The external prescription management model is a concrete digital application scenario under the background of the “Three-Medical linkage” reform and the “Dual-channel” policy，which it can solve the problems of accessibility and convenience of drugs.But at the same time， it is necessary to take a variety of measures， such as adopting drug traceability code management， strengthening the construction of the drug vigil system in medical institutions， enhancing the coordination mechanism among various departments， paying attention to patient education and science popularization， and so on.Among these， the pharmacovigilance system in medical institutions is a critical component. The construction of the pharmacovigilance system in medical institutions under the external prescription management model includes the quality system of medical institutions and the standard management out-prescription combination， which can control the risk of drug safety from the source and strengthen the implementation of the responsibility of out-prescription management.This study analyzes key aspects such as online pharmaceutical sales through internet hospitals， electronic prescription circulation， external prescription risks， and drug traceability code applications. It proposes a framework for constructing a pharmacovigilance system within medical institutions under the external prescription management model. This includes the establishment of an expert consensus system， clarification of responsibilities among external prescription stakeholders， development of interdepartmental coordination mechanisms， as well as initiatives for patient medication education and pharmaceutical science communication.The approach emphasizes regulatory compliance while adapting to the emerging trends of new digital business formats and technologies， leveraging drug traceability codes， blockchain， life-cycle management tools， and new media science outreach to advance the digital integration of the “Three-Medical Linkage” system.