Purpose Statement

This article provides guidance for California ePCR administrators to align their First Due configuration with updated CEMSIS schematron requirements. These changes ensure that all medication and procedure values used in ePCRs meet state-approved standards and successfully pass submission validation.

Download Reference: CEMSIS Approved Lists–Medications & Procedures 

This document contains the full CEMSIS-approved Medications list (RXCUI/RXNORM) and Procedures list (SNOMED CT) effective May 1, 2026.

CEMSIS_Approved_Lists_May2026 (2).pdf

Background Information

Beginning May 1, 2026, California EMSA will enforce updated schematron rules requiring all submitted ePCR records to use CEMSIS-approved Medications and Procedures values. Records containing non-approved values will fail export to CEMSIS.

Key Considerations:

• Restrictions on other fields (e.g., impressions, symptoms) already exist
• Medications and Procedures restrictions are newly enforced
• Agencies may need to:
  • Inactivate non-compliant values, activate replacement values, or remap existing values to an accepted CEMSIS equivalent
  • Create mapped custom values to retain internal terminology

Common Use Cases:

• Agency terminology differs from CEMSIS naming conventions
• Existing values are not on the approved list
• Need to maintain internal naming while remaining compliant

Required Permissions

• Administrative access to EMS Setup
• Access to:
  • Field Customization
  • Custom Elements
  • Protocol Configuration

(Standard users do not have access to these settings)

Step-by-Step Guide

1. Review Active Values in Field Customization

1. Navigate to EMS Setup
2. Select Field Customization
3. Open:
   • Medication Name or
   • Procedure Name
4. Compare active values against the CEMSIS-approved reference list

2. Inactivate Non-Accepted Values

1. Identify values not on the approved list

2. Inactivate all non-compliant values rather than deleting them. If a value has been used in a previous report, the system will not allow it to be deleted. Inactivating is the recommended approach regardless — it preserves your historical data and prevents the value from being selected going forward.

    

3. Create Custom Values (If Needed)

1. Navigate to:
   EMS Setup > Custom Elements > Custom Values for NEMSIS Questions

2. Click Add

3. Complete fields:
   • Data Set: EMSDataSet
   • Field: Medications Name or Procedures Name
   • Master Value: Closest approved CEMSIS value
   • Selectable Value: Agency-specific label
   • Reported Code: Unique code (e.g., A123456)
4. Click Add

4. Activate Custom Values

1. Return to EMS Setup > Field Customization
2. Open the relevant list
3. Locate new custom values
4. Set each to Active

5. Update Protocol Details

1. Navigate to:
   • Protocols > Medication Details OR
   • Protocols > Treatment Details
2. Configure for each custom value:
   • Certification Levels
   • Authorization Level
   • Additional settings (if applicable)

6. Review and Update Workflows

1. Check workflows for red warning indicators
2. Update logic if needed
3. If unchanged:
   • Open and click Save to clear warning

Best Practices

• Always review CEMSIS-approved lists before making changes
• Use Replace when a close match exists to reduce complexity
• Use Custom Values only when necessary
• Clearly label non-compliant values to prevent reuse
• Coordinate with your LEMSA for local compliance guidance
• Monitor product updates for newly added CEMSIS values

Troubleshooting & FAQs

Why is my record failing export?

Most likely due to use of a non-CEMSIS-approved medication or procedure value.

Can I delete old values?

• Yes, if unused
• If used → must be inactivated instead

Why are workflows showing red?

• Inactivated values may still be referenced
• Open and save workflows to clear or update logic

What if a CEMSIS value isn’t available in First Due?

• The development team is actively adding missing values
• Monitor product updates or contact support