ClinRx Copilot 🩺

AI-Assisted Prescription Drafting with 8-Layer Agentic Architecture

Doctor-first, human-in-the-loop clinical decision support for prescription drafting. Context compression + inventory-aware reasoning with deterministic safety gates.

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🏗️ Architecture

┌─────────────────────────────────────────────────────────────┐
│                    Doctor Control (Layer 7)                 │
│                   Edit / Override / Sign                    │
└─────────────────────────────────────────────────────────────┘
                              ▲
┌─────────────────────────────────────────────────────────────┐
│                   Explanation Agent (Layer 6)               │
│                   Human-readable XAI                        │
└─────────────────────────────────────────────────────────────┘
                              ▲
┌─────────────────────────────────────────────────────────────┐
│                  Substitution Agent (Layer 5)               │
│                  Drug equivalence & alternatives            │
└─────────────────────────────────────────────────────────────┘
                              ▲
┌─────────────────────────────────────────────────────────────┐
│                   Inventory Agent (Layer 4)                 │
│                   Real-world availability                   │
└─────────────────────────────────────────────────────────────┘
                              ▲
┌─────────────────────────────────────────────────────────────┐
│                  Clinical Reasoning (Layer 3)               │
│                  Claude 3.5 Sonnet / Rule-based                   │
└─────────────────────────────────────────────────────────────┘
                              ▲
┌─────────────────────────────────────────────────────────────┐
│           ⛔ SAFETY GUARD - Hard Gates (Layer 2)            │
│   Drug interactions | Allergies | Renal dosing | Pregnancy │
└─────────────────────────────────────────────────────────────┘
                              ▲
┌─────────────────────────────────────────────────────────────┐
│                Context Compression (Layer 1)                │
│                FHIR → Compressed JSON                       │
└─────────────────────────────────────────────────────────────┘
                              ▲
┌─────────────────────────────────────────────────────────────┐
│                    Data Ingestion Layer                     │
│               FHIR | OpenFDA | Inventory APIs               │
└─────────────────────────────────────────────────────────────┘

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🚀 Quick Start

# Install dependencies
npm install

# Run development server (works without API keys!)
npm run dev

# Open http://localhost:3000

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🔑 Environment Setup

Copy .env.example to .env.local:

cp .env.example .env.local

Minimum config (free): No API keys required - uses mock data + rule-based reasoning

Enhanced features:

• AWS_ACCESS_KEY_ID - Claude 3.5 Sonnet for clinical reasoning
• OPENFDA_API_KEY - Drug interaction data (120K req/day free)

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📁 Project Structure

src/
├── agents/                    # 8-Layer Agent System
│   ├── context-agent.ts       # Layer 1: Context Compression
│   ├── safety-agent.ts        # Layer 2: Deterministic Safety
│   ├── reasoning-agent.ts     # Layer 3: Clinical Reasoning
│   ├── inventory-agent.ts     # Layer 4: Availability Check
│   ├── substitution-agent.ts  # Layer 5: Drug Equivalence
│   ├── explanation-agent.ts   # Layer 6: XAI Output
│   ├── audit-agent.ts         # Layer 8: Compliance Logging
│   └── orchestrator.ts        # Pipeline Coordinator
├── lib/
│   └── connectors/            # External API Connectors
│       ├── fhir-connector.ts  # HAPI FHIR R4
│       ├── openfda-client.ts  # Drug Labels & Interactions
│       └── inventory-connector.ts
├── types/
│   └── agents.ts              # TypeScript Definitions
└── app/
    ├── api/                   # API Routes
    │   ├── context/           # Patient context
    │   └── prescription-draft/# Full pipeline
    └── page.tsx               # Main UI

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🛡️ Safety Features

• Allergy Detection: Blocks penicillin class for documented allergies
• Cross-Reactivity Warnings: 1-2% cephalosporin warning with penicillin allergy
• Renal Dose Adjustment: Auto-adjusts doses based on eGFR
• Drug Interactions: Checks against current medications
• Beers Criteria: Flags potentially inappropriate drugs for elderly

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🔌 API Endpoints

POST /api/context

Get compressed patient context

{
  "patient_id": "patient-001"
}

POST /api/prescription-draft

Generate AI-assisted prescription draft

{
  "patient_id": "patient-001",
  "doctor_notes": "Fever and productive cough. Suspect bacterial infection."
}

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🧪 Example Response

{
  "primary_recommendation": {
    "drug": "Azithromycin",
    "dose": "500mg",
    "frequency": "OD",
    "duration": "3 days",
    "reasoning": [
      "Non-beta-lactam selected due to documented allergy",
      "Dose adjusted for renal function (eGFR: 48)"
    ]
  },
  "warnings": [
    "Cephalosporin cross-reactivity ~1-2% with penicillin allergy"
  ],
  "pipeline_execution_ms": 4
}

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📜 License

MIT

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🤝 Contributing

PRs welcome! Please ensure safety-critical code maintains 100% deterministic behavior.