ePCR Release Notes - September 2025

ePCR Release Notes - September 2025

New Features

1. Transfers Agency to Agency - Setup and Implementation for Incident Transfers Between Different Agencies
  • What - A comprehensive agency-to-agency incident transfer system has been implemented to support scenarios where first responder agencies need to transfer patient care to transporting agencies, featuring a bilateral handshake system requiring mutual agreement between agencies. The system creates independent report copies in receiving agencies with preserved clinical data integrity, automatic "Prior to Arrival" marking for transferred clinical elements, and comprehensive audit trail generation while maintaining agency-specific configurations and NEMSIS version compatibility validation.
  • Why - This enhancement was implemented due to customer request to address complex EMS workflows where multiple licensed agencies collaborate in patient care with different documentation requirements, enabling seamless patient handoffs between first responder and transport agencies while maintaining proper clinical documentation and agency autonomy throughout the transfer process.
  • How - Agency-to-agency transfers are managed through comprehensive bilateral setup and validation processes:
    • Super Admin configures "Transfer To" and "Accept Transfer From" relationships between agencies in transfer setup
    • Bilateral agreement system requires both sending and receiving agencies to have corresponding configurations
    • System validates NEMSIS version compatibility and mutual transfer agreement before allowing transfer initiation
    • Transfer dropdown displays Agency Name, State License ID, and State for clear identification with state-based filtering
    • Independent report creation generates new reports in receiving agency with regenerated PCR Number, UUIDs, and agency-specific metadata
    • Clinical data preservation transfers medications, procedures, vitals, and devices even when not active in receiving agency
    • Personnel transfer includes crew names and certifications with claiming user automatically added as crew
    • Prior to Arrival logic automatically marks all transferred clinical elements as "Prior to Arrival = Yes"
    • Audit trail generation creates change logs in both agencies documenting transfer source, destination, and timing
    • Note: Original reports in sending agencies remain independent and can be completed, modified, or deleted
    • Note: Agency-specific data like response times and unit information are excluded from transfers
    • Note: Transfer setup requires "ePCR - Transfer Setting Agency to Agency" permission
  • Use Case - When a rural fire department provides first response to a cardiac arrest but requires hospital transport by a separate ambulance service, the fire department can transfer their documented patient care including vital signs, medications administered, and procedures performed to the transport agency. The transport agency receives an independent copy of the clinical data with all interventions marked as "Prior to Arrival = Yes," allowing them to continue documentation from their point of care while maintaining complete clinical continuity. Both agencies retain independent control of their respective reports for completion and billing purposes, with audit trails documenting the transfer for quality assurance and regulatory compliance.











2. ePCR Sections - Active/Inactive Setting
  • What - Active/Inactive status controls have been introduced for custom ePCR sections and sub-sections, enabling clients to manage section visibility without permanent deletion while maintaining data integrity and development workflow continuity. The system provides flexible section management through action icon integration, defaults new custom sections to Inactive status to prevent premature deployment, and automatically migrates existing custom sections to Active status while ensuring associated custom elements follow parent section status.
  • Why - This enhancement was implemented due to customer request to address scenarios where clients are testing functionality, building forms incrementally, or need to temporarily remove sections containing custom elements that cannot be deleted due to dependencies, providing an alternative to deletion when custom elements cannot be moved or removed.
  • How - Section status management is controlled through enhanced ePCR Sections setup interface:
    • Navigate to EMS Setup → ePCR Sections where custom sections display with status action icons
    • Visual indicators show section status - inactive sections display deactivate icon, active sections display activate icon
    • New custom sections default to Inactive status to prevent premature display in ePCR
    • Click activate icon to change section status from Inactive to Active, making section and associated custom elements visible
    • Use deactivate icon to hide active custom sections from ePCR display while preserving configuration and data
    • Associated custom elements automatically become unavailable in ePCR when parent sections are deactivated
    • Inactive status supports sections under development or testing without affecting live ePCR interface
    • Note: Status controls apply only to custom sections, preserving NEMSIS-defined section integrity
    • Note: Existing custom sections automatically migrated to Active status during feature deployment
    • Note: Custom element status flags must align with parent section status for consistent form behavior
  • Use Case - An EMS agency developing a custom "Community Paramedicine" section with specialized assessment fields can create and configure the section in Inactive status while building associated custom elements and testing workflows without the incomplete section appearing in live ePCR forms used by field personnel. Once development and testing are complete, administrators can activate the section to make it visible to crews, or temporarily deactivate it if issues arise without losing the configuration work, providing flexible form management that supports incremental development and quality assurance processes.







