> ## Documentation Index
> Fetch the complete documentation index at: https://docs.encoreos.io/llms.txt
> Use this file to discover all available pages before exploring further.

# DoseSpot ePrescribing — User Guide

> Send prescriptions, manage refills, and complete EPCS workflows from the patient chart using the embedded DoseSpot ePrescribing tab.

## Overview

DoseSpot ePrescribing lets prescribers send new prescriptions, manage refills, and complete EPCS (electronic prescribing for controlled substances) workflows without leaving the patient chart. The DoseSpot interface is embedded directly in the **Medications** tab so prescriptions stay tied to the same chart you use for clinical documentation.

Use DoseSpot when you need to:

* Send a new prescription to a pharmacy
* Approve or deny pharmacy refill requests
* Send a Schedule II–V controlled substance with two-factor EPCS signing
* View a patient's external prescription history (PDMP / Surescripts medication history)

## Quick reference

| I need to…                             | Where                                                          |
| -------------------------------------- | -------------------------------------------------------------- |
| Open ePrescribing for a patient        | Patient chart → **Medications** tab → **ePrescribing** sub-tab |
| Send a new prescription                | DoseSpot panel → **New Rx**                                    |
| Approve a refill request               | DoseSpot panel → **Pending** queue                             |
| Send a controlled substance            | DoseSpot panel → **New Rx** → complete EPCS two-factor prompt  |
| Confirm a prescription was transmitted | Chart **Medications** tab → **Prescriptions** sub-tab          |

***

## Prerequisites

Before you can use the ePrescribing tab:

* Your organization administrator has enabled DoseSpot in **Clinical Settings**. See the [DoseSpot ePrescribing — Admin Guide](/cl/dosespot-eprescribing-admin-guide).
* You have the `cl.dosespot.view` permission (assigned to prescriber roles by default).
* Your prescriber profile has been enrolled with DoseSpot (`cl.dosespot.enroll` is required to complete enrollment). New users see a one-time identity-proofing prompt the first time they open the tab.
* For controlled substances: your DEA registration and two-factor token are active.

If the **ePrescribing** sub-tab does not appear in a chart, DoseSpot is not enabled for your organization or your account does not have `cl.dosespot.view`.

***

## Open the ePrescribing tab

1. Navigate to **Clinical → Charts** and open a patient chart.
2. Select the **Medications** tab.
3. Select the **ePrescribing** sub-tab.

The DoseSpot interface loads in an embedded panel scoped to the current patient and your clinician profile. You stay inside Encore Health OS — there is no separate login.

While the patient record is loading you see a *Loading patient information…* placeholder. If the placeholder persists, refresh the chart; the panel needs both a patient ID and your clinician ID before it can render.

***

## Send a new prescription

1. In the **ePrescribing** sub-tab, select **New Rx**.
2. Search for the medication by name. The medication picker uses DoseSpot's drug database, so it includes brand and generic names, strengths, and dose forms.
3. Set:
   * **Sig** (directions for use)
   * **Quantity** and **Days supply**
   * **Refills**
   * **Pharmacy** — search by name, NPI, or ZIP. Mail-order, retail, and specialty pharmacies are all supported.
4. Review the alerts panel for any drug–drug or drug–allergy warnings.
5. Select **Send**.

DoseSpot transmits the prescription through Surescripts. Once acknowledged, the prescription appears in the **Prescriptions** sub-tab of the same Medications tab with a status of **Sent**.

### Sending controlled substances (EPCS)

Schedule II–V medications require EPCS two-factor signing:

1. Build the prescription as above. The form displays an **EPCS** badge when a controlled medication is selected.
2. Select **Sign & Send**.
3. Complete the EPCS prompt:
   * Enter your DoseSpot password.
   * Approve the push notification or enter the one-time code from your hardware/soft token.
4. The prescription is signed, transmitted, and an immutable EPCS audit entry is written.

