The client was losing enterprise hospital accounts because their legacy EHR lacked native e-prescribing capabilities.
Controlled Substance Prescribing for EHR Vendor
Yalantis developed a fully integrated e-prescription module with EPCS support, drug interaction checking, and real-time benefit verification, enabling the client to pass ONC certification and DEA audit on the first attempt and stop losing hospital contracts.
100%
DEA and ONC compliance
0
Enterprise accounts lost after launch
50%
Less time on refills and pharmacy calls
A certified, high-performance eRx engine embedded in the legacy EHR
1.
Clinical Decision Support with real-time drug interaction checking
Patient safety came first. We integrated with First Databank (FDB), the industry-standard drug knowledge base, to build a real-time interaction checker. As a doctor types a prescription, the system instantly analyzes the patient’s entire medication history. It flags allergies, drug-drug interactions, therapeutic duplications, and dosage warnings in under a second. This catches potentially fatal errors before the prescription reaches the pharmacy.
2.
EPCS with DEA-compliant identity proofing and two-factor authentication
Prescribing controlled substances requires a higher tier of security than standard eRx. The DEA Interim Final Rule mandates Identity Proofing (verifying the prescriber is who they claim to be) and two-factor authentication at the moment of signing each controlled substance prescription. We implemented a certified identity proofing workflow and integrated FIDO2-compliant hardware tokens as the second authentication factor. Biometric options (Face ID, fingerprint) are available as an alternative where the token is bound to a certified credential, meeting the DEA’s NIST SP 800-63 Level of Assurance requirements.
3.
Real-time Pharmacy Benefit verification via Surescripts
We connected the eRx module to the Surescripts network, the backbone of electronic prescribing in the US. This enables Real-Time Benefit Check (RTBC): before a doctor finalizes a prescription, the system queries the patient’s insurance to show whether the drug is covered, what the copay will be, and whether a cheaper therapeutic alternative exists. This transparency increases medication adherence because patients aren’t surprised by costs at the pharmacy.
4.
ONC Health IT Certification support
Yalantis engineers didn’t just code the module. We managed the technical documentation required for the ONC Health IT Certification Program. The eRx module had to meet all interoperability standards defined by NCPDP SCRIPT (the standard for electronic prescription messaging). We prepared the documentation, mapped the data flows, and supported the client through the certification process.
How we upgraded a legacy EHR to meet federal prescribing standards without breaking the existing system
The challenge was not just building eRx functionality – it was embedding it into a legacy .NET monolith without destabilizing the software that hospitals depended on daily. We used a micro-frontend approach to inject modern technology into the existing application. Discover the key milestones.The challenge was not just building eRx functionality – it was embedding it into a legacy .NET monolith without destabilizing the software that hospitals depended on daily. We used a micro-frontend approach to inject modern technology into the existing application. Discover the key milestones.
Zero enterprise accounts lost
The client retained all major hospital contracts by delivering the EPCS and eRx functionality before accounts churned to competitors.
50% less time on prescription tasks
Doctors spend half as much time on refills and pharmacy calls thanks to automated workflows, interaction checking, and real-time benefit verification.
First-attempt certification
The eRx module passed both ONC Health IT Certification and the DEA EPCS audit on the first submission, with no remediation required.
How we solved the client’s challenges
Built a complete eRx module with standard and controlled substance prescribing
Implemented DEA-compliant identity proofing and FIDO2 two-factor authentication
The system previously lacked EPCS capability, meaning doctors couldn’t prescribe Schedule II–V drugs electronically.
Integrated First Databank for real-time allergy, interaction, and duplication alerts in <1 second
The absence of automatic drug interaction checking was creating a significant patient safety risk and legal liability.
Prepared full technical documentation to pass ONC certification on the first attempt
The client was blocked from passing the mandatory ONC Health IT Certification without a fully compliant eRx module.
Connected to Surescripts for Real-Time Benefit Check showing copays and alternatives
Doctors previously had no way to see a patient’s insurance coverage or out-of-pocket costs before writing a prescription.
Used micro-frontend architecture to embed a modern .NET Core + React module
This allowed us to completely modernize the e-prescribing workflow without touching or breaking the client’s legacy .NET monolith.
Discover key project milestones
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Certifications:
27001 2022 / 27001 2015 / 13485
Advanced IoT Core Delivery / Advanced RDS Delivery / Advanced Tier Delivery
From medical devices to industrial automation — we deliver complete enterprise solutions with regulatory compliance built-in. Everything under one roof.
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FAQ
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What is EPCS and why does it require a higher level of security than standard e-prescribing?
EPCS (Electronic Prescribing of Controlled Substances) covers Schedule II–V drugs, including opioids. The DEA requires that every controlled substance prescription is signed with two-factor authentication and that prescribers undergo certified identity proofing before they can use EPCS. This is stricter than standard eRx because controlled substances carry higher abuse risk and legal consequences.
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What authentication methods meet DEA requirements for EPCS signing?
The DEA requires authentication at NIST SP 800-63 Assurance Level. In practice, this means a FIDO2 hardware security key or a certified biometric credential bound to a verified identity. Simple phone biometrics (Face ID alone) do not meet the requirement unless they are part of a DEA-certified credentialing service that has completed the identity proofing process.
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How did you embed a modern module into a legacy .NET monolith?
We used a micro-frontend architecture. The eRx module is a standalone .NET Core service with a React frontend that runs inside the existing application’s UI shell. It communicates with the legacy system through internal APIs for patient data and medication history but has its own deployment pipeline, database, and authentication layer. This approach avoids the risk of a full rewrite while delivering modern capabilities.
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How fast is the drug interaction check?
Under one second. When a doctor enters a prescription, the system sends the drug, dosage, and the patient’s full medication history to First Databank’s engine. FDB returns all alerts (allergies, drug-drug interactions, therapeutic duplications, dosage warnings) in a single synchronous call. The prescription cannot proceed until the doctor acknowledges or overrides each alert.
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What does Real-Time Benefit Check show the doctor?
Before finalizing a prescription, the system queries the patient’s insurance via Surescripts. The doctor sees whether the drug is covered, the expected copay amount, and cheaper therapeutic alternatives if available. This helps doctors prescribe medications patients can actually afford, which increases medication adherence.
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How long did the project take from start to passing certification?
The partnership ran from 2020 to 2022. Development of the eRx module, integration with FDB and Surescripts, EPCS implementation, and preparation of all documentation for ONC and DEA certification was completed within this timeframe. Both certifications passed on the first submission.
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