Modernizing E-Prescribing
How Pegasus One helped modernize E-Prescribing for a Pharmacy Benefit Manager
Client Overview.
Client is a Pharmacy Benefit Manager (PBM) specializing in hospice care. The platform connects clinicians, pharmacies, and care coordinators to streamline ePrescribing, ensure regulatory compliance, and accelerate medication delivery for end-of-life patients.
Client manages prescriptions across multiple hospice partners, supporting clinicians with diverse credentials, DEA registrations, and care settings.
The Challenge.
Hospice prescribing workflows are inherently complex multiple care teams, varying clinician credentials, and frequent controlled substance prescriptions.
Client faced several operational and technical challenges with their previous ePrescribing solution:
01 Legacy iframe-based ePrescribing experience
90% of eRx functionality was embedded from a third-party provider using iframes. This created:
- UI/UX inconsistencies and poor user experience.
- Limited control over features, styling, and interactions.
- Difficulties in error handling, logging, and performance optimization.
02 Fragmented user management
Clinician and admin access was managed separately within Client and the external eRx provider, causing:
- Duplicate onboarding workflows.
- Delays in IDP/TFA setup for new clinicians.
- Difficulty maintaining audit consistency between systems.
03 Inadequate support for hospice-specific workflows
- Limited ability to handle controlled (EPCS) medications.
- No customization for nurse-clinician delegation flows.
- Missing real-time interaction checks and audit logs.
04 Certification barrier
The legacy setup made it difficult for Client to achieve independent Surescripts certification since most workflows were opaque and controlled by the third party.
The Solution.
Pegasus One partnered with Client to rebuild the entire ePrescribing stack natively within the Wise Hospice Options platform fully integrated with DoseSpot’s RESTful API suite, yet maintaining Client’ independent control over UI, data, and workflows.
Architecture Overview
Front-End (Client App)
- Replaced iframe dependencies with native Angular screens for:
- Clinician management (DEA, IDP, TFA)
- NewRx , RxRenewals, RxChange, RXFill & CancelRx workflows
- Allergy interactions
- EPCS validation and approvals
- Prior authorization Flows
- Patient and pharmacy management
- Centralized identity and access management via Client user directory.
- Responsive UI with hospice-specific flow (multi-clinic, multi-prescriber).
Back-End Integration
- Added internal APIs for:
- Clinician-pharmacy mapping
- Drug-drug and drug-allergy interaction overrides
- Notification and audit trail management
- EPCS validation and approvals
- Prior authorization Flows
- Patient and pharmacy management
- Built a .NET Core middleware layer to handle secure interactions with DoseSpot.
- Compliance & EPCS Enablement.
- Implemented full DEA, IDP, and TFA lifecycle management (activate, reset, revoke).
- Ensured application is certified from Surescripts
- Integrated controlled medication safeguards and readiness indicators for certification.
Result and Impact.
- 90% reduction in iframe dependency - All ePrescribing functions are now native.
- Unified clinician onboarding - IDP, TFA, and PIN managed directly from Client.
- Full certification readiness for eRX and EPCS workflows.
- Improved clinician experience - Consistent UI, faster prescribing, and fewer logins.
- Hospice-specific enhancements - Delegation flow for nurses, internal pharmacy restrictions, and customized alerts for controlled meds.
Outcome.
With Pegasus One’ solution, Client transitioned from a dependent iframe-based model to a fully owned, certifiable, and scalable ePrescribing platform:
- Ready for Surescripts certification.
- Designed for future expansion for AI enabled features.
- Improved auditability, compliance, and clinician productivity.
