MEFIRS Updates March 2, 2026

Visibility Rule Changes

Visibility Rule 17499 will be marked inactive.

Visibility Rule 17499, LFOM Primary Impression Hides, will be marked inactive. The rule specifies" For the field Provider's Primary Impression (eSituation.11)the value(s): Aortic aneurysm or dissection; NEO - Congenital Defect; NEO - Hyperbilirubinemia; NEO - Sepsis; NEO - Neonatal Abstinence Syndrome; NEO - Hypoxic Ischemic Encephalopathy; NEO - Pneumothorax; NEO - Respiratory Distress Syndrome; NEO - Other not listed; NEO - Gestational Prematurity; Congenital malformati; NEO - Hypoglycemia will hide when: Agency Number is equal to 0807 or agency number is equal to LFOM Demo

Visibility Rule 25403, Hide Neo Primary Impressions for Non-Neo Patients, will be marked inactive.

Visibility Rule 25403, Hide Neo Primary Impressions for Non-Neo Patients, will go into effect. The rule specifies" For the field Provider's Primary Impression (eSituation.11) the value(s): NEO - Congenital Defect; NEO - Hyperbilirubinemia; NEO - Sepsis; NEO - Neonatal Abstinence Syndrome; NEO - Hypoxic Ischemic Encephalopathy; NEO - Pneumothorax; NEO - Respiratory Distress Syndrome; NEO - Other not listed; NEO - Gestational Prematurity; NEO - Hypoglycemia will hide when: the Unit Notified By Dispatch Date/Time (eTimes.03) is after March 2, 2026 00:00:00 and (Age Units (ePatient.16) is equal to Years or (Age Units (ePatient.16) is equal to Months and Age (ePatient.15) is greater than 1) or (Age Units (ePatient.16) is equal to Days and Age (ePatient.15) is greater than 28))

Visibility Rule 25404, Hide Neo Secondary Impressions for Non-Neo Patients, will be marked inactive.

Visibility Rule 25404, Hide Neo Secondary Impressions for Non-Neo Patients, will go into effect. The rule specifies" For the field Provider's Primary Impression (eSituation.11) the value(s): NEO - Congenital Defect; NEO - Hyperbilirubinemia; NEO - Sepsis; NEO - Neonatal Abstinence Syndrome; NEO - Hypoxic Ischemic Encephalopathy; NEO - Pneumothorax; NEO - Respiratory Distress Syndrome; NEO - Other not listed; NEO - Gestational Prematurity; NEO - Hypoglycemia will hide when: the Unit Notified By Dispatch Date/Time (eTimes.03) is after March 2, 2026 00:00:00 and (Age Units (ePatient.16) is equal to Years or (Age Units (ePatient.16) is equal to Months and Age (ePatient.15) is greater than 1) or (Age Units (ePatient.16) is equal to Days and Age (ePatient.15) is greater than 28))

Security and Permission Changes

Permission Changes For Agency Admins

A change is being made to the EMS Agency Admin Permission group, Fire/EMS Agency Admin Permission Group, and the Fire Agency Admin Permission group to allow agency admins to configure whether data from CAD overwrites data that exists within the report at the time of importing the CAD data. Agency admins will be able to access the CAD Overwrite Manager configuration under the Tools menu. When in the CAD Overwrite manager you are able to set whether data from CAD will overwrite user entered data for each field CAD populates. If no value has been entered by a user for the field the CAD data will be used to update the field.

Special note on Permission changes in MEFIRS. Recently it was necessary to make some permission changes within the MEFIRS system to address the addition of the NERIS module as well as several security concerns. There are users who may have lost access to features they once had and those users should be evaluated to ensure they are in the correct security group. Additionally, some users may have been granted an override permission, granting access to a feature that their security group would not normally have access to. Those having an override permission lost all of their override settings as the permission groups required a reset to close security holes. We apologize for any inconvenience this may have resulted in. We will also be noting security changes in these announcements to provide an advance warning of upcoming changes.

Accounts to be deactivated

Data security standards and statutes require that user accounts accessing personally identifiable information and protected health information be assigned a unique name and/or number to each employee or workforce member who uses a system that maintains electronic protected health information (e-PHI), so that system access and activity can be identified and tracked by user. We have Identified several accounts that do not meet the requirements established by standards and statutes and will be disabled On March 2, 2026. The accounts are; Dictation AAVersio, admin admin, Blood Bank CMMC, EMS Provider Other, Non-EMS Provider Other, NL Lab POCT, Mayo Provider, Pharmacy SMMC.

Supporting Agency Changes

Supporting agencies will be changed by adding the additional law enforcement agencies; National Park Service (NPS), Maine Marine Patrol (MMP), and Maine Warden Service (MWS).

Note: Agency Admins are able to fine tune supporting agencies for their own agency, limiting the supporting agencies to those they are likely to interact with. for more details on how to do this go to Fine Tuning Supporting Agencies.

Postal Code Lookup Changes

In order to facilitate ease of entry ImageTrend supports two types of buttons that will help fil the City/Town, State, and County by the postal code entered.