3. PWA - Implement In-App Debug Panel for Offline Save Diagnostics in PWA
  • What - A comprehensive in-app debug panel has been implemented within the PWA to provide self-service offline saving diagnostics for government customers who cannot access Chrome Developer Tools due to security restrictions. The system includes setup-controlled activation, real-time connection and save status monitoring, comprehensive storage metrics display, error logging capabilities, and log download functionality that operates in both online and offline modes for complete diagnostic coverage.
  • Why - This enhancement was implemented due to customer request from government agencies that need to verify offline saving functionality but face security restrictions preventing access to Chrome Developer Tools, requiring a self-contained diagnostic solution that enables troubleshooting and verification of offline operations without external development tools.
  • How - Debug panel functionality is accessed through enhanced setup controls and comprehensive diagnostic interface:
    • Administrator enables "Enable ePCR Debug Mode" setting in setup to activate debug functionality
    • Users access debug panel through dedicated button that appears when debug mode is enabled
    • Real-time diagnostics display current connection mode (Online/Offline), last save type (Server/Local cache), and save attempt timestamps
    • Storage metrics show pending local records count, total storage used, available storage quota, and pending data size
    • Error logging captures and displays last error messages with detailed diagnostic information
    • Log download functionality allows exporting diagnostic logs for sharing with support teams
    • Dual mode operation ensures debug panel functions in both online and offline modes
    • Note: Panel provides comprehensive storage information using navigator.storage.estimate() when supported
    • Note: Real-time metrics help troubleshoot offline save issues without requiring external diagnostic tools
    • Note: Downloaded logs enable detailed analysis and support team collaboration
  • Use Case - A government EMS agency operating in areas with limited connectivity can use the debug panel to verify their PWA offline saving functionality during system testing or troubleshooting. When experiencing potential offline save issues, administrators can enable debug mode and field personnel can monitor real-time diagnostics showing connection status, storage usage, and any error messages, then download comprehensive diagnostic logs to share with support teams for resolution without needing Chrome Developer Tools access that may be blocked by their IT security policies.








Enhancements

1. Custom Element - Button Packs
  • What - Button pack functionality has been extended to Custom Elements, providing cohesive uniformity across ePCR forms by implementing automatic button pack conversion for custom dropdowns with 6 or fewer values and toggle controls for dropdowns with 7 or more values. The enhancement mirrors existing NEMSIS field button pack capabilities while maintaining consistent visual styling and sort order preservation, integrating seamlessly into the existing Custom Element builder interface for unified user experience.
  • Why - This enhancement was implemented due to customer request to extend the established button pack functionality from NEMSIS fields to Custom Elements, ensuring consistent user interface design and improved usability across all form elements while maintaining the cohesive visual experience that users expect throughout ePCR documentation.
  • How - Button pack functionality is automatically applied based on custom dropdown configuration:
    • Create custom dropdown element using "text/string > dropdown" in Custom Element setup
    • Configure custom values through Custom Element builder interface
    • 6 or fewer values automatically display as button packs without additional configuration
    • 7 or more values include "Override Dropdown as a Button Pack" toggle in Custom Element setup
    • Enable toggle to convert large dropdowns to button pack format when desired
    • Sort order configured in Custom Element setup maintains consistency in button pack display
    • Visual styling matches existing NEMSIS field button packs for cohesive interface
    • Configuration persistence saves button pack settings across form sessions
    • Note: Dynamic value threshold automatically switches display based on configured value count
    • Note: Button pack configurations integrate into existing custom element builder modal
    • Note: Implementation leverages existing sort order functionality for consistent value ordering
  • Use Case - An EMS agency using custom elements for "Transport Decision" with values like "ALS Transport," "BLS Transport," "Refusal," "Treat & Release," and "Cancelled" will automatically see these options displayed as buttons instead of a dropdown, providing faster selection that matches the button pack experience users already know from NEMSIS fields. For agencies with more complex custom dropdowns containing 10+ options, administrators can choose whether to enable button pack display based on their workflow preferences, ensuring consistent user experience across all form elements regardless of whether they're standard NEMSIS fields or agency-specific custom elements.







