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

# Prescription Signing

> Understand how electronic prescription signing (QES) works in RxScale

# Prescription Signing

Before a prescription can be sent to a pharmacy, it must be electronically signed by the prescribing doctor. This page explains how the signing process works.

## What is Electronic Signing (QES)?

QES stands for **Qualified Electronic Signature**. It is a legally binding digital signature that has the same legal validity as a handwritten signature. In Germany and the EU, QES is required for electronic prescriptions to be legally valid.

When a doctor signs a prescription with QES:

* The prescription becomes a legally valid document.
* The patient can use it at any pharmacy.
* The signing is traceable and tamper-proof.

## How the Signing Process Works

```
Doctor approves prescription
          |
          v
  Signing request created (IN_PROGRESS)
          |
          v
  Doctor signs via sign center (RxScaleSign)
          |
          v
  Signing request completed (DONE)
          |
          v
  Prescription status changes to "signed"
```

### Step by Step

1. **Doctor approves the prescription.** After reviewing the patient's information and medication request, the doctor approves the prescription in the RxScale system.

2. **A signing request is created.** The system creates a signing request and sends it to the sign center. The signing request status is set to `IN_PROGRESS`.

3. **The doctor signs via the sign center.** RxScale uses RxScaleSign as the signing provider. Doctors can sign prescriptions individually or in batches through the sign center. Batch signing allows doctors to sign multiple prescriptions at once, saving time.

4. **The signing request is completed.** Once the doctor has applied their qualified electronic signature, the signing request status changes to `DONE`.

5. **The prescription status updates.** The prescription moves from "approved" to "signed". It is now legally valid and the associated order can proceed to a pharmacy.

## Signing Request Statuses

| Status        | What It Means                                                                                                                                                                      |
| ------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| `IN_PROGRESS` | The signing request has been created and is waiting for the doctor to sign. The doctor may see this in their sign center queue.                                                    |
| `DONE`        | The doctor has successfully signed the prescription. The prescription is now legally valid.                                                                                        |
| `EXPIRED`     | The signing request expired before the doctor signed it. This can happen if the doctor does not sign within the allowed time window. A new signing request may need to be created. |

## The Sign Center

The sign center is where doctors go to review and sign pending prescriptions. Key features:

* **Batch signing** -- Doctors can select multiple prescriptions and sign them all at once, rather than signing each one individually. This is especially useful when there are many prescriptions waiting.
* **Powered by RxScaleSign** -- The sign center uses RxScaleSign, a certified provider of qualified electronic signatures, to ensure legal compliance.
* **Secure authentication** -- Doctors must authenticate themselves before signing to ensure only authorized doctors can sign prescriptions.

### Optional Batch Review Before RxScaleSign

Doctors can enable an additional review step before starting a batch with RxScaleSign. When enabled, the Sign Center shows every prescription that will be included in the next batch together with the associated questionnaire information.

The doctor can remove individual prescriptions before signing. Each removed prescription requires its own comment and is returned for follow-up review. After the doctor confirms the batch, the remaining prescriptions continue to RxScaleSign.

## What Happens After Signing?

Once a prescription is signed:

1. The prescription status changes to **signed**.
2. The associated order moves to **waiting for pharmacy** status.
3. The order is routed to an appropriate pharmacy for fulfillment.
4. The patient and pharmacy are notified that the prescription is ready.

## Frequently Asked Questions

<AccordionGroup>
  <Accordion title="What if a signing request expires?">
    If a signing request expires, the system may automatically create a new one, or the support team may need to intervene. The prescription remains in "approved" status until it is successfully signed.
  </Accordion>

  <Accordion title="Can a prescription be sent to a pharmacy without QES?">
    In most cases, no. A qualified electronic signature is required for legal validity. In rare situations, a prescription may be marked as NON\_QES\_SIGNED, but this is only used in specific circumstances.
  </Accordion>

  <Accordion title="How long does signing take?">
    Signing itself takes just a few seconds. The total time depends on when the doctor reviews and signs the prescription in the sign center.
  </Accordion>
</AccordionGroup>

## Related Topics

* [Prescription Statuses](/help-center/prescription-statuses) -- See all prescription statuses and their meanings.
* [Order Statuses](/help-center/order-statuses) -- Understand how signing affects the overall order flow.