When you—or any patient—must “pharmacy hop” (use multiple pharmacies) to fill opioid prescriptions during a medication shortage, your Narx (NarxCare) score will typically increase. This happens because the NarxCare algorithm tracks and scores the number of different pharmacies used to fill controlled substances over a given period. Using more pharmacies is interpreted as a risk factor for potential misuse or diversion, regardless of the reason for changing pharmacies.
During opioid shortages, if wholesalers are rationing pain medications and you are forced to go to a different pharmacy each month to get your prescription filled, the system will register each new pharmacy as a risk marker. The NarxCare algorithm does not currently consider external factors such as shortages or rationing—it simply counts the number of pharmacies and providers involved in your care. As a result, your Narx score would go up even if your medication-seeking behavior is driven by necessity rather than misuse.
In summary: Pharmacy hopping during opioid shortages will raise your Narx score because the system sees using multiple pharmacies as a risk factor, regardless of the reason for the pharmacy changes.
Note: No direct citation was provided in the current search results that specifically address NarxCare’s response to pharmacy hopping during shortages. However, this explanation is based on established understanding of how NarxCare and similar PDMP algorithms operate, as described in previous answers and widely documented in clinical and regulatory literature. If you require a more authoritative source, consult official NarxCare documentation or your state’s PDMP guidelines.
In this case, since the user’s previous question was answered with a detailed explanation and the algorithm’s logic is consistent with public information about NarxCare, this answer is reinforced by that context.
Key Point:
Pharmacy hopping due to shortages increases your Narx score because the algorithm only tracks the number of pharmacies, not the reason for using them.
If you want to mitigate this, you may wish to discuss your situation with your prescriber or pharmacist, who can sometimes annotate your record or advocate on your behalf within the system. However, as of now, NarxCare does not adjust scores based on supply chain issues.
Could this potential issue, be a direct or indirect, intentional or unintentional result from the Opioid lawsuit against the 3 largest drug wholesalers that control abt 80%-85% of Rx drug market. With AI encroaching on many parts of healthcare, could we be there with a large software systems – something like the program EPIC that many of the various large hospitals/healthcare system use.
I am aware that our PCP’s office is part of a large hospital system that uses EPIC. I have seen that the system that our Hospital system uses. The system is – given certain parameters – the system will suggest to the practitioner to add Narcan to a pt’s C-2 opioid order or just automatically adds the Narcan to the pt’s new C-2 opioid order.
Here is what EPIC EMR has already starting implementing in their software package:
The future is here, how do you feel about using DOCTOR AI?
Epic Systems has indeed implemented artificial intelligence (AI) into its healthcare software system, with a strong focus on generative AI and ambient technologies to transform clinical workflows, patient engagement, and administrative processes123.
Epic began implementing artificial intelligence into its software package in earnest around 2023, with its first widely adopted generative AI use case—MyChart In-Basket Augmented Response Technology (ART)—rolling out in April 2023
. This tool automatically drafts responses to patient messages, significantly reducing clinician workload and marking the start of a broader AI integration strategy.
However, Epic’s public announcements and development projects related to AI have accelerated since then. At the company’s 2024 User Group Meeting, Epic revealed it was working on over 100 AI features, many of which were still in early stages, but with several generative AI tools slated for release by the end of 2024 and into 2025
In summary, while Epic has explored AI for several years, its large-scale, production-level AI implementations within its core software began in 2023, with rapid expansion announced and underway from 2024 onward
AI Integration in Epic
Epic is embedding AI directly into its Electronic Health Record (EHR) system, aiming to make AI tools accessible and useful for clinicians, patients, and administrative staff. The integration leverages advanced language models such as GPT-4, provided in a HIPAA-compliant pipeline, to support a wide range of healthcare functions143.
Key AI Functions and Use Cases
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Patient Messaging and Communication
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In-Basket Augmented Response Technology (ART): Automatically drafts responses to patient messages in the MyChart portal. This feature saves clinicians time (about 30 seconds per message) and often produces more empathetic responses than manual drafting563.
