Many states have introduced Prescription Drug Monitoring Programs (PDMP) to help combat the opioid epidemic, and more and more states are mandating Electronic Prescription of Controlled Substances (EPCS). It’s been almost three years since Medicaid prescriptions were mandated to be submitted electronically in the United States. In this post, we’ll outline the tools that are integrated into Open Dental that will help you comply with your state’s mandates for both EPCS and PDMP.

What is the mandate in my state?

Many states already have EPCS and PDMP mandates in place. If your state mandates one of these programs, you will already have received a notification. Heads-up for practices in Illinois, your mandate kicks in on January 1, 2024.
This map shows the states that have/will have EPCS mandates and PDMP in place as of the date of this post. To use the interactive map with more details, click on the image below.

Can I e-prescribe in Open Dental?

Yes! There are two options for e-prescribing (eRx) in Open Dental. Your practice must be on support and using version 21.2 or greater to e-prescribe through Open Dental.

ALERT:
It is important that you start the eRx Setup process well before the Electronic Prescribing deadline, and especially well before you send your first prescription, as the process may take up to two weeks. 

1. DoseSpot
   DoseSpot is an internet-based, secure e-prescribing system that integrates with Open Dental using a program link and offers two-way medication syncing. It is also integrated into Open Dental Mobile.
   Learn more in our DoseSpot integration video, and in our online manual.
   Note: If you are planning to switch to Open Dental, but need electronic prescriptions available sooner due to new regulations, DoseSpot has a stand-alone product that can be used until your conversion is complete and you can use the integration. The two systems are distinct and data will not transfer, but you can continue to look in the standalone product for the older eRx data as needed. See our manual page for more.
2. NewCrop eRx
   NewCrop eRx is an internet-based, secure ePrescribing system that integrates with Open Dental using a program link. Learn more in our DoseSpot integration video and in our online manual.

This handy comparison chart may help:

Can I connect my state’s PDMP to Open Dental?

Yes! The PDMP integration was recently expanded to include all states that currently have programs.

To set up the PDMP integration in Open Dental:

• Your practice must be on support.
• Make sure to update your software to the latest stable version to take advantage of all the latest integrations. You must be on version 20.4 or greater to use the PDMP integration.
• Register with your state’s PDMP program.
  • Illinois users can register here: https://www.ilpmp.org/PMPnowRegistration.php
  • California, Kentucky, Maryland, Utah, and Washington can register here: https://signup.logicoy.com/PDMPSystemEhrSignup/register
  • For all other states, register here: https://info.apprisshealth.com/ehrrequest
• Enable the bridge in Open Dental in Setup > Program Links and select the bridge indicated for your state.
  • Practices in California, Illinois, Kentucky, Maryland, Utah, and Washington will use the PDMP bridge.
  • Users in all other states will use the Appriss (Bamboo) bridge.

A few things to note:

• The PDMP bridges will open PDMP for the selected patient. No information is imported into Open Dental.
• DoseSpot and NewCrop both have a direct integration with Appriss/Bamboo that shows the patient’s PDMP information in the software. If you choose not to register for Appriss/Bamboo, they will provide a link to the state PDMP.
• If you would like to access your state’s PDMP through your eRx software (DoseSpot or NewCrop) rather than via a bridge in Open Dental, please contact Open Dental Support for help registering.

Bamboo “reads” a patient’s PDMP record and returns these scores to give you as the provider an indicator of how often a patient is using controlled substances and their likelihood of opioid abuse.

Scores are not meant to drive prescribing decisions, but rather, to prompt a conversation between the provider and the patient and keep lines of communication open.

The Narx Score (000 – 999)

This is calculated by looking at the number of prescribers, pharmacies, milligram equivalents, overlapping prescriptions, and recent activity for the patient concerning narcotics, sedatives, and stimulants (each will have a separate score). The last number in the score is always the number of prescriptions that are currently prescribed for that drug type. The lower the score the better. 

000: This may be the first type of drug prescribed to this patient. May consider discussing risks.
010-200: 75% of users will fall in this range. 
201-650: 24% of users will fall in this range. Consider reviewing patterns for unsafe conditions.
>650: 1% of scores will fall in this range. Consider reviewing with other prescribers of the patient and the patient.
This may be grounds for patient evaluation.

Overdose Risk Scores

This takes into account the Narx Scores and many other variables to determine a general likelihood of opioid abuse. It is also a three-digit number and follows the same percentage pattern as the Narx Scores above.

Stay tuned for our Getting Started with eRx post, coming soon! In the meantime, check our Manual for more info or contact Support. Our team is happy to help with any questions about PDMP or e-prescribing in Open Dental. For help setting up any of these integrations or info on e-prescribing, please contact us.