Every day, millions of prescriptions move through the U.S. healthcare system. Patients expect them to arrive on time. Providers expect them to be accurate. Pharmacies expect them to be verifiable. But what ensures all of this actually happens?
The answer is the Surescripts network, the digital infrastructure that routes nearly every electronic prescription in the country.
More than just a connector, Surescripts plays a central role in protecting sensitive health information, verifying prescriber identities, ensuring regulatory compliance, and maintaining the trust that providers and pharmacies depend on. With stricter mandates around electronic prescribing, growing concerns about medication errors, and rising expectations for speed and security, the way eRx data moves matters more than ever.
In this blog, we’ll take a closer look at how the Surescripts network works, how it keeps prescription data secure, and why its presence is foundational to the future of safe and compliant healthcare delivery.
What Is the Surescripts Network?
The Surescripts network is a nationwide health information exchange platform that facilitates the secure and efficient transmission of electronic prescriptions (eRx) and related healthcare data. It connects a vast array of stakeholders, including prescribers, pharmacies, pharmacy benefit managers (PBMs), and electronic health record (EHR) systems, enabling seamless communication and data sharing across the healthcare continuum.
Scale and Reach
As of 2024, the Surescripts network has achieved remarkable scale, processing over 2.6 billion e-prescriptions annually. It connects approximately 1.34 million prescribers and virtually all pharmacies across the United States, reaching more than 99% of the U.S. population. This extensive reach ensures that healthcare providers and pharmacies can collaborate effectively, regardless of their location or the EHR systems they use.
Core Services
Surescripts offers a suite of services designed to enhance the safety, efficiency, and accuracy of the prescribing process:
- E-Prescribing: Enables prescribers to send prescriptions electronically to pharmacies, reducing errors associated with handwritten prescriptions and streamlining the medication dispensing process.
- Medication History: Provides prescribers with access to a patient’s comprehensive medication history, including data from PBMs and pharmacies. This information aids in informed decision-making and helps prevent adverse drug events.
- Electronic Benefit Verification: Allows prescribers to verify a patient’s insurance coverage and out-of-pocket costs in real-time, facilitating more informed prescribing decisions and reducing delays in therapy initiation.
- Clinical Direct Messaging: Offers a secure, HIPAA-compliant platform for healthcare providers to exchange clinical information, such as lab results and care summaries, enhancing care coordination.
Impact on Healthcare Workflow and Patient Safety
The integration of Surescripts’ services into clinical workflows has significantly improved the efficiency of the prescribing process. By providing real-time access to critical patient information, such as medication histories and insurance coverage, prescribers can make more informed decisions, reduce the likelihood of medication errors, and enhance patient safety.
Moreover, the network’s ability to facilitate secure and timely communication among healthcare providers supports better care coordination, particularly during transitions of care. This comprehensive approach to information sharing contributes to improved clinical outcomes and a more streamlined healthcare experience for patients and providers alike.
How ePrescriptions Are Delivered Securely Within the Surescripts Network
Ensuring the secure transmission of eRx is paramount in safeguarding patient health information and maintaining the integrity of the healthcare system. The Surescripts network employs a comprehensive suite of security measures to protect eRx data throughout its journey from prescriber to pharmacy.
Encrypted Data Transmission
Surescripts utilizes robust encryption protocols to secure data in transit. By implementing industry-standard encryption methods, the network ensures that sensitive patient information remains confidential and protected against unauthorized access during transmission.
Two-Factor Authentication (2FA)
To enhance the security of ePrescribing, particularly for controlled substances, Surescripts mandates two-factor authentication for prescribers. This process requires prescribers to verify their identity using two separate methods, such as a password and a physical token or biometric verification, before they can electronically sign and send prescriptions.
Audit Logs
Comprehensive audit logging is integral to the Surescripts network. Every action taken within the system is recorded, creating a detailed trail that can be reviewed to monitor compliance, detect anomalies, and investigate any potential security incidents.
Digital Signing and Identity Proofing
Digital signatures are employed to authenticate the origin of electronic prescriptions and ensure their integrity. Surescripts requires prescribers to undergo identity proofing through certified credential service providers, establishing a trusted link between the prescriber and their digital credentials.
