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Send RxFill to EHR only after NCPDP REMS interactions. #150

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Merged
smalho01 merged 3 commits into from
Mar 5, 2026
Merged

Send RxFill to EHR only after NCPDP REMS interactions. #150

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5307f7a
Send RxFill to EHR only after NCPDP REMS interactions.
plarocque4 Feb 19, 2026
c94b46d
updates from auto code review
plarocque4 Feb 19, 2026
93cf85d
Merge branch 'dev' into 869-rxfill-errors
smalho01 Mar 5, 2026
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25 changes: 11 additions & 14 deletions backend/src/ncpdpScriptBuilder/buildScript.v2017071.js
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Original file line number Diff line number Diff line change
Expand Up @@ -3,7 +3,6 @@ import { XMLBuilder } from 'fast-xml-parser';
import { v4 as uuidv4 } from 'uuid';

const MOCK_VALUE = 'MOCK_VALUE';
const PICKED_UP = 'Picked up';

const XML_BUILDER_OPTIONS = {
ignoreAttributes: false,
Expand Down Expand Up @@ -97,10 +96,10 @@ export function buildRxError(newRxMessageConvertedToJSON, errorMessage) {
* Per NCPDP spec: Sent when medication is dispensed/picked up
* Must be sent to both EHR and REMS Admin for REMS drugs
*/
export const buildRxFill = newRx => {
export const buildRxFill = (newRx, toEhr, dispensed, note) => {
const { Message } = JSON.parse(newRx.serializedJSON);
const { Header, Body } = Message;
console.log('Building RxFill per NCPDP SCRIPT');
console.log('Building RxFill per NCPDP SCRIPT, ' + (toEhr ? 'To: EHR' : 'To: REMS') + ', dispensed: ' + dispensed + ', note: ' + note);
const time = new Date();

// Extract medication data from NewRx
Expand Down Expand Up @@ -145,8 +144,8 @@ export const buildRxFill = newRx => {
Header: [
{
To: {
'#text': Header.From._,
'@@Qualifier': Header.From.$.Qualifier
'#text': (toEhr ? Header.From._: 'REMS Administrator'),
'@@Qualifier': (toEhr ? Header.From.$.Qualifier : 'REMS')
}
},
{
Expand All @@ -164,11 +163,9 @@ export const buildRxFill = newRx => {
Body: [
{
RxFill: {
FillStatus: {
Dispensed: {
Note: PICKED_UP
}
},
FillStatus:
dispensed ? { Dispensed: { Note: note }} : { NotDispensed: { Note: note }}
,
Patient: Body.NewRx.Patient,
Pharmacy: {
Identification: {
Expand Down Expand Up @@ -235,13 +232,13 @@ export const buildREMSInitiationRequest = newRx => {
{
To: {
'#text': ndcCode,
'@@Qualifier': 'ZZZ'
'@@Qualifier': 'REMS'
}
},
{
From: {
'#text': Header.To._ || 'PIMS Pharmacy',
'@@Qualifier': 'REMS'
'@@Qualifier': 'P'
}
},
{ MessageID: uuidv4() },
Expand Down Expand Up @@ -318,13 +315,13 @@ export const buildREMSRequest = (newRx, caseNumber) => {
{
To: {
'#text': ndcCode,
'@@Qualifier': 'ZZZ'
'@@Qualifier': 'REMS'
}
},
{
From: {
'#text': Header.To._ || 'PIMS Pharmacy',
'@@Qualifier': 'REMS'
'@@Qualifier': 'P'
}
},
{ MessageID: uuidv4() },
Expand Down
141 changes: 91 additions & 50 deletions backend/src/routes/doctorOrders.js
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Original file line number Diff line number Diff line change
Expand Up @@ -16,7 +16,7 @@ import {
} from '../ncpdpScriptBuilder/buildScript.v2017071.js';
import { NewRx } from '../database/schemas/newRx.js';
import { medicationRequestToRemsAdmins } from '../database/data.js';
import { getConfig, updateConfig, getNCPDPEndpoint, getETASUEndpoint, getRxFillEndpoint } from '../lib/pharmacyConfig.js';
import { getConfig, updateConfig, getNCPDPEndpoint, getRxFillEndpoint } from '../lib/pharmacyConfig.js';

bpx(bodyParser);
router.use(
Expand Down Expand Up @@ -156,6 +156,8 @@ router.patch('/api/updateRx/:id', async (req, res) => {
try {
const order = await doctorOrder.findById(req.params.id).exec();
console.log('Found doctor order by id! --- ', order);

let prescriberOrderNumber = order.prescriberOrderNumber;

// Non-REMS drugs auto-approve
if (!isRemsDrug(order)) {
Expand Down Expand Up @@ -184,6 +186,8 @@ router.patch('/api/updateRx/:id', async (req, res) => {
dispenseStatus: getDispenseStatus(order, ncpdpResponse)
};

let rxFillNote;

if (ncpdpResponse.status === 'APPROVED') {
updateData.authorizationNumber = ncpdpResponse.authorizationNumber;
updateData.authorizationExpiration = ncpdpResponse.authorizationExpiration;
Expand All @@ -194,11 +198,34 @@ router.patch('/api/updateRx/:id', async (req, res) => {
updateData.remsNote = approvalNote;
updateData.denialReasonCode = null;
console.log('APPROVED:', ncpdpResponse.authorizationNumber);

rxFillNote = 'REMS Requirements Verified';
} else if (ncpdpResponse.status === 'DENIED') {
updateData.denialReasonCode = ncpdpResponse.reasonCode;
updateData.remsNote = ncpdpResponse.remsNote;
updateData.caseNumber = ncpdpResponse.caseId;
console.log('DENIED:', ncpdpResponse.reasonCode);

rxFillNote = updateData.remsNote;
}

// Send the RxFill message to the EHR
if (rxFillNote) {
try {
const newRx = await NewRx.findOne({
prescriberOrderNumber: prescriberOrderNumber
});

if (!newRx) {
console.log('NewRx not found for RxFill');
return;
}

await sendRxFill(newRx, prescriberOrderNumber, false, rxFillNote);

