eRx & EPCS

Electronic prescribing is the backbone of the ambulatory medication workflow — and the gap between "can e-prescribe" and "can e-prescribe controlled substances" is the difference between a convenient feature and a regulatory mandate. The eRx & EPCS module connects the prescriber to >95% of US pharmacies through the Surescripts network for routine prescriptions, renewal workflows, and real-time pharmacy-benefit cost checks, and wraps controlled-substance prescribing in the DEA-mandated two-factor EPCS envelope (IAL2 identity proofing, AAL2 MFA, FIPS 140-2 digital signature). Because REV.health is a single platform spanning all of a patient's care relationships, the medication history accumulates longitudinally across every prescribing org, giving the DUR engine a more comprehensive view than any single EHR could offer.

Key Capabilities

• Core

  E-Prescribing with Formulary Check

  Select a medication, run DUR checks (DDI, allergy, condition, dose-range), fetch patient-specific pharmacy-benefit cost via RTPB, surface formulary alternatives — all before the Rx is signed. Full NCPDP SCRIPT 2017071 NewRx message with SIG, quantity, DAW, and refills.

• Compliance

  EPCS Two-Factor Authentication

  DEA 21 CFR 1311–compliant controlled-substance signing: IAL2 identity proofing via ID.me, AAL2 MFA (hard token or soft token), FIPS 140-2 digital signature applied in an HSM. Only DEA-registered prescribers with active Schedule II–V authority can sign. Any gate failure blocks the Rx — hard enforcement, not a soft prompt.

• Network

  Pharmacy Finder & Routing

  Search pharmacies by NCPDP ID, name, or proximity. Filter by insurance match, compounding capability, and specialty designation. Selected pharmacy becomes the default for future Rx. CancelRx propagates instantly to prevent erroneous fills.

• Core

  Refill Management

  Pharmacist-initiated RxRenewal and RxChange requests land in the prescriber's inbasket as tasks. Approve, deny, or modify with one click; the response flows back through Surescripts automatically. Patients request refills through the Patient Portal; the request creates an inbasket task for the prescriber or MA.

• Core

  RxNorm / NDC Coding

  Every prescription is coded with RxNorm RxCUI or NDC for the ordered product, supporting interoperable medication exchange. Structured SIG maps to NCPDP SCRIPT fields. Medication History (MHX) import from Surescripts populates the active medication list with fill data from all participating pharmacies, feeding the longitudinal DUR engine.

• Compliance

  PDMP Query & Mandate Enforcement

  State-by-state PDMP integration via Bamboo Health PMP Gateway (>46 states) and LogiCoy (Illinois). When a state mandates a PDMP check before a controlled-substance Rx, the system queries automatically and blocks the Rx if the mandate is not satisfied. NarxCare scores surface alongside fill history.

Persona Connections

Three personas interact with eRx & EPCS daily. The Doctor signs every Rx and needs EPCS two-factor for controlled substances. The Patient requests refills and views medication cost transparency. The MA processes renewal requests and reconciles medication lists under standing orders.

Technical Highlights

Phase Roadmap

Cross-Module Connections

• Coding / CDS — authors and versions DUR rules (DDI, drug-allergy, drug-condition, dose-range) invoked at prescribing via CDS Hooks
• Clinical Documentation — the patient's global medication list is populated and refreshed by MHX import and every NewRx/RxRenewal event
• Eligibility — medical-benefit PA is handed off when the prescribing flow detects a medical-benefit requirement; pharmacy-benefit PA stays in eRx
• Task Management — RxRenewal/RxChange requests, ePA decisions, EPCS token expirations, and PDMP alerts create inbasket tasks
• Patient Portal — patients request refills and view medication cost transparency; refill requests route to prescriber inbasket

Try This in the Demo