The Set From Postal Code will use the postal code to search the Geographic Names Information System (GNIS) for records having a matching postal code and a GNIS Feature Class of Civil. This generally returns fewer results, and some agencies are finding that the use of the button is not allowing them to document accurately.
The Location Lookup Buttons will use the postal code to search the Geographic Names Information System (GNIS) for records having a matching postal code and having a GNIS Feature Class of Civil, Populated Places and all other GNIS codes.

With either button type, if there is a single matching record found it will auto-populate the City/Town, County, and State. Also, with either button type, if there is more than one record found it will present the matches found to the user to select from and then use the selected result to populate the City/Town, County, and State

Destination Postal Code Lookup.

The Destination Address Postal Code Lookup Button was intended to be used as a lookup button based upon the entry of a postal code.

In the ImageTrend documentation a "Set from postal code button returns a list of only GNIS records where the postal code matches and the GNIS Feature Class is "Civil" whereas a location lookup button returns a list of GNIS records where the postal code matches and is in any GNIS Feature Class. In either case if there is only one matching record it will automatically set it to that value.

Some users have found that because the form is using the Destination Address Postal Code Lookup it is only listing Civil matches, functioning as a Set From Postal Code button instead of a lookup button.

We will be replacing the Destination Address Postal Code Lookup button with the Destination Address Location Lookup Button which functions as a lookup button and returns to the user postal code matches for any GNIS Feature Class. When there is only a single matching record it will auto-populate the result without additional user interaction.

Patient Postal Code Lookup.

The Patient Address Postal Code Lookup Button was intended to be used as a lookup button based upon the entry of a postal code.

We will be replacing the Patient Address Postal Code Lookup button with the Patient Address Location Lookup Button which functions as a lookup button and returns to the user postal code matches for any GNIS Feature Class. When there is only a single matching record it will auto-populate the result without additional user interaction.

Patient Alternate Postal Code Lookup.

The Patient Alternate Address Postal Code Lookup Button was intended to be used as a lookup button based upon the entry of a postal code.

We will be replacing the Patient Alternate Address Postal Code Lookup button with the Patient Alternate Address Location Lookup Button which functions as a lookup button and returns to the user postal code matches for any GNIS Feature Class. When there is only a single matching record it will auto-populate the result without additional user interaction.

Medication Ordered Dataset Changes

At some point in the past the Medication Ordered data set was relabeled as a Medication Prior To Arrival dataset. Medications administered prior to arrival should be documented using the medications dataset and setting the Medication Administered Prior to this Units EMS Care to "Yes". As we are preparing to add Procedures Ordered and Medications Ordered to the Patient Care form, we will be returning the labelling of the Medication Ordered dataset to Medication Ordered instead of Medication Given PTA. Specifically the data elements:

Medication Given Prior To Arrival (itMedicationOrdered.001) will be returned to its defined name of Medication Ordered
Medication Given By (PTA) (itMedicationOrdered.002) will be returned to its defined name of Medication Ordered By
Medication Given Dosage (PTA) (itMedicationOrdered.003) will be returned to its defined name of Medication Ordered Dosage
Medication Given Dosage Units (PTA) (itMedicationOrdered.004) will be returned to its defined name of Medication Ordered Dosage Units
Medication Given Route (PTA) (itMedicationOrdered.005 ) will be returned to its defined name of Medication Ordered Route
Medication Given Response (PTA) (itMedicationOrdered.006 ) will be returned to its defined name of Medication Ordered Response
Medication Given (PTA) Date/Time (itMedicationOrdered.007) will be returned to its defined name of Medication Ordered Date/Time
Medication Given (PTA) Comments (itMedicationOrdered.008) will be returned to its defined name of Medication Ordered Comments

Controlled Substances

Controlled Substance Grid added to Patient Care Form

A new panel is being added to allow for documenting controlled substances. The panel will appear below the medications panel when documenting the administration of; Diazepam, Fentanyl, HYDROmorphone, Ketamine, Lorazepam/Ativan, Midazolam, Morphine, oxyCODONE, and Phenobarbital. The data elements include:

Controlled Substance Medication Name (itControlledSubstances.009): The name of the controlled substance that was administered.
Controlled Substance Vial/Package Number (itControlledSubstances.013): A unique number for the controlled substance's packaging, if available.
Broken Seal Number (itControlledSubstances.003): The seal number the user broke to access the controlled substance, if available.
New Seal Number (itControlledSubstances.004): The seal number the user broke to access the controlled substance, if available.
Controlled Substance Amount Administered (itControlledSubstances.011): The amount of the controlled substance that was administered.
Controlled Substance Amount Returned (itControlledSubstances.001): The amount of the controlled substance that was returned to distributor of the controlled substance
Controlled Substance Amount Wasted (itControlledSubstances.012): The amount of the controlled substance that was wasted and/or discarded
Controlled Substance Amount Units (itControlledSubstances.002): The unit of measurement of the controlled substance amounts
Crew #1 Verification (itControlledSubstances.014) - Currently Inactive: A mechanism that could be used to verify that the Crew #1 user is the identified user.
Crew #1 Licensure ID (itControlledSubstances.007): The license number of Crew member #1 providing the controlled substance information
Crew #1 Signature/Initial (itControlledSubstances.005): The signature/initial of Crew member #1 providing the controlled substance information
Crew #2 Verification (itControlledSubstances.015) - Currently Inactive: A mechanism that could be used to verify that the Crew #2 user is the identified user.
Crew #2 Licensure ID (itControlledSubstances.008): The license number of Crew member #2 providing the controlled substance information
Crew #2 Signature/Initial (itControlledSubstances.006): The signature/initial of Crew member #2 providing the controlled substance information