2. ePCR Sections - Validation on ePCR Setup
  • What - Comprehensive validation has been implemented for ePCR section configurations to prevent technical failures when active custom elements are placed in inactive sections, building upon the Active/Inactive setting functionality with error validation, hover help, and visual indicators. The system provides real-time validation feedback through red circle error counts, visual highlighting of problematic configurations, detailed error messages, and contextual guidance to ensure proper section configuration while maintaining data integrity and system stability.
  • Why - This enhancement was implemented due to customer request to prevent configuration conflicts that could cause system errors when active custom elements exist within inactive sections, providing administrators with clear guidance and immediate feedback to maintain proper ePCR setup configurations and prevent deployment of problematic section arrangements.
  • How - Validation functionality provides comprehensive configuration error detection and resolution guidance:
    • Navigate to EMS Setup → ePCR Sections where validation indicators and hover help are displayed
    • Contextual hover help appears on plus buttons with explanatory tooltips for sections, subsections, and custom questions functionality
    • Real-time error validation displays red circle with error count indicating configuration conflicts
    • Visual error highlighting outlines inactive sections containing active custom questions in red for immediate identification
    • Detailed error messages provide clear explanations with specific lists of affected active custom questions
    • Resolution options include activating inactive sections or deactivating active custom questions to resolve conflicts
    • Status inheritance logic ensures custom elements automatically inherit parent section status
    • Note: Validation applies only to custom sections, preserving NEMSIS section behavior without interference
    • Note: Real-time validation provides immediate feedback when section or custom question statuses are modified
    • Note: Configuration guidance helps prevent deployment of problematic setups that could cause technical failures
  • Use Case - An EMS administrator configuring custom sections for "Community Paramedicine" can see immediate validation errors if they deactivate the section while leaving custom questions like "Home Safety Assessment Completed" and "Medication Reconciliation Performed" in active status. The system displays a red error indicator showing "2 configuration conflicts" with clear messaging that "Active custom questions cannot display when their section is inactive" along with the specific question names, allowing the administrator to either activate the Community Paramedicine section or deactivate the individual questions to resolve the conflict and prevent system errors during ePCR deployment.








3. QA/QI - Add Notifications for Green Comments
  • What - The QA/QI notification system has been extended to include positive feedback through green comments, enabling crews to receive recognition for quality work without requiring corrective actions. The enhancement builds upon existing colored comments functionality by providing automated notifications for positive feedback, enhanced Request Review logic for green-only comments, automatic QA status progression to "Approved" for positive feedback scenarios, and flexible crew response options while maintaining bidirectional communication capabilities.
  • Why - This enhancement was implemented due to customer request to ensure crews receive recognition for quality work and positive feedback, addressing the gap where only corrective comments (yellow/red) generated notifications while commendations went unnoticed, supporting a comprehensive quality assurance culture that includes recognition alongside improvement opportunities.
  • How - Green comment notifications are integrated into the existing QA/QI workflow with enhanced automation:
    • QA reviewers add green comments for positive feedback and recognition without requiring crew action
    • Request Review button becomes available when only green comments are present, replacing gray state with Approve-only option
    • Automated notification sent to crew using standard message format: "This is an automated notification that (Incident Number) has necessary review"
    • QA status automatically updates to "Approved" when reports containing only green comments are sent to crew
    • Crew response is optional and can be reviewed at convenience without time pressure or completion requirements
    • Bidirectional communication maintained - crew responses return QA status to "Pending" to continue dialogue
    • Mixed comment handling preserves standard approval and resolution processes for reports containing both green and corrective comments
    • Note: Green comments represent positive feedback with no required crew action (no Resolve or Approve buttons)
    • Note: Feature reduces reviewer workload by automating approval for positive-only feedback scenarios
    • Note: System supports recognition culture while maintaining efficient QA workflow management
  • Use Case - A QA supervisor reviewing an excellent cardiac arrest response can add green comments like "Outstanding CPR technique and medication administration" and "Exemplary communication with receiving hospital" then use Request Review to send recognition to the crew. The system automatically approves the report and notifies the crew of the positive feedback without creating additional workload or requiring corrective actions. If the crew chooses to respond with "Thank you for the feedback, we're proud of our teamwork on this call," the QA status returns to Pending, allowing continued positive dialogue while maintaining the approved status and recognition of quality patient care.

