E-prescribing

e-prescribing turns an active medication order into a prescription. A prescription starts as a draft, the prescriber signs it, a gateway delivers it to a pharmacy or a national prescription service, and the pharmacy's answer marks it dispensed. The block bundles no national format: you write the gateway against the PrescriptionGateway port.

better-supabase add e-prescribing

import { createEPrescribing } from "better-supabase/blocks/e-prescribing";

The module requires memberships, permissions, subjects and medications. With outbox it records its events, and every step is audited under the data category.

TablesCopy Anchor Link

A record has one live prescription per order. A cancelled prescription frees the order for a new draft.

Admins have all four; members get none, so grant them to the roles that prescribe and dispense.

StatesCopy Anchor Link

draft -> signed -> sent -> dispensed
  \        \        \
   +--------+--------+--> cancelled

const draft = await db.ePrescribing
  .create(order.id, { prescriberName: "Dr. Jansen" })
  .orThrow();
const signed = await db.ePrescribing.sign(draft.id).orThrow();
const sent = await db.ePrescribing.send(signed.id).orThrow();
await db.ePrescribing.dispense(sent.id).orThrow();

sign needs e_prescribing.sign and a signed-in user who is the prescriber of the draft. The database checks this against auth.uid(), so the service role never signs, and neither does another member with the permission. Signing freezes the order into snapshot, so a later change to the medication order does not alter what was signed. It fails when the order is no longer active.

A delivery that fails keeps the prescription signed, stores the error in delivery_error and raises prescription.delivery_failed, so you retry send. A signed or sent prescription is cancelled with a reason. Cancelling a sent one asks the gateway to withdraw it first.

A gatewayCopy Anchor Link

import type { PrescriptionGateway } from "better-supabase/blocks/e-prescribing";

const pharmacy: PrescriptionGateway = {
  key: "my-pharmacy",
  async deliver({ prescription, medicationRequest }, { signal }) {
    const response = await fetch("https://pharmacy.example/requests", {
      method: "POST",
      body: JSON.stringify(medicationRequest),
      signal,
    });
    if (!response.ok) throw new Error(`Pharmacy answered ${response.status}`);
    const { id } = await response.json();
    return { reference: id };
  },
};

const prescribing = createEPrescribing({ transport, gateway: pharmacy });

The port is versioned with apiVersion: 1 (omit it for 1). deliver gets the signed prescription and its FHIR R4 MedicationRequest and returns a reference, or throws. cancel is optional. Without a gateway, send is an error with hint PRESCRIPTION_GATEWAY_MISSING.

Test a gateway with testPrescriptionGateway from better-supabase/testing.

FHIRCopy Anchor Link

db.ePrescribing.medicationRequest(id) returns a signed prescription as a MedicationRequest, built with toFhirPrescription from better-supabase/fhir: the prescription's identifier, its status (active once signed or sent, completed once dispensed), authoredOn and the requester. A draft has no request and is a PRESCRIPTION_STATUS error.

EventsCopy Anchor Link

HooksCopy Anchor Link

before_prescription_sign and after_prescription_sign run around a signature. A before hook can refuse it.

ErrorsCopy Anchor Link

Without the clientCopy Anchor Link

db.ePrescribing is this client. Code that does not go through bsb.db() builds it with a transport:

const prescribing = createEPrescribing({
  transport,
  tenant: organizationId,
  gateway: pharmacy,
});
const drafts = await prescribing.list({ status: "draft" }).orThrow();