Prescription Refills
via SMS.
No Phone Tag.

Patients send "REFILL" to your clinic's Twilio number. The system catches the inbound webhook, sends an OTP back via Twilio, and presents a CSRF-protected web form where patients select their medication, confirm dosage, report side effects, and choose their pharmacy. The completed request is stored in PostgreSQL and surfaces on the nurse dashboard (Node.js + Express + EJS). On approval, a one-time UUID-based pharmacy link is generated and sent — it expires after a single open.

Yes. The codebase implements OTP authentication, bcrypt password hashing, CSRF token protection on every form (csurf middleware), Helmet.js security headers, express-rate-limit on all endpoints, XSS sanitization (xss library), and one-time expiring pharmacy links using UUID v4. Sessions are stored in PostgreSQL via connect-pg-simple with configurable TTLs. Sentry monitors for runtime errors. Winston captures structured logs. Patient records are never exposed in URLs or public endpoints.

The system automatically detects controlled substances during the medication selection step and applies a "Controlled Substance — Review Required" flag. On the nurse dashboard, these requests display a distinct red warning badge and cannot be fast-tracked. The nurse must explicitly review all patient context before any approval action becomes available.

Primary data store: PostgreSQL (via the pg driver). Session management: connect-pg-simple. Job queuing and caching: Redis with ioredis + BullMQ for reliable background job processing. Lightweight local storage: better-sqlite3. The server runs on Node.js ≥18 with Express. Deployable with PM2 (pm2-start.js included). Production-check and preflight scripts are built in.

node-cron runs scheduled jobs server-side. Reminder SMS messages are dispatched through Twilio at configurable intervals. For high-volume delivery, BullMQ queues outbound messages in Redis so retries and failures are handled gracefully. Transactional email confirmations use Paubox.

When a nurse approves a refill, the system generates a UUID v4 token and creates a time-limited record in PostgreSQL linking that token to the prescription. The pharmacy receives this token as a URL. When the pharmacy opens the link, the token is immediately invalidated. Any subsequent attempt to load the same link returns an expired/invalid response. This ensures prescription details are never persistently accessible via a URL.

Each request card displays: patient full name and phone number, requested medication and dosage, current medication list, medical history summary, self-reported side effects, pharmacy name and location, and any controlled substance or urgency flags. Tabs organize requests by status: Pending, Approved, Denied, Needs Visit, and Flagged — each with a live count badge. Actions available are: Approve, Deny, Flag, and Request Visit.

The Starter plan at $199/month includes up to 500 active patients, SMS and email reminders, the nurse dashboard with full approval workflow, basic analytics, email support, and one user account. It's designed for small practices wanting to eliminate phone tag without a large upfront commitment.