4. EKG/Physio/Monitor Import - LifePak Defibrillation Type Classification
  • What - Intelligent classification of defibrillation events from LifePak monitor data has been implemented to accurately reflect specific defibrillation types used, replacing the generic "Defibrillation Manual" designation. The system analyzes event sequences preceding each shock delivery to automatically categorize defibrillations into three distinct clinical types: Synchronized Cardioversion, Manual Defibrillation, and AED Mode Defibrillation, providing clinically meaningful documentation that reflects actual defibrillation methods used during patient care while preserving original event data structure.
  • Why - This enhancement was implemented due to customer request to improve clinical documentation accuracy by providing specific defibrillation type classification instead of generic designations, enabling better clinical record keeping that reflects the actual defibrillation methods used during patient treatment and supports more precise medical documentation requirements.
  • How - Defibrillation classification is automatically applied through intelligent event sequence analysis:
    • LifePak monitor data is processed to identify shock events containing "Shock" labels with energy values
    • Event sequence analysis scans preceding events in reverse chronological order to determine shock context
    • Synchronized Cardioversion classification applied when "Sync On" immediately precedes shock event
    • AED Mode Defibrillation requires complete sequence validation: AED Mode → Shock Advised → Actual Shock
    • Manual Defibrillation classification applied when "Sync Off" precedes shock, no sync status defined, or AED sequence incomplete
    • Edge case handling manages multiple mode changes using most recent mode and incomplete sequences
    • Data structure preservation maintains original LifePak event integrity while adding classification metadata
    • Note: Classification logic analyzes preceding events to determine appropriate clinical category for each shock
    • Note: System defaults to Manual Defibrillation when mode context is unclear or sequences are incomplete
    • Note: Enhanced documentation provides clinically meaningful classification reflecting actual treatment methods
  • Use Case - When a paramedic treating a patient with unstable atrial fibrillation uses synchronized cardioversion at 100 joules, the LifePak monitor data showing "Sync On" followed by "Shock 100J" will now be classified as "Synchronized Cardioversion" instead of the previous generic "Defibrillation Manual" designation. Similarly, when the same crew later responds to a cardiac arrest and uses the monitor in AED mode, the complete sequence of "AED Mode," "Shock Advised," and "Shock 200J" will be accurately classified as "AED Mode Defibrillation," providing precise clinical documentation that reflects the actual defibrillation methods used for different patient conditions and treatment protocols.