Compliance with NCPDP SCRIPT Standard
The network adheres to the National Council for Prescription Drug Programs (NCPDP) SCRIPT standard, which defines the format and content of electronic prescriptions. Compliance with this standard ensures interoperability between different systems and reduces the likelihood of errors in prescription data.
HIPAA Compliance
Surescripts’ operations are fully compliant with HIPAA, which sets national standards for the protection of health information. This compliance ensures that patient data is handled with the highest level of confidentiality and security.
Network Security and Monitoring
The network’s infrastructure is fortified with continuous monitoring and security measures to detect and respond to potential threats. Surescripts maintains certifications such as HITRUST and SOC 2 Type II, demonstrating its commitment to maintaining a secure and reliable ePrescribing environment.
Compliance with State Laws
Surescripts ensures adherence to state-specific regulations regarding electronic prescribing, including mandates for controlled substances. As of the latest reports, a significant number of states have enacted laws requiring electronic prescribing for controlled substances, and SureScripts’ network is equipped to support compliance with these varying requirements.
Through these comprehensive security measures, the Surescripts network provides a trusted platform for the safe and efficient delivery of electronic prescriptions, supporting the broader goals of patient safety and healthcare system integrity.
The Surescripts Network Alliance: Collaborating for Better Healthcare
The Surescripts Network Alliance is a collaborative ecosystem that brings together a diverse array of healthcare stakeholders to enhance the exchange of health information. This alliance includes EHR vendors, pharmacy benefit managers (PBMs), pharmacies, clinicians, health plans, long-term and post-acute care organizations, specialty pharmacy organizations, and veterinary technology vendors. By uniting these entities, the Network Alliance aims to simplify and secure the sharing of health intelligence across the healthcare continuum.
Expanding Impact Through Collaboration
In 2024, the Network Alliance facilitated the exchange of 27.2 billion health intelligence transactions, marking a 14.2% increase from the previous year. This extensive network connected 2.29 million healthcare professionals and organizations, providing access to clinical and benefit information for virtually every insured American.
Addressing Healthcare Challenges Collectively
By fostering cross-industry collaboration, the Network Alliance tackles complex healthcare challenges such as data quality improvements, process enhancements, and the development of innovative solutions. This collaborative approach allows for the sharing of diverse perspectives and the co-creation of strategies to improve patient care and operational efficiency.
Driving Innovation and Interoperability
The alliance’s commitment to innovation is evident in its efforts to advance interoperability and health information exchange. For instance, in 2024, Surescripts and its Network Alliance partners facilitated nearly 27.2 billion exchanges of patient clinical and benefit information, connecting over 2.29 million healthcare professionals and organizations across the country.
Engaging Through Events and Forums
The Surescripts Network Alliance actively engages its members through events such as the annual Network Alliance Forum. These gatherings provide a platform for stakeholders to collaborate, share best practices, and identify opportunities to enhance healthcare interoperability and patient care.
Through these collaborative efforts, the Surescripts Network Alliance plays a pivotal role in advancing healthcare by promoting secure, efficient, and interoperable health information exchange.
The Network Integrity Framework: Building Trust and Reliability
The value of any health information network depends on trust. In the case of ePrescribing, trust means knowing that prescriptions originate from verified sources, haven’t been tampered with, and reach the intended destination without errors or delays. This is where the Surescripts Network Integrity Framework comes in.
The Integrity Framework is a set of principles, rules, and operational safeguards designed to protect the network’s reliability and reputation. It focuses on four key areas: identity verification, data accuracy, access control, and compliance monitoring. Every participant in the Surescripts network, from prescribers to software vendors, is expected to meet and maintain these requirements.
To verify identity, Surescripts relies on certified credential service providers who perform identity proofing before allowing a prescriber to transmit electronic prescriptions. This process is especially critical for controlled substances, where strict DEA and state-level rules apply. Once verified, each prescriber is issued digital credentials that are used to authenticate every ePrescription sent through the network.
Data accuracy is another pillar of the framework. Surescripts regularly audits network participants and technology vendors to ensure that the data being exchanged, such as patient identifiers, drug names, and dosage details, meets quality standards. Poor data practices are flagged, and in some cases, access can be restricted until issues are resolved.
