West Virginia EHR Integration Request Form


West Virginia is implementing a statewide, comprehensive platform for healthcare professionals to review patients' controlled-substance prescription history more quickly and efficiently. This platform utilizes current West Virginia Controlled Substances Monitoring Program prescription data and transfers it into electronic health records (EHR) and pharmacy management systems. Statewide integration is a key component of West Virginia’s ongoing efforts to address the opioid crisis. It is important to note that not all EHR vendors are currently integrated. Your integration process and duration time is dependent upon your EHR vendor.

Integration Process:

  1. Follow the instructions and complete ALL of the following (only authorized decision makers at the healthcare entity should fill out these forms):
    • Integration Request Form (located on the right of this page)
    • End User License Agreement (EULA) (emailed to you within 24 hours)
    • PMP Gateway Licensee Questionnaire (emailed within 24 hours)
  2. Upon approval of your completed forms, Appriss Health will provide you with information to begin the integration process.
  3. If your forms are not properly completed, they will be returned to you for correction and re-submission.

For more detailed information about this important initiative, please review the WV RxDataTrack/CSAPP Integration Initiative Welcome Packet.

PLEASE NOTE: Per a directive by the WV RxDataTrack/CSAPP Administrator, you may request access to the following states:

  • Virginia
  • Ohio
  • Kentucky
  • Pennsylvania
  • Maryland

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