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Verify-REMS-Integration-Prototype-Works.md

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How to generate a test request

  1. Access the EHR gateway at http://localhost:3000. Click Launch with the default FHIR Server Endpoint, Client ID, and Scope values.
  2. You'll be redirected to http://localhost:8180. Authenticate with alice as the username and password. You'll then be redirected back to the EHR UI at http://localhost:3000 to play the role of a prescriber.
  3. Click Select a Patient in the middle of the page.
  4. Locate Jon Snow in the list of patients and click the "Select a medication request" dropdown.
  5. Locate Turalio 200 MG Oral Capsule (Medication request: 2183126).
  6. Click Select to assign Jon Snow as the medication request recipient.
  7. Click Send Rx to Pharmacy to dispatch the prescription.
  8. Click Sign Order, which demonstrates the case where an EHR has CDS Hooks natively.
  9. Await the arrival of two CDS cards.
  10. Click Patient Enrollment Form on the returned CDS card titled Turalio REMS Patient Requirements.
  11. A questionnaire will appear at http://localhost:4040 in a new tab.
  12. Complete and submit the questionnaire via Submit REMS Bundle.
    • 12a. For demonstrating an asynchronous workflow, partially complete the questionnaire and click Save to EHR.
    • 12b. Visit the Patient Portal at http://localhost:3000/#/patient-portal as the patient.
    • 12c. Login with JonSnow as the username and jon for the password.
    • 12d. Select the saved Questionnaire, complete it, and click Save to EHR.
    • 12e. Return to the EHR UI at http://localhost:3000, select the latest saved questionnaire from the second dropdown next to Jon Snow's name, and continue as the prescriber.
    • 12f. Click Launch SMART on FHIR App and fill out the remainder of the questionnaire, including the prescriber signature, then click Submit REMS Bundle.
  13. A new UI will appear with REMS Admin Status and Medication Status.
  14. Visit the Pharmacy Information Management System at http://localhost:5050 to play the role of a pharmacist.
  15. Click Doctor Orders in the top navigation.
  16. View the Doctor Order that was sent to the pharmacist from the prescriber and use the Verify ETASU button to get a status update of the REMS requirements submitted.
  17. Return to the EHR UI at http://localhost:3000 and play the role of the prescriber again. Select patient Jon Snow from the patient select UI and click Launch SMART on FHIR App, which will open the SMART on FHIR App in its own view and demonstrate the case where an EHR does not have CDS Hooks implemented natively.
  18. From the medications dropdown select Turalio 200 MG Oral Capsule, which should populate the screen with cards similar to those seen in step 9.
  19. Click Check ETASU and Check Pharmacy buttons to get status updates on the prescription and REMS request.
  20. Use the Prescriber Enrollment Form and Prescriber Knowledge Assessment links and repeat steps 10-12 to submit those ETASU requirements and see how the ETASU status changes in both the pharmacist UI and prescriber UI.
  21. Once all the REMS ETASU are met, return to http://localhost:5050 as the pharmacist, and click Verify Order to move the prescription over to the Verified Orders tab. Click on the Verified Orders tab and click Mark as Picked Up to move the prescription over to the Picked Up Orders tab.
  22. Return to the SMART on FHIR App launched in step 17, assume the prescriber role, and click Check Pharmacy to view the prescription status.
  23. Repeat step 20 to submit followup/monitoring requests via the Patient Status Update Form, on an as need basis. These forms can be submitted multiple times in the prototype, with each submission appearing as a distinct ETASU element.

Congratulations! The REMS Integration prototype is fully installed and ready for you to use!