RxRenewal Message

Overview

RxRenewal is a type of message sent by pharmacy to subscriber when the medication should be renewed. It is required that RxRenewal is preceded by NewRx.

Receiving RxRenewalRequest

Once the pharmacy sends an RxRenewal, ePrescription module receives Surescripts message at /eprescriptions/rx endpoint and saves it to Aidbox. The message is converted to a MedicationRequest and the creation is registered as a Provenance resource. There are several ways to track the newly created MedicationRequests:

• Either of Aidbox Subscriptions mechanisms.

• Manual/automated tracking based on MedicationRequest modification date and/or status.

• Provenance tracking.

Detected Issues

In case some related resources (Patient, Organisation, PractitionerRole, Practitioner, Medication, or Location) were not found or didn't match the provided ones, ePrescription module additionally creates a DetectedIssue resource in Aidbox. There's only one DetectedIssue per RxRenewal, containing all the problematic resources. TODO: ARE THERE OTHER EXCEPTIONAL SITUATIONS? I DIDN'T FIND ANY?

Renewal statuses

The status of the request is stored in the created MedicationRequest's extension field under http://aidbox.app/ePrescription/FHIRSchema/medication-request-rx-renewal-status extension. There's also http://aidbox.app/ePrescription/FHIRSchema/medication-request-rx-renewal-status-reason with a human-readable description of a status.

GET /fhir/MedicationRequest

resourceType: Bundle
type: searchset
meta:
  versionId: '0'
total: ...
link:
  - relation: first
    url: http://127.0.0.1:8789/fhir/MedicationRequest?page=1
  - relation: self
    url: http://127.0.0.1:8789/fhir/MedicationRequest?page=1
entry:
  ...
  - resource:
      ...
      resourceType: MedicationRequest
      extension:
        - url: >-
            http://aidbox.app/ePrescription/FHIRSchema/medication-request-rx-renewal-status
          valueCode: active
      ...

The initial status is active. For the rest, consult NewRx status table TODO: ARE THESE ALWAYS MATCHING THE NEWRX ONES?

Responding to RxRenewalRequest

Response to RxRenewalRequest consists of two parts:

1. Changing the status of the MedicationRequest in Aidbox. Note that the actual status resides in extension, and not in the status field.

PATCH /fhir/MedicationRequest/mr1?_method=fhir-patch

resourceType: Parameters
parameter:
  - name: operation
    part:
      - name: type
        valueCode: replace
      - name: path
        valueString: MedicationRequest.extension('http://aidbox.app/ePrescription/FHIRSchema/medication-request-renewal-decision').value
      - name: value
        valueString: approved

1. And calling the /eprescription/rx/respond-to-renewal endpoint with the ID of the MedicationRequest created by the initial RxRenewalRequest.

POST /eprescription/rx/respond-to-renewal

{
  "medicationRequestId": "mr1"
}