Directive 2011/24/EU “on the application of patients’ rights in cross-border healthcare” stipulates the "Recognition of prescriptions issued in another Member State" for dispensation across the Union. Furthermore, “the Commission shall adopt guidelines supporting the Member States in developing the interoperability of ePrescriptions.” The study drafted such guide-lines as a base for further political process. Initially, it analysed the present status of ePrescription in Member States, identified good practice, and assessed the feasibility of drafting detailed guideline beneficial for moving to-wards a single market for prescription drugs. Close cooperation was established with the "epSOS Smart Open Services for European Patients" project and national experts to validate outcomes. The potential benefits and costs from ePrescribing are summarised, and initial estimates of marginal costs for readiness clusters of Member States when establishing cross-border ePrescribing services presented. Based on a novel four domain, three level interoperability concept, principal requirements for data exchange are discussed, open versus proprietary standards explored, and still pending policy and technical challenges identified. A comprehensive ePrescription draft Guideline Proposal is complemented by a detailed roadmap for action steps to be undertaken at both the European and Member State levels when indeed introducing Union-wide ePrescription services for all people.