} catch (error) {
console.log('Error in RxFill workflow:', error);
}
}

const newOrder = await doctorOrder.findOneAndUpdate(
Expand Down Expand Up @@ -275,52 +302,8 @@ router.patch('/api/updateRx/:id/pickedUp', async (req, res) => {
return;
}

const rxFill = buildRxFill(newRx);
console.log('Sending RxFill per NCPDP workflow');

const config = getConfig();

if (config.useIntermediary) {
// Send to intermediary - it will forward to both EHR and REMS Admin
const endpoint = getRxFillEndpoint();
console.log(`Sending RxFill to intermediary: ${endpoint}`);
await axios.post(endpoint, rxFill, {
headers: { 'Content-Type': 'application/xml' }
});
} else {
// Send to EHR
try {
const ehrStatus = await axios.post(env.EHR_RXFILL_URL, rxFill, {
headers: {
Accept: 'application/xml',
'Content-Type': 'application/xml'
}
});
console.log('Sent RxFill to EHR, received status:', ehrStatus.data);
} catch (ehrError) {
console.log('Failed to send RxFill to EHR:', ehrError.message);
}
await sendRxFill(newRx, prescriberOrderNumber, true, 'Picked up');

// Send to REMS Admin (required by NCPDP spec for REMS drugs)
const order = await doctorOrder.findOne({ prescriberOrderNumber });
if (isRemsDrug(order)) {
try {
const remsAdminStatus = await axios.post(
env.REMS_ADMIN_NCPDP,
rxFill,
{
headers: {
Accept: 'application/xml',
'Content-Type': 'application/xml'
}
}
);
console.log('Sent RxFill to REMS Admin, received status:', remsAdminStatus.data);
} catch (remsError) {
console.log('Failed to send RxFill to REMS Admin:', remsError.message);
}
}
}
} catch (error) {
console.log('Error in RxFill workflow:', error);
}
Expand Down Expand Up @@ -508,6 +491,66 @@ const getGuidanceResponse = async order => {
}
};

/**
* Send NCPDP RxFill to the EHR and REMS Administrator
*/
const sendRxFill = async (newRx, prescriberOrderNumber, dispensed, note) => {
console.log('Sending RxFill per NCPDP workflow');

const config = getConfig();
const useIntermediary = config.useIntermediary;

// send to the EHR
const rxFillEhr = buildRxFill(newRx, true, dispensed, note);
let endpoint = env.EHR_RXFILL_URL;

if (useIntermediary) {
endpoint = getRxFillEndpoint();
}

try {
console.log(`Sending RxFill to EHR${(useIntermediary ? ' (through Intermediary)' : '')}: ${endpoint}`);
const ehrStatus = await axios.post(endpoint, rxFillEhr, {
headers: {
Accept: 'application/xml',
'Content-Type': 'application/xml'
}
});
console.log(`Sent RxFill to EHR${(useIntermediary ? ' (through Intermediary)' : '')}, received status: `);
console.log(ehrStatus.data);
} catch (ehrError) {
console.log(`Failed to send RxFill to EHR: ${ehrError.message}`);
}

// if dispensed, send to both EHR and REMS Admin
if (dispensed) {
// Send to REMS Admin (required by NCPDP spec for REMS drugs)
const order = await doctorOrder.findOne({ prescriberOrderNumber });
if (isRemsDrug(order)) {
const rxFillRems = buildRxFill(newRx, false, dispensed, note);
endpoint = env.REMS_ADMIN_NCPDP;

if (useIntermediary) {
endpoint = getRxFillEndpoint();
}

try {
console.log(`Sending RxFill to REMS Admin${(useIntermediary ? ' (through Intermediary)' : '')}: ${endpoint}`);
const remsAdminStatus = await axios.post(endpoint, rxFillRems, {
headers: {
Accept: 'application/xml',
'Content-Type': 'application/xml'
}
});
console.log(`Sent RxFill to REMS Admin${(useIntermediary ? ' (through Intermediary)' : '')}, received status: `);
console.log(remsAdminStatus.data);
} catch (remsError) {
console.log('Failed to send RxFill to REMS Admin:', remsError.message);
}
}
}
};

/**
* Send NCPDP REMSInitiationRequest to REMS Admin
* Per NCPDP spec: Sent when prescription arrives to check REMS case status
Expand All @@ -526,7 +569,7 @@ const sendREMSInitiationRequest = async order => {
const initiationRequest = buildREMSInitiationRequest(newRx);
console.log('Sending REMSInitiationRequest to REMS Admin');

console.log(initiationRequest)
console.log(initiationRequest);

const endpoint = getNCPDPEndpoint();
console.log(`Sending REMSInitiationRequest to: ${endpoint}`);
Expand Down Expand Up @@ -577,7 +620,7 @@ const sendREMSRequest = async order => {

const remsRequest = buildREMSRequest(newRx, order.caseNumber);
console.log('Sending REMSRequest to REMS Admin for case:', order.caseNumber);
console.log(remsRequest)
console.log(remsRequest);

const endpoint = getNCPDPEndpoint();
console.log(`Sending REMSRequest to: ${endpoint}`);
Expand Down Expand Up @@ -673,8 +716,6 @@ const parseREMSResponse = parsedXml => {
return null;
}

const request = remsResponse.request;

const response = remsResponse.response;
const responseStatus = response?.responsestatus;

Expand Down
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