Every Surescripts solution—and every Surescripts Network Alliance participant—benefits from the industry-leading reliability, security and scalability of the Surescripts network.

We represent our network with a set of core building blocks. These building blocks intersect with each other and with our entire portfolio of solutions—but for the sake of simplicity, we can stack them into four layers:


The Trust Fabric


The Transport Layer


The Usability Layer


The Optimization Layer

These are the technologies, standards and practices that make it possible to securely deliver actionable intelligence across the nation at great scale and speed.

Inform Care Decisions Chart



Essential to any two-sided network, the trust fabric creates confidence in participants, the integrity of the system, and how shared data can and cannot be used.



Surescripts ensures HIPAA compliance and network security with continuous real-time monitoring and a security infrastructure designed for high-transaction-rate auditing. Fraud detection, data protections, audit storage, encryption best practices and risk mitigation are all built into the network.

Information Security

Surescripts has achieved a number of certifications and accreditations to help ensure the security of our network. A few highlights:

  • Key platforms within Surescripts Enhance Prescribing and Inform Care Decisions solution structures hold HITRUST CSF Certified status, placing Surescripts in an elite group of organizations worldwide.
  • Surescripts participates in the rigorous EHNAC accreditation program to demonstrate its commitment to quality in all aspects of its healthcare technology and show compliance with DirectTrust.
  • Surescripts undergoes an annual Service Organization Control (SOC) 2 Type II examination conducted by an independent American Institute of Certified Public Accountants audit firm to thoroughly assess our service organization’s solutions, controls and compliance.


Our alliance is governed by a web of contractual chains of trust and governance, certification and implementation requirements, ongoing compliance and enforcement activities and continued flexibility and responsiveness to industry needs. We also are founding members of Carequality, a national interoperability framework for trusted exchange between and among health information networks, programs and services.

Through the network governance we’ve established over the past two decades—and the thousands of legal agreements and partnerships we manage—we’re successfully enabling interoperability and high-quality communications across the Surescripts Network Alliance.



The transport layer makes it technologically possible to exchange electronic health information across multiple domains.


Provider Directories

Our provider directory makes it possible to deliver actionable clinical intelligence to 1.61 million healthcare professionals within their electronic workflows, while our pharmacy directory connects clinicians with 98% of U.S. pharmacies.

Record Locating

Our Record Locator & Exchange solution delivered 108 million links to clinical document sources and 99 million care location summaries in 2018, giving more than 100,000 clinicians from nearly 5,000 healthcare organizations access to nationwide health information exchange through a single connection at the point of care. Record Locator & Exchange transactions are exchanged under the governance of the Carequality framework.

Transaction Standards

Our transaction types are based on NCPDP SCRIPT, Fast Healthcare Interoperability Resources (FHIR) and other industry standards, and we actively engage with the standards bodies that develop them to ensure that updates effectively support real clinical use cases across the Surescripts Network Alliance.

Workflow Integration

In addition to our native integrations with virtually all electronic health record (EHR) systems and pharmacy technology platforms—enabling easy access for clinicians and pharmacists—workflow tools allow our technology partners to get valuable new features in front of end users sooner by plugging additional capabilities into existing interfaces for a nearly seamless user experience. Many of our workflow tools are built to FHIR standards and leverage the SMART protocol.

Patient Matching

The Surescripts master patient index lets healthcare providers uniquely identify and access data for 258 million patients—encom/passing 93% of insured patients in the U.S. On average, queries return aggregated patient data in less than one second.

Application Programming Interfaces (APIs)

Surescripts works with other industry stakeholders to innovate by leveraging FHIR standards and open APIs as part of HL7’s Argonaut Project and Da Vinci Project.



The usability layer enables delivery of actionable patient intelligence to the point of care within existing clinical workflows.


Data Transformation

Surescripts has the ability to transform data and translate between data standards to ensure messages can be used by the receiving system.

For instance, Surescripts translates from the HL7 Consolidated-Clinical Document Architecture (CCDA) standard to the FHIR standard in real time, enabling cross-enterprise transactions. We also help automate the prior authorization and specialty prescribing processes in part by transforming question and answer sets for communication between prescribers, pharmacies and specialty hubs.

Transaction Sequencing

Surescripts orchestrates transaction steps to automate the exchange of healthcare information in an intelligent, secure, and orderly fashion.

For instance, in emergency departments using Surescripts Medication History for Reconciliation, intake staff can submit a simple query using their EHR and promptly receive the patient’s electronic medication history. Behind the scenes, the EHR submits a medication history request to Surescripts, which matches five patient identifiers and routes the request to the appropriate pharmacy benefit manager (PBM), which returns a medication history response transaction to Surescripts, which then routes the information back to the EHR, which displays the information to the end user.


The Optimization Layer

Touching every transaction Surescripts handles, the optimization layer helps continuously improve network performance in order to deliver actionable patient intelligence as quickly and accurately as possible.

Data Quality

Monitoring and continuously improving data quality is essential to ensuring that messages preserve the integrity of patient health information and providers’ intent.

Surescripts Sentinel® monitors the accuracy of all electronic prescriptions sent across the Surescripts network to pinpoint areas for data quality improvement and analyze electronic prescribing trends. We also regularly convene more than 100 industry leaders to address e-prescribing pain points through our Critical Performance Improvement program.

Thanks to these efforts, we improved the accuracy of e-prescription transactions by 64% between 2016 and 2018.

Measurement & Reporting

We proactively monitor, analyze and report on network transactions to help spot trends and make performance improvements. Network partners often rely on our reporting to better understand usage of their own systems.

Technical Support

In a two-sided network environment with hundreds of different system connections, thousands of potential transaction routes and multiple potential failure points along each path, Surescripts technical support works to swiftly coordinate communication and resolution efforts among all Network Alliance participants.

Surescripts customers also have access to a secured admin environment where they can carry out a variety of testing, troubleshooting and maintenance activities.