NC CSRS Gateway Integration De-mystified

In 2009 the Obama Administration championed the development of the HITECH Act.  Among its many ramifications were the development of “meaningful use” parameters intended to provide financial incentives through health care insurance reimbursement (Medicare, Medicaid) for health care entities to adopt technological advances to make health care more accessible and affordable.

The HITECH Act accomplished this through the elimination of commercial, economic, and technical barriers. The HITECH Act focuses on “interoperability,” meaning that policies, programs, and incentives must aim for EHR software and systems that can share information with other EHR software and systems.  The ability of electronic healthcare records (EHR) to exchange information is referred to as “information exchange” or simply “IE” – an example of which might be for enterprise entities to access state public health databases (vaccination records, etc) to update their EHRs with that data.

Meaningful use parameter such as IE have been integrated into enterprise medical EHR platforms within hospitals and their patient care networks.  However, since Dentistry does not have any significant reimbursement through Medicare there are no incentives for dental EHR platforms to adopt many of these parameters.

In 2017 the NC General Assembly passed the “Strengthen Opioid Misuse Prevention Act” or “STOP Act.” Portions of the Act went into effect immediately, others were to go into effect at later dates.  However, the time has now come for the  requirement that all prescribers of targeted substances  consult with the DHHS’s Controlled Substance Reporting System (CSRS).

On June 25,2021 the NC Board of Dental Examiners (NCBDE) issued an advisory that effective July 7, 2021 all NC dentists MUST consult the CSRS prior to prescribing a targeted substance and must make note of it in the patients dental record.

NC Dental Licensees – July 7th approaches!!!!  If you are a dentist who prescribes opioids in NC, know this date. The STOP Act, passed by the NC General Assembly in 2017, takes full effect on this date. As of July 7, you MUST query CSRS before prescribing any controlled substance, and you MUST note in the patient record that you have done so. The NCBDE is also more likely to begin to enforce the mandate of e-prescribing of controlled substances at this time. (See Mr Kurdy’s Blog post here)

by Sean Kurdys, Old Well Consulting

Apriss Health – the software vendor for NC CSRS – has provided some integrations to it’s API (application programming interface – or “the handshake”) that make accessing CSRS from within common medical EHR systems and often times it is seamlessly integrated.  This is facilitated by the fact there is one EHR platform – EPIC – which dominates the health care domain.  However, again, within popular dental EHR programs, there is no standardization and little if any interoperability.  This is further complicated by the fact that many states utilize differing prescription drug monitoring programs (PDMPs) aside from those offered by Apriss. Even more there is no clear dental EHR platform which dominates the market.  Therefore, there is no default integration for PDMP data.  

Anyone in Dentistry who has significant experience with NC CSRS will acknowledge that while it provides essential information, it is not necessarily efficient to use.  Fortunately for NC dentists however, as noted in the June 25, 2021 advisory, Apriss Health has developed a piece of software – known as gateway integration – that will integrate NC CSRS data into some of the more popular dental EHR programs.

The following dental EHR software programs are compatible with NC CSRS gateway integration:

  • All Carestream products
  • Dentrix
  • EasyDental
  • Henry Schein Medical (Dental?)
  • Medent
  • Open Dental
  • Patterson EagleSoft
  • Practiceworks
  • SoftDent
  • WinOMS

Dental practices can initiate the CSRS gateway integration by clicking this link and following the instructions listed.  If uncertain as to how to proceed, practices should consult their respective IT professionals for further advise and guidance.

There are a number of low tech strategies that can also be adopted such as the exporting of patient data from dental EHR schedules.  There is some formatting that is required to bulk query NC CSRS and the file must be in the proper format.  Please do not hesitate to contact us if you have any further questions.

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