Surescripts Report Highlights Data Quality, Automation Improvements in E-Prescribing

Each year e-prescribing company Surescripts publishes an Annual Impact Report highlighting trends in improved interoperability and clinical coordination nationwide. Healthcare professionals exchanged 30.5 billion transactions through the Surescripts Network Alliance in 2025, and this year Surescripts pointed to improvements in several areas including electronic prior authorization and data quality improvements via automation.

The “Sig” is a data field of an e-prescription with directions to the patient, such as “take one tablet by mouth daily.” To catch confusing or potentially dangerous Sigs before they reach patients, Surescripts has deployed the machine learning-powered Sig IQ, which translates free-text Sigs into the Structured & Codified Sig format, a standardized structure that removes ambiguity. Surescripts says this leads to safer prescriptions for patients and less need for data entry and manual interventions by their care teams. In 2025, 12.7% of all e-prescribing transactions were augmented by Sig IQ, and 60% of Medication History for Ambulatory and Reconciliation responses were augmented by Sig IQ (up from 52% in 2024).

Prior authorization automation

Surescripts says it can accelerate prior authorization approvals by automatically matching clinical data with determination criteria at the time of prescribing.

In 2025, Surescripts continued partnering closely with pharmacy benefit managers (PBMs) and health systems on this type of automation. The earliest adopters of prior authorization automation include Fairview Health Services and Cleveland Clinic—as well as Optum Rx, a major PBM.

Surescripts analyzed changes in prior authorization metrics for requests sent from those two health systems to Optum Rx. Compared to prior authorizations processed through previous methods, requests handled with automation saw 11% lower rate of denials due to lack of information and 17% lower rate of appeals. Before automation, the percentage of requests abandoned by prescribers was 22%; with automation in 2025, that number dropped to 4%.

In 2025, Surescripts also worked to migrate the network to NCPDP SCRIPT Standard v2023011, which covers Electronic Prior Authorization. With this upgrade, the company said users can expect clearer communication about prior authorizations between the prescriber and pharmacy, fewer duplicate transactions and the ability to specify medications more precisely.

Surescripts says it keeps fine-tuning tools to help prescribers and pharmacists connect quickly when needed. With CancelRx, prescribers can instantly alert the pharmacy when they discontinue a patient’s medication. RxChange allows pharmacists to recommend an update to a patient’s prescription and get approval from the prescriber. When a pharmacy needs to forward a prescription to a different location, RxTransfer makes it easier. In 2025, this transaction gained momentum that has already dramatically accelerated in 2026: RxTransfer transactions in January 2026 alone have already surpassed transactions for all of 2025.

“When we talk about advancing healthcare interoperability, we are talking about strengthening the connection between people—between providers, payers and the patients they serve,” said Frank Harvey, CEO of Surescripts, in a statement. “This year’s report shows what’s possible when we bring healthcare together around a shared purpose: accelerating informed decisions that help keep care on track.

“Innovation, like automated prior authorization, which returns approvals in just 18 seconds, means patients have one less barrier to navigate and enables faster access to the therapy they need. That’s the kind of impact that can meaningfully improve care," he added.