In the middle of an October night in 2020, 40-year–old Nita Enyeart suddenly awoke with radiating pain. She stayed up all night trying to self-treat the throbbing twinge emanating from her back with heat, ice, numbing creams, hot baths, and hot showers. Nothing worked. Years earlier, Enyeart had undergone surgery for kidney stones and she remembered that the surgeon had told her that they could recur. Believing that to be the cause of her pain, she went to the emergency department closest to her small town in Louisiana.
The clinical team at St. Tammany Parish Hospital immediately diagnosed a kidney stone. Enyeart breathed a sigh of relief thinking she would receive a couple days’ worth of pain medicine and be on her way while the kidney stone passed. However, the dynamic between her and the clinical staff took a sharp turn. “Everything suddenly changed,” Enyeart told Annals. “It was like they flipped a switch.” Baffled by the sudden shift in demeanor, Enyeart asked the nurse what was wrong. “We saw your score and saw that you were trying to seek drugs,” the nurse responded.
“My score? What do you mean?” Enyeart was puzzled over the accusation of being a “doctor shopper” or “drug seeker.” She had a kidney stone. Of course she wanted pain control. It was at this moment when Enyeart first learned about her “NarxCare scores.”
On the basis of a machine-learning algorithm that trawls state-governed Prescription Drug Monitoring Program (PDMP) databases, NarxCare scores purport to predict a patient’s risk of prescription drug overdose. The higher the score the higher is the risk of unintentional overdose according to Bamboo Health, formerly known as Appriss, the health technology company that designed the algorithm that is being used in hospitals across the country. The overdose risk algorithm is embedded within NarxCare, Bamboo Health’s flagship product.