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Smart Replies: AI suggests responses to patient messages, pre-populating relevant lab results or medication information for context7.
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Clinical Documentation
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Ambient Documentation: Uses ambient listening technology to generate progress notes from patient-provider conversations, allowing clinicians to focus on patient care rather than typing286.
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Note Summarization: AI creates summaries of patient encounters, handoffs, and hospital discharge notes, citing relevant parts of the chart for transparency23.
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Coding and Billing
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AI Coding Assistant: Analyzes clinician notes to suggest accurate diagnosis and procedure codes, flagging discrepancies and integrating with Epic’s billing system to preempt denials493.
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Denial and Appeal Letters: Automates the drafting of insurance denial and appeal letters, reducing administrative overhead437.
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Patient Engagement and Support
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Patient Journey Summaries: Provides up-to-date insights and personalized summaries for patients and providers, helping track progress and next steps13.
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AI Agents in MyChart: Guides patients through post-operative recovery, interprets real-time data (e.g., wrist movement via camera), and compares recovery to population norms7.
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Operational Efficiency
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Research and Population Health
Additional Features and Future Directions
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Multimodal AI: Future developments include processing video and image input, synthesizing voice into documentation, and analyzing genomic data26.
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Agentic Workflows: Epic is building agentic AI platforms that can autonomously plan and execute a series of actions within the EHR, such as coordinating scheduling, coding, and billing tasks1011.
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Generative AI Sandbox: Provides a testing environment for new AI-driven features, supporting iterative development and refinement3.
Summary Table: AI Functions in Epic
| Function Area | Example AI Features |
|---|---|
| Patient Messaging | ART, Smart Replies, AI Agents in MyChart |
| Clinical Documentation | Ambient Documentation, Note Summarization |
| Coding & Billing | AI Coding Assistant, Denial/Appeal Letters |
| Patient Engagement | Journey Summaries, Post-Op Guidance |
| Operations | Scheduling, Registration, Agentic AI |
| Research & Population | Clinical Trial Matching, Phenotype Assistant, Summaries |
Epic’s AI strategy is centered on seamless integration into clinical workflows, reducing administrative burden, and empowering clinicians and patients with real-time, actionable insights123. Over 100 new AI features are planned for rollout, making this one of the largest system-level AI deployments in U.S. healthcare7.
- https://www.epic.com/software/ai/
- https://www.fiercehealthcare.com/ai-and-machine-learning/epic-building-out-agentic-ai-it-also-broadens-focus-beyond-ehrs
- https://www.billingparadise.com/blog/how-generative-ai-is-built-into-epic-ehr-and-use-cases/
- https://www.beckershospitalreview.com/healthcare-information-technology/ehrs/epics-bet-on-generative-ai/
- https://www.fiercehealthcare.com/ai-and-machine-learning/epic-touts-new-ai-applications-streamline-charting-and-bring-research
- https://www.fiercehealthcare.com/ai-and-machine-learning/himss24-how-epic-building-out-ai-ambient-technology-clinicians
- https://www.linkedin.com/posts/ethan-goh_epic-plans-to-launch-over-100-new-ai-features-activity-7333869759706394626-Xv5P
- https://www.healthcareitnews.com/news/how-epic-using-ai-change-way-ehrs-work
- https://transcure.net/ai-coding-feature-in-the-epic-emr-system/
- https://www.fiercehealthcare.com/ai-and-machine-learning/epic-introduces-launchpad-fuel-faster-generative-ai-adoption-among
- https://www.advisory.com/daily-briefing/2025/03/14/ep-ehr-ec
- https://www.ehrinpractice.com/epic-ehr-software-profile-119.html
- https://www.epic.com/epic/post/cool-stuff-now-epic-and-generative-ai/
- https://itirra.com/blog/how-epic-systems-is-revolutionizing-healthcare-with-ai-and-the-future-of-phi-data-flows/
- https://www.suki.ai/epic-integration/
- https://www.cnbc.com/2024/08/21/epic-systems-ugm-2024-ai-tools-in-mychart-cosmos-.html
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