Since Bamboo is a recent result of Appriss Health’s acquisition of PatientPing, we haven’t had time to move all of our content to one website. For this specific content, we’re sending you to one of our other sites.
Welcome to Bamboo Health, formerly Appriss Health + PatientPing.
Patients are at the heart of what we do
At Bamboo Health, we put patients at the forefront when we design solutions. We have developed dozens of awareness applications for healthcare providers and pharmacists to use to make more informed clinical decisions. We regularly check-in with our customers to see how we can make improvements and support whole person care.
Bamboo Health offers a range of solutions that support both physical and mental health in a variety of ways – from prevention of substance misuse, to facilitating behavioral health intervention and care, and increasing communication among providers for continuity of care. Most of these solutions work behind the scenes to support your care team. We encourage patients and their families to learn more about all our solutions, but we most frequently receive questions about the NarxCare application.
The goal of this page is to help patients and their families understand what NarxCare is, what it does, how it works, and why your provider may use it.
Frequently Asked Questions
A controlled substance is an illegal or prescription drug regulated by the government, as covered by the Controlled Substances Act (CSA). The act categorizes substances into different schedules depending on “the drug’s acceptable medical use and the drug’s abuse or dependency potential,” according to the Drug Enforcement Administration.
In addition to CSA, states have laws in regard to controlled substances which healthcare providers and pharmacists must abide by when prescribing and dispensing drugs. States oversee Prescription Drug Monitoring Programs (see next question) to monitor prescribing of controlled substances.
Depending on your treatment plan, your doctor(s), provider(s), or pharmacist(s) may have been required to, or opted to, check your state’s prescription drug monitoring program (PDMP) prior to writing or dispensing a prescription. PDMP’s collect and distribute data about controlled substance prescribing and dispensing and provide up-to-date information about a patient’s prescription history. Providers check PDMP’s for individual patients to evaluate risk factors when prescribing/dispensing certain medications.
The NarxCare solution uses PDMP data from the states. NarxCare’s report helps your healthcare provider or pharmacist better understand the information in the PDMP through interactive visualizations and a set of risk scores that correspond to a patient’s data in the PDMP from the last two years.
The scores are a set of three-digit numbers that correspond to dispensing information for three different types of controlled substances (prescriptions). A separate score exists for narcotics, sedatives, and stimulants. The scores range from 000-999. The third number in the score indicates the number of current dispensations. The first two numbers are calculated based on data from the PDMP, including:
Number of prescribers,
Number of pharmacies where prescriptions were dispensed,
Strength of the prescriptions, and
The NarxCare algorithm – or mathematical model – weighs recent prescriptions and changes more heavily than older prescribing patterns.
Bamboo Health worked first with the State of Ohio, and then later Arizona and Michigan, to match unintentional overdose deaths with PDMP data. Data scientists used a retrospective model to determine components within the PDMP that may have indicated increased overdose risk. Those variables were used to build the overdose risk scores within NarxCare. You can read more about the study through this white paper
Since then, the scores were externally validated by peer-reviewed research
conducted through the National Institute on Drug Abuse’s (NIDA) National Drug Abuse Treatment Clinical Trials Network and funded by the National Institute of Health’s (NIH) HEAL Initiative. The study found the NarxCare solution is an effective “initial universal prescription opioid-risk screener.”
NarxCare is designed to highlight either the absence or the presence of risk factors for substance misuse to make it easier for your provider to more accurately understand the PDMP data. The scores provided by NarxCare are solely intended to help providers–and patients–become more aware of risk and make smarter decisions about the care they provide, and in turn, receive.
Prescribers and pharmacists are expected to review a patient’s PDMP report; in certain clinical situations, they are required by law to check it before prescribing certain types of medications or combinations of medications. NarxCare is intended to support healthcare providers and pharmacists by raising awareness of the use of controlled substances by a patient as represented in a state’s PDMP report. It is not intended to replace the clinician’s professional or medical judgment in deciding whether or not to prescribe medications and/or refer for other treatment.
Providers review the NarxCare report and determine if there are any concerns that would suggest further assessment, evaluation, and/or discussion with the patient. This report helps providers holistically interpret data and avoid making judgments based on a limited number of data elements. This view benefits patients as it reduces the chance of any one factor unduly influencing a provider’s assessment.
A patient who uses higher doses of medication for a long period of time, such as with chronic pain or severe anxiety, will not necessarily have a high score.
For patients who have well-managed chronic conditions, as indicated by a relatively stable dose of medication from a limited number of prescribers and pharmacies, the Narcotic, Sedative, and Stimulant Scores are expected to be in the lower half of the score range. This is true even if the patient is prescribed high doses of medication.
Your pharmacist or healthcare provider makes decisions about the recommended plan of treatment. The scores themselves are NOT intended to be the sole basis for any clinical decision by your provider or pharmacist. Providers should discuss any concerns with a patient prior to making or changing a prescription or other treatment decision.
Rules vary by state. Please contact your state’s PDMP to determine how you may obtain a copy of your report. Here is a link
with contact information for each state.
You may also ask your physician or healthcare provider. While they may or may not be able to provide you a copy, depending on state restrictions, they can discuss any concerns and/or opportunities for improved care.
Your state’s PDMP is the point of contact for any requested corrections to PDMP data. Here is a link with contact information for each state.
The scores represent only PDMP data and are calculated using a mathematical formula. Scores are always calculated the same way for every patient, based on the data in the PDMP. You should discuss your score with your physician who can help you understand how or why a particular score may be elevated. If you or your physician or pharmacist believe the PDMP data itself is wrong, then please contact your state PDMP program. Here is a link
with contact information for each state.
Bamboo Health’s training materials very specifically advise that the scores should not be used in this manner. NarxCare is intended to aid, but not replace, clinical decision making. None of the information presented should be used as sole justification for providing or refusing to provide medications. Your provider should offer an alternative plan of care for you and should not refuse to prescribe based on your scores alone.
If you believe a NarxCare report or score has been used inappropriately by a provider, then we suggest discussing your concern directly with the provider and asking what PDMP information was concerning. You may also call your state PDMP and address any concerns about your providers use of the NarxCare report.