Purpose Statement
This article explains how to add an Addendum to a completed electronic Patient Care Report (ePCR) in First Due. The Addendum feature allows EMS providers to document additional information, clarification, or context after an ePCR has been completed without modifying the original report.
Addendums provide a way to supplement existing documentation while preserving the integrity of the completed patient care report.
Background Information
An Addendum is a supplementary entry added to an already completed ePCR. It allows EMS providers to document information that may have been missed during the original report or provide additional clarification identified during a Quality Assurance/Quality Improvement (QA/QI) review.
Common reasons for adding an Addendum include:
Documenting additional information that was not included in the original report.
Providing clarification about patient care or treatment.
Addressing documentation concerns identified during the QA/QI process.
Adding relevant details without reopening or modifying the completed report.
Important: Addendums do not modify the original ePCR data. They are included in the printed report but are not exported as part of the NEMSIS XML. Agencies should consider this limitation when determining whether to use an Addendum or update the original report.
Multiple Addendums can be added to the same ePCR as needed.
Required Permissions
To use the Addendum feature, users must have the appropriate permissions to access and view completed ePCR records.
EMS Administrators: Access to EMS Setup to enable the Addendum feature.
EMS Providers: Access to the completed ePCR record and the ability to manage Addendums.
Video
Step-by-Step Guide
Step 1: Enable Addendums (Administrator Setup)
Before users can add Addendums to completed ePCRs, an administrator must enable the feature.
Navigate to Incident Documentation.
Select EMS Setup.
Open General > General.
Locate the Enable Addendums setting.
Check the box to enable Addendums.
Save the configuration.
Once enabled, a new Addendum(s) section will be available within the ePCR form.
Note: When this setting is disabled, the Addendum section will not appear, and the existing ePCR functionality remains unchanged.
Step 2: Open a Completed ePCR
Navigate to Incident Documentation > EMS Incident List.
Locate the completed ePCR that requires additional documentation.
Open the completed report by clicking on the eye icon in the actions area.
Locate the Addendum(s) section.
Important Note:
The Addendum(s) section remains disabled until the ePCR has been completed for the first time.
Once completed, the Addendum(s) section becomes available for editing, even though the remainder of the report is in Read Only mode.
Step 3: Add a New Addendum
Within the Addendum(s) section, click +Add.
Enter the appropriate Date/Time for the Addendum.
The Date/Time field uses the same date and time selection functionality found throughout the ePCR.
Enter the additional documentation in the Addendum Text field.
Save the Addendum.
The new entry will appear in the Addendum(s) grid.
The grid contains the following columns:
| Column | Description |
|---|---|
| Date/Time | Date and time associated with the Addendum |
| Addendum Text | Additional documentation or clarification |
| Actions | Options to Edit or Delete an Addendum |
Step 4: Edit or Delete an Existing Addendum
Users can manage existing Addendums without reopening the original ePCR for editing.
To Edit an Addendum:
Open the completed ePCR.
Navigate to the Addendum(s) section.
Locate the Addendum that needs to be updated.
Select the Edit action.
Make the necessary changes.
Save the updated Addendum.
To Delete an Addendum:
Locate the Addendum in the grid.
Select the Trash/Delete icon.
Follow any confirmation prompts presented by the system.
Step 5: Add Multiple Addendums
The Addendum(s) section supports multiple entries on a single completed ePCR.
Navigate to the Addendum(s) section.
Select +Add.
Enter the Date/Time and Addendum Text.
Save the entry.
Repeat as necessary.
Each Addendum is displayed as a separate entry in the grid.
There is no specified limit to the number of Addendums that may be added to a report.
Step 6: View Addendums on the Printed ePCR
Addendums are included in the standard ePCR print report.
Open the completed ePCR.
Select the option to print or generate the ePCR report.
Navigate to the end of the printed report.
Locate the Addendum section.
The Addendum section appears after the Attachments section and displays the Addendum entries in a grid format.
Best Practices
Use Addendums for supplemental information: Addendums should provide clarification or additional context rather than replace existing clinical documentation.
Document clearly: Include specific, factual information that explains the reason for the additional entry.
Use accurate Date/Time values: Ensure the Date/Time entered accurately reflects the Addendum documentation.
Avoid unnecessary duplication: Review existing Addendums before creating additional entries.
Understand export limitations: Addendum information is not included in the NEMSIS XML export and therefore may not be available to state reporting systems or billing platforms consuming XML data.
Follow agency documentation policies: Agencies should establish when an Addendum is appropriate versus reopening and modifying an existing ePCR.
Troubleshooting & FAQs
Q: Why can't I see the Addendum(s) section in my ePCR?
A: The Enable Addendums setting may not be enabled. Contact your EMS administrator to verify the setting under EMS Setup > General > General.
Q: Why is the Addendum(s) section greyed out?
A: The Addendum(s) section is unavailable until the ePCR has been completed for the first time. Once the report is completed, the section becomes available.
Q: Can I add an Addendum without reopening the ePCR?
A: Yes. The Addendum(s) section is the only section designed to remain editable while the rest of the completed ePCR is in Read Only mode.
Q: Can I add more than one Addendum to an ePCR?
A: Yes. Multiple Addendums can be added to the same completed ePCR.
Q: Can I edit or delete an Addendum?
A: Yes. The Addendum grid provides Edit and Delete actions for managing existing entries.
Q: Does adding an Addendum change the original ePCR?
A: No. Addendums are supplementary entries and do not modify the original ePCR fields or clinical documentation.
Q: Will Addendums be included in the NEMSIS XML export?
A: No. Addendums are not included in the NEMSIS XML export. The information is only available within First Due and on the printed ePCR report.
Q: Will Addendums appear on the printed ePCR?
A: Yes. The printed report includes an Addendum section at the end of the report, following Attachments.
Q: Should I use an Addendum or reopen the report to correct documentation?
A: This depends on your agency's documentation policies. Because Addendums are not included in NEMSIS XML exports, corrections that must be reflected in state reporting or downstream billing systems may require updating the original ePCR.