If two-factor fails or your token has expired, the prescription is held as a draft. Contact your administrator to refresh your EPCS credentials.

***

## Manage refill requests

Pharmacy refill requests route to the **Pending** queue inside the DoseSpot panel.

1. Open any patient chart → **Medications** → **ePrescribing**.
2. Select **Pending**. Requests for the active patient appear at the top.
3. For each request, select:
   * **Approve** — sends the refill authorization.
   * **Approve with changes** — adjust quantity, days supply, or sig before approving.
   * **Deny** — pick a reason (e.g., *Patient should contact provider*).

Approved refills show as new prescription records in the **Prescriptions** sub-tab.

***

## View external medication history

DoseSpot can return a patient's medication fill history from Surescripts (pharmacies and PBMs). To view it:

1. In the **ePrescribing** sub-tab, select **Rx History**.
2. The history list shows medication, prescriber, pharmacy, fill date, and days supply.

Use this view to reconcile what the patient is actually filling against what is documented in their chart.

***

## How DoseSpot interacts with the rest of the chart

| Encore feature                                  | Behavior                                                                                                                                                |
| ----------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Medications list** (Medications tab → Active) | DoseSpot prescriptions are also recorded as `cl_prescriptions` rows and appear in the Active list and reconciliation flows.                             |
| **Drug–drug interactions**                      | Encore's interaction checker (CL-05) runs alongside DoseSpot's clinical screening. Both sets of alerts are surfaced.                                    |
| **Medication reconciliation**                   | DoseSpot-sourced prescriptions are eligible for the standard reconciliation workflow.                                                                   |
| **MAT/MOUD tracking**                           | Buprenorphine and naltrexone prescriptions sent through DoseSpot automatically create a linked medication event on the patient's active MAT enrollment. |
| **Audit log**                                   | Every send, sign, approve, and deny action is logged with your user ID and timestamp. EPCS signings include the two-factor method used.                 |

***

## Troubleshooting

| Symptom                                                    | Likely cause                                                       | What to do                                                                                                          |
| ---------------------------------------------------------- | ------------------------------------------------------------------ | ------------------------------------------------------------------------------------------------------------------- |
| **ePrescribing** sub-tab is missing                        | DoseSpot disabled for org, or missing `cl.dosespot.view`           | Ask your administrator to enable DoseSpot and assign the permission.                                                |
| Panel shows *Loading patient information…* indefinitely    | Chart record has not finished loading, or patient has no record ID | Refresh the chart. If it persists, the patient may need a chart record created first.                               |
| *Enrollment required* prompt on first open                 | Your prescriber profile is not yet enrolled with DoseSpot          | Complete the enrollment wizard. You need `cl.dosespot.enroll`; ask your administrator if the option is unavailable. |
| Controlled substance send fails with *EPCS not authorized* | Two-factor token expired or DEA registration not synced            | Re-pair your token in DoseSpot, then retry. Contact your administrator if the failure repeats.                      |
| Refill requests are not appearing                          | DoseSpot webhook is not delivering events to Encore                | Administrator must verify the `cl-dosespot-webhook` endpoint is reachable and the signing secret is current.        |

***

## Permissions

| Permission              | Purpose                                           | Typical role                      |
| ----------------------- | ------------------------------------------------- | --------------------------------- |
| `cl.dosespot.view`      | Open the ePrescribing tab and view prescriptions  | Prescribers, Clinical Pharmacists |
| `cl.dosespot.enroll`    | Complete or update DoseSpot prescriber enrollment | Prescribers                       |
| `cl.dosespot.configure` | Configure org-wide DoseSpot settings              | Administrators only               |

***

## Related guides

* [DoseSpot ePrescribing — Admin Guide](/cl/dosespot-eprescribing-admin-guide)
* [MAT/MOUD Tracking — User Guide](/cl/mat-moud-user-guide)
* [Lab & Diagnostic Orders — User Guide](/cl/lab-orders-user-guide)