When/If: Treatments | Medication | Authorization

• Condition/Is: Equal

• Parameter/Value(s): Protocol (Standing Order)

Click Save.

Confirm the workflow now appears in the active workflow list for Authorized by (eMedications.12).

4. Return to Authorized by (eMedications.12)

From the EMS Workflows list, locate:

Treatments | Medication | Authorized by (eMedications.12)

Click the pencil icon in the Actions column to open the field again for additional workflow configuration.

5. Create the Error Validation Workflow

Add a new workflow using the + button.

Complete the workflow fields as follows:

• Description: DEA Required MD Initials

• Validation Message: DEA Required MD Initials

Add the following two conditions using And logic.

Condition 1

• When/If: Treatments | Medication | Authorized by

• Condition/Is: Empty

• Parameter/Value(s): Leave blank

Condition 2

• When/If: Treatments | Medication | Name

• Condition/Is: In

• Parameter/Value(s): Select all controlled substances your agency carries, such as:

  • Buprenorphine/Naloxone

  • Fentanyl

  • Ketamine

  • Midazolam

  • Morphine

Click Save.

Confirm the workflow appears in the active workflow list for Authorized by (eMedications.12).

6. Test the Configuration

Create a test patient care record and document a controlled substance medication.

Verify the following:

1. eMedications.12 pre-populates when the medication authorization is Protocol (Standing Order)

2. Leaving eMedications.12 blank triggers the configured error message

3. The validation appears only when the medication selected is one of the controlled substances included in the workflow

Best Practices

• Use a clear workflow description that identifies both the purpose and trigger condition

• Standardize the Medical Director value format across your agency, such as initials or last name only

• Test workflows in a non-production or test record before rolling them out broadly

• Keep validation messaging short and clear so field users immediately understand what must be corrected

• Revisit this configuration whenever agency protocols, formulary, or compliance requirements change

Troubleshooting & FAQs

Why is the Authorized by field not auto-populating?
Confirm the medication authorization value is set to Protocol (Standing Order) and that the Default Value workflow is active on Authorized by (eMedications.12).

Why is the error not firing for a controlled substance?
Review the second condition in the Error Validation workflow and make sure the medication is included in the selected list of controlled substances.

Why is the error firing for the wrong medications?
Check the medication list configured under the In condition and remove any medications that should not require this validation.

Can we use initials or a last name for the Default Value?
Yes. The workflow can populate whichever value your agency has standardized for the Medication Authorizing Physician field.

Who should configure this workflow?
A system administrator, EMS administrator, or implementation/configuration user with access to EMS Setup and Workflows should complete this setup.

Should this be applied to all medications?
This workflow is typically intended only for the controlled substances carried by your agency. Review your compliance requirements and medication formulary before configuring the validation list.

Related Articles

• EMS Setup: Managing Workflows

• Default Value Workflows Overview

• Error Validation Workflows Overview