The framework also includes controls around access and use of the network. Vendors and intermediaries must demonstrate that their systems are secure and that only authorized users can access prescribing functions. Additionally, Surescripts utilizes machine learning models and transaction-level monitoring to identify anomalies that may indicate fraud, abuse, or technical errors. In recent years, Surescripts has partnered with identity verification specialists like CLEAR and others to further strengthen these controls.
Together, these safeguards allow the network to function with high levels of confidence and compliance not just for prescribers, but for pharmacies, regulators, and patients as well. The Integrity Framework isn’t just about policy; it’s the operational backbone that keeps Surescripts reliable at scale.
Why Surescripts’ Network Matters in Healthcare Today
Reducing Risk in the Prescribing Process
Every prescription sent through the Surescripts network carries essential safeguards. Prescribers get real-time access to patient medication histories, allergy data, and insurance information—all within their EHR. This visibility helps prevent errors, eliminates manual workarounds, and supports safer prescribing decisions, especially during care transitions.
Improving Operational Efficiency
Pharmacies and providers benefit from faster workflows and fewer back-and-forth communications. With tools like electronic prior authorization and real-time benefit checks integrated into prescribing workflows, delays in therapy initiation are reduced. This contributes directly to better adherence and fewer avoidable callbacks.
Ensuring Regulatory Compliance
The network is built to meet the demands of regulations like EPCS, HIPAA, and individual state mandates for controlled substance prescriptions. Features such as digital identity proofing, two-factor authentication, and certified transaction logs help prescribers and organizations stay audit-ready and compliant.
Supporting Nationwide Interoperability
Surescripts continues to act as a neutral intermediary connecting thousands of systems—EHRs, PBMs, pharmacies, and health plans. By maintaining data standards and transaction integrity across these touchpoints, it enables the kind of seamless information exchange that broader healthcare interoperability efforts depend on.
Conclusion
Surescripts is more than a messaging layer between prescribers and pharmacies. It is a regulated network with defined technical, identity, and data quality standards. These are closely tied to how healthcare organizations meet compliance, reduce prescription errors, and enable real-time decision-making.
For teams working on interoperability solutions, understanding how Surescripts handles identity proofing, transaction integrity, and regulatory enforcement is not just useful. It is essential. These are not simple APIs to connect with, but systems that require alignment with frameworks like NCPDP SCRIPT, EPCS, and HIPAA.
Nalashaa supports healthcare IT teams in integrating and operationalizing networks like Surescripts within clinical and administrative systems. From building ePrescribing modules that meet state mandates to aligning workflows with the Surescripts Integrity Framework, we bring the technical clarity and execution these implementations demand.
If Surescripts is a part of your interoperability stack, we can help make it work reliably, securely, and in full compliance with evolving healthcare standards. Connect with us at info@nalashaa.com.
FAQs
1. Can patients see their electronic prescriptions sent through Surescripts?
Surescripts does not provide a direct patient portal. However, patients can often view their ePrescriptions through their provider’s patient portal or by contacting their pharmacy. Prescription status, fill history, and medication details are typically available once processed by the pharmacy.
2. What happens if an ePrescription fails to reach the pharmacy?
If an ePrescription fails transmission, the system typically alerts the prescriber via their EHR interface. Common reasons include mismatched pharmacy identifiers, system outages, or authentication issues. Prescribers can resend or issue a corrected order. Surescripts’ network logs the failed attempt for auditing.
3. How does Surescripts prevent duplicate or fraudulent prescriptions?
Surescripts uses a combination of audit logs, real-time data validation, and digital identity controls to detect duplicate or suspicious activity. The network monitors prescribing patterns and supports CancelRx to void previous prescriptions if a replacement is issued. Controlled substances are additionally protected by DEA-compliant safeguards.
4. Does Surescripts store prescription data permanently?
No, Surescripts does not act as a long-term storage provider. It functions as a transaction intermediary, securely routing data between systems. While it maintains temporary logs for tracking and auditing purposes, long-term storage resides in the EHR or pharmacy system involved in the transaction.
5. Are there alternatives to Surescripts for ePrescribing?
Yes, while Surescripts is the most widely adopted eRx network in the US, there are other certified intermediaries and EHR-integrated solutions that offer electronic prescribing services. However, few match Surescripts’ scale or integration footprint across retail pharmacies and benefit managers.
Latest posts by Priti Prabha (see all)
- Inside the Surescripts Network: How eRx Gets Delivered Safely - June 10, 2025