Controlled Substance Grid Visibility Rule

Visibility Rule 25406, Hide Controlled Substance Grid by Medication Administered, will be added. The rule states: The Controlled Substances grid will hide when: The number of Medications where Medication Administered (eMedications.03) is one of these values: Diazepam, Fentanyl, HYDROmorphone, Ketamine, Lorazepam/Ativan, Midazolam, Morphine, oxyCODONE, and Phenobarbital is less than 1 AND the Unit Notified By Dispatch Date/Time (eTimes.03) is after 3/2/2026 00:00

Controlled Substance Grid Validation Rules

Validation Rule 3841, Controlled Substance Grid for Fentanyl, will flag Orange (Recommended) if: The Unit Notified By Dispatch Date/Time (eTimes.03) is after 3/2/2026 00:00 AND the number of Medications where Medication Administered (eMedications.03) is equal to Fentanyl is greater than 0 and the number of Controlled substances where the Controlled Substance Medication Name (itControlledSusbtances.009) is equal to Fentanyl is less than 1.

Validation Rule 3842, Controlled Substance Grid for HYDROmorphone, will flag Orange (Recommended) if: The Unit Notified By Dispatch Date/Time (eTimes.03) is after 3/2/2026 00:00 AND the number of Medications where Medication Administered (eMedications.03) is equal to HYDROmorphone is greater than 0 and the number of Controlled substances where the Controlled Substance Medication Name (itControlledSusbtances.009) is equal to HYDROmorphone is less than 1.

Validation Rule 3843, Controlled Substance Grid for Ketamine, will flag Orange (Recommended) if: The Unit Notified By Dispatch Date/Time (eTimes.03) is after 3/2/2026 00:00 AND the number of Medications where Medication Administered (eMedications.03) is equal to Ketamine is greater than 0 and the number of Controlled substances where the Controlled Substance Medication Name (itControlledSusbtances.009) is equal to Ketamine is less than 1.

Validation Rule 3844, Controlled Substance Grid for Lorazepam, will flag Orange (Recommended) if: The Unit Notified By Dispatch Date/Time (eTimes.03) is after 3/2/2026 00:00 AND the number of Medications where Medication Administered (eMedications.03) is equal to Lorazepam/Ativan is greater than 0 and the number of Controlled substances where the Controlled Substance Medication Name (itControlledSusbtances.009) is equal to Lorazepam/Ativan is less than 1.

Validation Rule 3845, Controlled Substance Grid for Midazolam, will flag Orange (Recommended) if: The Unit Notified By Dispatch Date/Time (eTimes.03) is after 3/2/2026 00:00 AND the number of Medications where Medication Administered (eMedications.03) is equal to Midazolam is greater than 0 and the number of Controlled substances where the Controlled Substance Medication Name (itControlledSusbtances.009) is equal to Midazolam is less than 1.

Validation Rule 3846, Controlled Substance Grid for Morphine, will flag Orange (Recommended) if: The Unit Notified By Dispatch Date/Time (eTimes.03) is after 3/2/2026 00:00 AND the number of Medications where Medication Administered (eMedications.03) is equal to Morphine is greater than 0 and the number of Controlled substances where the Controlled Substance Medication Name (itControlledSusbtances.009) is equal to Morphine is less than 1.

Emerging Infections Disease (EID) Surveillance Code

Emerging Infections Disease (EID) Surveillance Code added to Patient Care Form

With the emergence of Measles cases in Maine, the Emerging Infections Disease (EID) Surveillance Code field has been added to the patient care form on the Dispatch Section, Dispatch Information Panel. The field allows EMS clinicians to document the Surveillance code received from Dispatch; Positive U-21, Negative U-21, Inconclusive U-21, or No EIDS Code Available.

Emerging Infections Disease (EID) Surveillance Code Validation Rule

Validation Rule 1205, EID coding, will flag Red (Required) and assess 5 validation points if: The Unit Notified By Dispatch Date/Time (eTimes.03) is after 3/2/2026 00:00 AND the Emerging Infections Disease (EID) Surveillance Code field is blank.

Signature Panel Changes

Addition of Type of Patient Representative (eOther.14).

The Type of Patient Representative (eOther.14) is being added to several Signature Types, to include; Other EMS Crew Signatures, Authorization for Transport Witness Signatures, Medical Control Signature, Witness to Patient Refusal of Care Signature.

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