One screen replaces the phone, the fax, and the eRx widget.
Surescripts to 95%+ of US pharmacies, real-time benefit cost, and DEA two-factor EPCS — with PDMP checks where state law requires them.
The signature mechanic
Every prescription runs the same gauntlet. Controlled ones hit a hard gate.
Compose, check interactions against the patient's global medication list, price it in real time, and — for Schedule II–V — clear the PDMP mandate and pass the DEA two-factor envelope before a single byte transmits. The EPCS gate is not a workflow preference; it's a hard stop.
Only DEA-registered prescribers with active Schedule authority can reach the transmit button on a controlled substance, and the medication-history feed means the DUR check sees fills from every pharmacy the patient uses — not just this practice's slice.
The problem
Phone, fax, and a loosely tethered widget is not a prescribing system.
Prescribers can't see fill history from other providers, can't check cost before choosing a drug, and call in Schedule II–V scripts because their EHR lacks EPCS — a regulatory exposure the SUPPORT Act made financially urgent. Pharmacies call back; patients get sticker shock at the counter.
The whole Surescripts transaction set, native
NewRx, RxRenewal, RxChange, CancelRx, Medication History, RTPB, and ePA — all NCPDP SCRIPT 2017071, all inside the chart. Pharmacist-initiated renewal requests land in the prescriber's inbasket for one-click approve, deny, or modify. A cancellation propagates to the pharmacy instantly, before the wrong fill happens.
A medication list no single EHR can match
On chart open, the Surescripts medication-history feed populates the active list with fill data from all participating pharmacies. And because rev.health spans every practice the patient visits, the drug-utilization review engine evaluates against a longitudinal medication and allergy record — not one practice's partial view.
Key capabilities
From routine refills to Schedule II — one workflow.
NewRx with DUR + RTPB
Select a drug; interaction, allergy, condition, and dose-range checks run in real time, the patient's benefit cost appears, and formulary alternatives surface — all before signing.
EPCS two-factor signing
DEA 21 CFR 1311 compliant: IAL2 identity proofing, AAL2 multi-factor authentication (hard or soft token), FIPS 140-2 digital signature. Every controlled Rx, every time.
PDMP with mandate enforcement
Where state law mandates a PDMP check, the query runs automatically, the fill history surfaces, and the Rx is blocked until the mandate is satisfied. State-by-state coverage through PMP gateway integrations.
Real-Time Prescription Benefit
Copay, tier, PA requirement, and cheaper on-formulary alternatives — patient-specific, at the point of prescribing. No more pharmacy-counter surprises.
Renewal & change inbasket
Pharmacy-initiated requests arrive as structured messages, route as tasks, and resolve with one click. Median turnaround target: two business hours.
CancelRx that actually cancels
Wrong drug, late-discovered allergy, duplicate therapy — the cancel reaches the pharmacy instantly and prevents the fill.
Medication history import
Surescripts MHX fills the active medication list on chart open and feeds medication reconciliation in the documentation flow.
ePA from the prescribing screen
Pharmacy-benefit prior auth initiated, tracked, and resolved inline through the Surescripts ePA network. No fax, no payer portal login.
Formulary alternatives
When the selected drug is non-preferred, on-formulary alternatives are suggested with the cost difference shown — a 30-second conversation instead of a next-day callback.
Workflow
A controlled-substance script, done right in 40 seconds.
Order from the A/P
The scribe proposed the medication; the prescriber confirms drug, dose, and duration from the encounter screen.
DUR + PDMP run automatically
The interaction check clears against the global med list; the state-mandated PDMP query completes and the fill history is one tap away.
Two-factor sign
Token plus credential inside the DEA envelope. Only DEA-registered prescribers with active Schedule authority can reach this button.
Transmitted — and tracked
First-attempt delivery target is 99.5%. The prescription status is visible to the care team and, through the portal, to the patient.
Who benefits
DUR alerts, benefit cost, and formulary alternatives at the point of prescribing. One screen replaces phone, fax, and a separate eRx app.
Same flow with co-sign routing through Task Management where supervision requires it. EPCS identity proofing applies equally.
Works the renewal inbasket under standing orders; refill authorizations stop living in a paper tray.
Knows the drug costs $4.20 before leaving the room — and sees prescription status in the portal.
CheapRX integration · Phase 3 in development
The cheapest Rx, before it leaves the screen.
RTPB shows the insurance copay. CheapRX goes further — querying cash-price and discount-card databases across 70,000+ US pharmacies, then embedding the best coupon directly in the eRx. When the cash price beats the copay, the patient saves automatically. No separate app. No card to show at the counter.
Price comparison at prescribe time
Before you sign, CheapRX shows the insurance copay alongside the cheapest cash price at nearby pharmacies. If cash wins, the coupon is embedded in the eRx as a pharmacy note. Patient sees the savings in the portal.
One-click reorder
When a prescription is due for renewal, both patient and provider see a Reorder button. Provider click: renewal Rx sent to the same pharmacy with the original NDC, quantity, and CheapRX coupon. Patient click: renewal request sent to the provider's task queue. No refaxing, no phone tag.
Adherence tracking & smart nudges
Surescripts RxFill notifications tell us when a script is picked up. If a refill isn't filled within the day-supply window + 3-day grace, both patient and care team get a nudge. Catches the ~30% of scripts written but never filled, and the ~50% who abandon chronic meds within 6 months.
Performance targets
The numbers this module is built to hit.
| Metric | Target |
|---|---|
| Prescriptions sent electronically | ≥ 98% |
| Controlled-substance Rx signed via EPCS | 100% |
| PDMP query compliance in mandated states | 100% — zero tolerance |
| RTPB coverage on new prescriptions | ≥ 90% |
| Renewal / change turnaround | ≤ 2 business hours median |
| ePA decision turnaround | ≤ 24 hours median |
| NewRx first-attempt delivery | ≥ 99.5% |
| DUR alert overrides | ≤ 15% DDI · ≤ 5% drug-allergy |
Standards & the regulatory envelope
The network, the network's security, and the law around it.
The SUPPORT Act made EPCS a Medicare requirement, and most states now mandate electronic controlled-substance prescribing — rev.health treats a paper or fax Schedule II–V script as a compliance violation rather than a workflow option.
Connected modules
Prescribing in context.
Coding & CDS
Interaction, allergy, and dose-range rules fire here via CDS Hooks at prescribing time.
Module 04 →Clinical Documentation
The chart's medication list is refreshed by MHX import and every prescribing event.
Module 01 →Task Management
Renewals, ePA decisions, and co-sign requests land in the prescriber's queue.
Module 09 →Retire the fax line.
The full Surescripts network, EPCS, and PDMP — native to the chart.
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