Multiple Practice Locations | Medplum

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A single Medplum Project can serve many ScriptSure practice locations. This guide describes the data model and how prescribing resolves the correct practice per request.

Data model

ScriptSure's administrative hierarchy is Organization → Business Unit → Practice → User. Medplum maps it as follows:

ScriptSure entity	Medplum representation
Organization	The Medplum Project (id held in the `SCRIPTSURE_DEFAULT_ORG_ID` project secret)
Business Unit	An `Organization` with identifier `https://scriptsure.com/business-unit-id` and `type` coding `https://scriptsure.com/organization-type` = `business-unit`
Practice	An `Organization` with identifier `https://scriptsure.com/practice-id` (and optional facility NPI), `partOf` its Business Unit Organization, `type` = `practice`
Prescriber ↔ Practice	A `PractitionerRole` whose `organization` references the Practice Organization

Example Practice Organization:

{
  "resourceType": "Organization",
  "name": "Downtown Clinic",
  "type": [{ "coding": [{ "system": "https://scriptsure.com/organization-type", "code": "practice" }] }],
  "partOf": { "reference": "Organization/<business-unit-org-id>" },
  "identifier": [
    { "system": "https://scriptsure.com/practice-id", "value": "6159" },
    { "system": "http://hl7.org/fhir/sid/us-npi", "value": "1097724946" }
  ]
}

How the practice is resolved per request

Each prescribing call resolves the target practice in this order:

Explicit organizationId — the Provider App passes the selected practice Organization id on the operation (e.g. $order-medication, $order-set-url, $drug-search) or bot input.
Prescriber affiliation — the prescriber's single ScriptSure practice Organization (via PractitionerRole.organization / ProjectMembership.access). If the prescriber is affiliated with more than one practice and no organizationId was passed, the request errors asking the caller to choose a location.
Legacy secret — the SCRIPTSURE_PRACTICE_ID / SCRIPTSURE_BUSINESS_UNIT_ID project secrets (backward compatibility for single-practice projects).

The Provider App shows a location switcher (top of the prescribe screen) when the prescriber has more than one ScriptSure practice; the selection is passed as organizationId.

Provisioning the Organizations

You can create the practice/business-unit Organizations in two ways:

Entity webhook (recommended for ongoing sync). In the ScriptSure console, open the Organization / Business Unit / Practice profile and click SEND ENTITY WEBHOOK. Point the entity webhook endpoint (at the Organization level) at the scriptsure-entity-webhook-bot. It idempotently upserts the two-level Organizations, prescriber PractitionerRole affiliations, and the ScriptSure user id on each prescriber's ProjectMembership.
Migration from existing secrets. For a project already using a single SCRIPTSURE_PRACTICE_ID, run the migration to create the two-level Organizations from the secrets (additive; the secrets remain the fallback).

Prescriber enrollment

Each prescriber must be associated with the practice(s) they prescribe from on the ScriptSure side, and have:

a ProjectMembership identifier with system = the ScriptSure platform URL and value = their ScriptSure user id, and
a PractitionerRole referencing each practice Organization (created automatically by the entity webhook bot, or manually).
Data model
How the practice is resolved per request
Provisioning the Organizations
Prescriber enrollment