Setting up DoseSpot

Ona prescribes through DoseSpot, a certified e-prescribing service. Enrolment happens once for the clinic and once for each person, and it's the only setup between an empty practice and a prescription arriving at a pharmacy.

Go to Settings → DoseSpot — "Set up e-prescribing, link prescribers, and sync patients before launching DoseSpot charts." Everything on this page is admin work; nobody else needs to see it.

The connection card

The card at the top is the clinic's own connection, in one of three states:

• Ready — "Linked prescribers and proxies can launch DoseSpot from any patient chart."
• Setup incomplete — the clinic exists in DoseSpot, but nobody is linked yet.
• Not provisioned — the clinic hasn't been created yet. Start at Step 1.

Beneath it sit Clinic ID, Members linked, and Charts — either Launchable or Locked.

Read Ready carefully: it describes the clinic, not any one person. A practice can sit at Ready all day while a newly hired doctor still can't open a chart, because they haven't been provisioned in Step 2. That gap is the single most common cause of "prescribing is broken".

Step 1 — Provision clinic

"One-time setup. Creates the DoseSpot clinic and the proxy account used to mint prescriber sessions." You give the clinic name (it defaults to your organisation name), a primary phone, and a full US address. Once a Clinic ID exists the card disappears and Steps 2 and 3 take its place.

The optional Proxy clinician block at the bottom — first name, last name, date of birth — is worth explaining, because the word proxy means two unrelated things in DoseSpot and this is the one nobody interacts with. What Step 1 creates is a service account: a machine identity Ona uses behind the scenes to sync patients and mint sessions. No human ever signs in as it, it never touches a prescription, and it has nothing to do with the staff proxies you create in Step 2. Leave the fields blank and they default to the clinic name.

Step 2 — Provision prescribers and proxies

"Link team members who will prescribe, and staff who prepare prescriptions for a prescriber to send." Every active team member is listed with their NPI and their DoseSpot access — Not linked, Prescriber, or Proxy — and an action to Provision or Relink them.

The two account types

• Prescriber — signs and transmits prescriptions. Requires an NPI and Surescripts registration.
• Proxy — prepares prescriptions for a prescriber to review and send. No NPI, no DEA numbers, no Surescripts registration.

The distinction is enforced by DoseSpot itself, not by an Ona permission: a proxy account simply has no send action inside the DoseSpot interface. So choose deliberately — the account type is what decides whether someone can put a prescription on the wire.

Provisioning someone

Provision opens the Provision DoseSpot account dialog. Pick the account type, then fill in date of birth, address line 1, city, state, ZIP code and a primary phone; fax is optional. These are DoseSpot's own registration details and can be the clinic's address and phone rather than the person's home ones.

The only field that differs between the two types is the NPI, which only a prescriber has — it prefills from their team profile if it's stored there, and the field disappears entirely for a proxy.

Note the different waiting times. A prescriber's NPI goes to Surescripts for verification, which runs in the background and can sit at Pending for a few minutes after you submit; re-running with the same NPI is idempotent and recovers or relinks the existing account rather than creating a second one. A proxy is never sent to Surescripts at all, so it works the moment you save.

Give each staff member their own proxy

Don't share one proxy account across the front desk. DoseSpot attributes a queued prescription to the account that staged it, so a shared proxy loses that trail — you end up with a prescription that a prescriber signed on somebody's word, and no record of whose. One person, one account.

Step 3 — DEA numbers

"Store DEA registrations for provisioned prescribers." Choose a clinician, then Add DEA and record the number with the address it's registered to. The format is two letters followed by seven digits, such as AB1234563.

This step gates controlled substances and nothing else. A prescriber can write ordinary medications the moment they're linked in Step 2; EPCS — electronic prescribing of controlled substances — additionally needs a DEA number recorded here.

One trap: proxies appear in the clinician dropdown, because it lists everyone who is linked. Never add a DEA number to one. A proxy has no NPI and can't transmit anything, so a DEA registration sitting on a proxy account is a compliance record pointing at an account that never prescribed.

Relinking and unlinking

Relink reopens the same dialog for someone already connected. For a prescriber it recovers or re-establishes their existing DoseSpot account against the same NPI, which is safe to repeat.

What Relink can't do is change someone's account type. Switching a proxy to a prescriber, or the reverse, means unlinking them first and then provisioning again with the other type — attempting it directly is refused, and today the refusal only surfaces as the generic "Prescriber not provisioned — Check the details and try again". If a relink keeps failing on someone who is already a proxy, that's what's happening.

Unlink stops Ona issuing DoseSpot sessions for that person immediately, and disables their DoseSpot account where it can. When it can't, you get a yellow callout naming the DoseSpot user id to disable by hand in the DoseSpot admin console. Act on that callout: the person can no longer reach DoseSpot through Ona, but their upstream account is still live, and retrying the unlink won't clear it.

Details that matter

• Ready doesn't mean everyone can prescribe. The connection card is about the clinic. Check the DoseSpot access badge on the individual row before concluding that someone's access is fine.
• Anyone linked before proxies existed is a prescriber. Proxy accounts were added later, so an older link carries no account type and is treated as a prescriber. If that's wrong for a staff member, unlink and provision them again as a proxy.
• A proxy isn't blocked, only limited. They open DoseSpot normally and can do everything except send. Don't read a working DoseSpot chart as proof that someone can transmit a prescription.
• Address line 1 is capped at 35 characters. DoseSpot rejects a longer one outright rather than truncating it.
• There is no patient sync step here. Patients are pushed to DoseSpot automatically the first time someone opens their chart — see Sending a prescription.