{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T06:07:28Z","timestamp":1779084448826,"version":"3.51.4"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n Irrational drug use poses a persistent challenge to healthcare quality and economic efficiency. In the context of China\u2019s \u201cTight-knit Urban Medical Group\u201d reform, this study analyzes a digitized pharmaceutical governance model designed to bridge the gap in pharmaceutical care between tertiary hospitals and primary healthcare facilities. We aimed to analyze the implementation and public health correlation of a Centralized E-prescription Review (CEPR) platform within a regional medical network.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective, observational real-world study was conducted in Sanya, China. We implemented a CEPR platform utilizing a dual-layered cloud architecture and non-invasive data acquisition (XTL) to integrate regional drug metadata. The system incorporates an AI-driven engine fusing Large Language Models (LLMs) with Retrieval-Augmented Generation (RAG) to provide clinical decision support. A total of 441,327 prescriptions were analyzed over a 12-month longitudinal period. The Cochran-Armitage trend test was employed to evaluate temporal shifts in prescription safety, economic efficiency, and service homogeneity.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Following the implementation of the CEPR platform, the initial prescription pass rate at primary healthcare institutions rose significantly from 75.00 to 95.12%, and a 99.30% pharmacist intervention success rate was achieved across more than 16,000 intercepted high-risk orders. Regarding economic efficiency, the average cost per outpatient visit decreased by 4.58%, while inpatient drug costs dropped by 23.5%, accompanied by the implementation of a technology-based integrity oversight mechanism. Notably, the regional irrational prescription rate over 12 consecutive months of operation decreased markedly from 11.92 to 7.35% (\n \n \u03c7\n 2<\/jats:sup>\n <\/jats:italic>\n \u202f=\u202f328.42,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), demonstrating a robust temporal association between platform deployment and quality improvement.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The CEPR model, characterized by the \u201cSanya Model,\u201d serves as a digital lever for enhancing the accessibility and homogeneity of high-quality pharmaceutical services. By shifting medication safety from a site-specific resource to a standardized public service, this framework supports the \u201cThree medical linkage\u201d (San Yi Lian Dong, i.e., the integrated reform of medical services, health insurance, and pharmaceutical systems) collaborative reform. These findings provide a scalable governance paradigm for improving public health resilience in regions with unevenly distributed medical resources.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1836281","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T05:39:52Z","timestamp":1779082792000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The role of digital pharmaceutical governance in alleviating health inequality: a case study of the \u201cSanya Model\u201d for centralized regional prescription review"],"prefix":"10.3389","volume":"14","author":[{"given":"Xu","family":"Jia","sequence":"first","affiliation":[{"name":"Department of IT & Data Management of West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of IT & Data Management of West China Hospital, Sichuan University","place":["Chengdu, China"]},{"name":"Sanya People's Hospital","place":["Sanya, China"]},{"name":"West China (Sanya) Hospital, Sichuan University","place":["Sanya, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang","family":"Chai","sequence":"additional","affiliation":[{"name":"Sanya People's Hospital","place":["Sanya, China"]},{"name":"West China (Sanya) Hospital, Sichuan University","place":["Sanya, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"HaoBo","family":"Jiang","sequence":"additional","affiliation":[{"name":"Sanya People's Hospital","place":["Sanya, China"]},{"name":"West China (Sanya) Hospital, Sichuan University","place":["Sanya, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of IT & Data Management of West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"20552076251335707","DOI":"10.1177\/20552076251335707","article-title":"Global trends in internet hospitals and electronic prescriptions: insights for China","volume":"11","author":"Luo","year":"2025","journal-title":"Digit Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1186\/s12913-023-09931-5","article-title":"Prospective prescription review system correlated with more rational PPI medication use, better clinical outcomes and reduced PPI costs: experience from a retrospective cohort study","volume":"23","author":"Fan","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e40883","DOI":"10.7759\/cureus.40883","article-title":"The emerging role of generative artificial intelligence in medical 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analgesics, improves clinical outcomes, and saves medical costs in surgical patients: insights from Nanjing drum tower hospital","volume":"39","author":"Xie","year":"2022","journal-title":"Adv Ther"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e101561","DOI":"10.1136\/bmjhci-2025-101561","article-title":"Enhancing medication safety with system approach to verifying electronic prescriptions (SAVE-Rx): pharmacists' review of product selection outcomes between prescribed and dispensed medications","volume":"32","author":"Gong","year":"2025","journal-title":"BMJ Healthc Inform"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1186\/s12913-025-12901-8","article-title":"Establishment, maintenance and application effect analysis of the prescription pre-review system in a tertiary hospital in China","volume":"25","author":"Zhou","year":"2025","journal-title":"BMC Health Serv 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