5. EKG - When 12-lead EKG Event Type is Documented, Automatically Add 12-Lead EKG as a Procedure with Same Timestamp
  • What - EKG integration has been enhanced to automatically add specific procedure codes based on captured EKG event types, improving billing accuracy and documentation completeness by using actual captured event data rather than configuration settings to trigger procedure entries. The system identifies "Leads On" events to automatically add 3-lead electrocardiographic monitoring procedure code (428803005) with matching timestamps, processes only first occurrence events to avoid duplicates, and handles both active and inactive procedure codes according to existing field customization display rules.
  • Why - This enhancement was implemented due to customer request to improve billing documentation accuracy and ensure clinical procedures are properly captured with accurate timestamps when EKG monitoring events occur during patient care, moving away from settings-based triggers to event-driven automation for more precise documentation.
  • How - Automatic procedure addition is triggered through intelligent EKG event analysis:
    • EKG case data is processed to identify specific event types indicating clinical procedures
    • "Leads On" events are scanned to detect when EKG leads are placed and monitoring initiated
    • First occurrence logic processes only the earliest timestamp "Leads On" event, ignoring subsequent occurrences from lead repositioning
    • 3-lead monitoring procedure code 428803005 is automatically added with timestamp matching the original event
    • Active procedures display normally when they exist in client's active custom procedure list
    • Inactive procedures display with warning message: "This procedure cannot be used in the report, to use it you must first add it to your custom list"
    • Clinical timeline accuracy maintained by matching procedure timestamps to actual EKG event timing
    • Note: Procedures are added regardless of their active status in field customization for complete documentation
    • Note: System handles inactive procedure codes similar to other imported data not in active custom lists
    • Note: Enhancement integrates seamlessly with existing procedure documentation and field customization workflows
  • Use Case - When a paramedic places EKG leads on a chest pain patient and begins 3-lead monitoring, the LifePak monitor captures a "Leads On" event at 14:32:15. The system automatically adds procedure code 428803005 (3 lead electrocardiographic monitoring procedure) with the exact same timestamp, ensuring proper billing documentation without requiring manual entry. If the agency hasn't added this procedure code to their active custom list, it appears with a warning message allowing them to recognize the documentation need and add it to their custom procedures, while still preserving the automatically captured clinical timeline for accurate patient care documentation.






6. Endpoint - Is this a Billing Export?
  • What - An "Export Type" classification field has been added to the Endpoint setup page to identify the purpose of each data export endpoint, with particular emphasis on billing exports that are critical to EMS agency revenue operations. The system provides six distinct export type categories including Billing, State Export, Community Health, Syndromic Surveillance, Health Information Exchange, and Other, with a default blank selection to avoid assumptions about existing endpoint configurations and enable better support prioritization based on export criticality.
  • Why - This enhancement was implemented due to customer request to help administrators identify and manage different data export purposes, ensuring that critical billing exports can be easily identified and prioritized for system reliability, support escalation, and incident response since these exports directly impact agency revenue and budget operations.
  • How - Export type classification is managed through enhanced Endpoint setup interface:
    • Navigate to Endpoint setup page where new "Export Type" field appears alongside existing configuration options
    • Select from available export categories: "--" (default blank), "Billing" (critical revenue-related), "State Export" (regulatory reporting), "Community Health" (public health data), "Syndromic Surveillance" (disease monitoring), "Health Information Exchange" (healthcare data sharing), and "Other" (additional purposes)
    • "Billing" classification marks exports essential to agency revenue requiring high availability
    • Export type information enables support teams to prioritize billing-related issues affecting agency operations
    • Configuration clarity helps administrators understand and document each endpoint's business purpose
    • Note: Default blank state ensures no assumptions about existing endpoint configurations
    • Note: Classification aids in understanding data flow purposes and compliance requirements
    • Note: Export type identification supports better incident response and troubleshooting prioritization
  • Use Case - An EMS agency configuring multiple data export endpoints can now clearly identify their billing export to their third-party billing company as "Billing" type, their state EMS registry submission as "State Export," and their hospital data sharing as "Health Information Exchange." When the billing export experiences issues affecting revenue collection, support teams can immediately recognize the critical nature of the problem and prioritize resolution, while routine maintenance on the community health export can be scheduled appropriately without the same urgency level, ensuring proper resource allocation for system reliability and agency operations.




