EMA Clinical Workflows & mmRxService: Electronic Prescribing

Problem and Approach

Electronic prescribing modernization at a clinical SaaS platform: build the clinical user interface and the AWS-hosted backend pipeline for sending prescriptions electronically to pharmacies, then layer Generative AI onto the workflow without letting free-form model output into a regulated clinical path.

• GenAI clinical decision support. A drug interaction alert panel backed by Amazon Bedrock surfaces real-time LLM-generated clinical guidance inline in the prescribing workflow. Guidance is presented to the clinician; it never auto-acts.
• Agentic prior authorization. A LangGraph-based workflow drafts PA requests autonomously from clinical context, routes every draft to a human reviewer for approval, and submits to payers with audit-logged escalation paths. Bedrock Agents provide the agentic layer behind CDS and PA drafting with human-in-the-loop review gates.
• Event-driven prescription processing. Prescription orders flow through SQS/SNS and Lambda, with Redis for low-latency session state and PostgreSQL for prescription records. The event-driven shape keeps the prescription path resilient to transient SureScripts failures and rate-limit windows.
• Contract-first APIs. Prescribing and medication-history endpoints documented with Swagger/OpenAPI, consumed by downstream pharmacy and payer partners.
• Identity and authorization. Okta-based RBAC scoped to DEA EPCS and NPI requirements, ensuring only credentialed providers submit controlled-substance prescriptions.
• Architectural carryover. NemoRx SureScripts and FHIR API patterns (retry semantics, partial-write recovery, expired-token handling) carried directly into mmRxService, shortening team ramp-up on the e-prescribing surface. Clinical workflow expertise from prior podiatry EHR work guided charting, billing, and scheduling decisions before they reached implementation.

Outcomes

• Python/FastAPI prescribing backend in production with the Bedrock-backed CDS drug interaction panel inline in the clinical workflow.
• LangGraph prior-authorization drafting workflow behind a human review gate, with audit-logged escalation paths to payers.
• Event-driven pipeline on AWS SQS/SNS and Lambda resilient to transient SureScripts failures.
• DEA EPCS / NPI-compliant RBAC on Okta delivered alongside the prescription flow.