7. UI Improvements - Date/Time Focus, Search Bar Autofocus, and Mobile Keyboard Enhancements
  • What - Three critical UI improvements have been implemented to enhance user experience, particularly on mobile and tablet devices, including intelligent date/time focus management that automatically shifts to time components when default dates are used, search bar autofocus control that eliminates disruptive keyboard behavior in list fields, and field-specific mobile keyboard recognition that automatically triggers appropriate input methods. These enhancements significantly improve data entry speed and reduce user friction in clinical documentation workflows while maintaining consistency across all relevant input fields and components.
  • Why - These enhancements were implemented due to customer request to address workflow interruption issues where keyboards obscured list values on tablets, improve date/time input efficiency when using default dates, and ensure appropriate mobile keyboards appear automatically for different field types, particularly benefiting keyboard-heavy workflows common in EMS and clinical documentation.
  • How - UI improvements are automatically applied across all relevant interface components with intelligent behavior:
    • Date/Time focus management automatically shifts input focus to time component when users select "Yes" to use default date, enabling immediate time entry
    • Search bar autofocus control removes automatic keyboard activation in list fields, displaying full list values clearly until users explicitly select the search bar
    • Field-specific mobile keyboards implement proper HTML input types to trigger numeric keypad for numbers and phone keyboard for phone fields automatically
    • List values remain visible when fields are selected, with keyboard only appearing when search functionality is needed
    • Cross-platform consistency ensures improvements function across tablet and mobile device platforms
    • Note: If user selects "No" to default date, focus remains on blank date field as expected
    • Note: Free text fields maintain automatic keyboard activation to preserve expected behavior
    • Note: Behavior applies consistently to both dropdown and side panel list views
  • Use Case - A paramedic using a tablet to document patient care can now select an incident time field, choose "Yes" to use today's date, and immediately type the time (like "1430" for 2:30 PM) without manually navigating to the time component. When selecting from medication lists, the full list of options remains visible for easy selection instead of being obscured by an automatically-activated search keyboard, and when entering vital signs, the numeric keypad automatically appears for number fields while phone keyboards activate for contact information, streamlining the entire clinical documentation process and reducing input friction during patient care.







8. AI QA/QI - Add Column/Indication on External Resource that the Protocol Document has been Sync'd to the AI Server
  • What - Visual status indicators have been added to the External Resources section to display the synchronization status of protocol documents uploaded to the AI server, providing real-time feedback through three distinct status icons during the approximately 10-minute sync process. The system shows Failed (Red X), Processing (Yellow spinning wheel), and Success (Green check) states with contextual tooltips, enabling administrators to monitor protocol upload progress and identify synchronization issues that could affect AI-powered QA/QI review capabilities.
  • Why - This enhancement was implemented due to customer request to provide transparency into the protocol synchronization process that was previously hidden from users, helping administrators troubleshoot AI QA/QI issues by identifying failed protocol syncs and managing expectations during the upload process that serves both crew reference and AI model input purposes.
  • How - Protocol sync status is displayed through dynamic visual indicators in the External Resources interface:
    • Protocol document upload to External Resources with "Is Current Protocol" toggle enabled initiates sync process
    • Yellow spinning wheel appears indicating sync in progress (approximately 10 minutes duration)
    • Status icons update automatically to either Green check (successful sync) or Red X (failed sync)
    • Contextual tooltips provide status descriptions: "Sync in Progress," "Sync Successful," or "Sync Failed"
    • Single icon display shows only current status to avoid interface clutter
    • Real-time updates occur without page refresh for immediate visibility
    • Independent status tracking for each protocol document enables comprehensive system monitoring
    • Note: Failed syncs can be retried with status indicators updating through the process
    • Note: Green check confirmation ensures protocol document is available for AI-powered review processes
    • Note: Red X indicator alerts administrators to synchronization errors requiring attention
  • Use Case - An EMS administrator uploads updated cardiac arrest protocols to External Resources and enables the "Is Current Protocol" setting, immediately seeing a yellow spinning wheel indicating the sync process has started. After monitoring for about 10 minutes, they see the green check mark appear, confirming the protocols are successfully synchronized with the AI server and available for QA/QI analysis. If a red X appears instead, they know to investigate the sync failure and retry the upload to ensure their AI-powered QA reviews can access the current protocols for accurate patient care assessment and feedback generation.


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