diff --git a/.env b/.env
index d4b9e1e..f6a3868 100644
--- a/.env
+++ b/.env
@@ -30,3 +30,5 @@ VITE_USE_PHARMACY_IN_PREFETCH = true
 VITE_INTERMEDIARY = http://localhost:3003
 VITE_DISABLE_MEDICATION_STATUS = false
 VITE_PHARMACY_ID = pharm0111
+VITE_PACIO_EHR_URL = https://gw.interop.community/paciosandbox2/open/Bundle
+VITE_PACIO_NEW_PRESCRIBER_ID=pra1234
diff --git a/src/PrefetchTemplate.js b/src/PrefetchTemplate.js
index 573a880..7ee00ca 100644
--- a/src/PrefetchTemplate.js
+++ b/src/PrefetchTemplate.js
@@ -3,10 +3,9 @@
 export class PrefetchTemplate {
   static generatePrefetchMap(settings = null) {
     // If no settings provided, use defaults from data.js
-    const includePharmacy = settings?.includePharmacyInPreFetch ?? 
-                           headerDefinitions.includePharmacyInPreFetch.default;
-    const pharmacyId = settings?.pharmacyId ?? 
-                      headerDefinitions.pharmacyId.default;
+    const includePharmacy =
+      settings?.includePharmacyInPreFetch ?? headerDefinitions.includePharmacyInPreFetch.default;
+    const pharmacyId = settings?.pharmacyId ?? headerDefinitions.pharmacyId.default;
 
     const prefetchMap = new Map();
 
@@ -64,7 +63,7 @@ export class PrefetchTemplate {
   ) {
     const prefetchMap = PrefetchTemplate.generatePrefetchMap(settings);
     const paramElementMap = PrefetchTemplate.generateParamElementMap();
-    
+
     var resolvedQueries = new Map();
     for (var i = 0; i < prefetchKeys.length; i++) {
       var prefetchKey = prefetchKeys[i];
@@ -73,7 +72,7 @@ export class PrefetchTemplate {
       // Regex source: https://regexland.com/all-between-specified-characters/
       var parametersToFill = query.match(/(?<={{).*?(?=}})/gs);
       var resolvedQuery = query.slice();
-      
+
       if (parametersToFill) {
         for (var j = 0; j < parametersToFill.length; j++) {
           var unresolvedParameter = parametersToFill[j];
@@ -135,4 +134,4 @@ export class PrefetchTemplate {
   getQuery() {
     return this.query;
   }
-}
\ No newline at end of file
+}
diff --git a/src/components/RequestDashboard/Communication.jsx b/src/components/RequestDashboard/Communication.jsx
index ecf490b..05de736 100644
--- a/src/components/RequestDashboard/Communication.jsx
+++ b/src/components/RequestDashboard/Communication.jsx
@@ -1,45 +1,44 @@
-import { Button, Grid } from "@mui/material";
+import { Button, Grid } from '@mui/material';
 import DeleteIcon from '@mui/icons-material/Delete';
 import useStyles from './styles';
 
-
 const Communication = props => {
-    const classes = useStyles();
-    const { communication, deleteCommunication } = props;
+  const classes = useStyles();
+  const { communication, deleteCommunication } = props;
 
-    const convertTimeStamp = (timeStamp) => {
-        const date = new Date(timeStamp);
-        return date.toLocaleString();
-    };
+  const convertTimeStamp = timeStamp => {
+    const date = new Date(timeStamp);
+    return date.toLocaleString();
+  };
 
-    return (
-        <div>
-            <Grid container>
-                <Grid className={classes.communicationHeader} item xs={2}>
-                    {`ID: ${communication.id}`}
-                </Grid>
-                <Grid className={classes.communicationHeader} item xs={8.7}>
-                    {`Received: ${convertTimeStamp(communication.received)}`}
-                </Grid>
-                <Grid className={classes.communicationHeaderButton} item xs={1.3}>
-                    <Button
-                        fullWidth
-                        variant="contained"
-                        color="error"
-                        startIcon={<DeleteIcon />}
-                        onClick={() => {
-                            deleteCommunication(communication.id);
-                        }}
-                    >
-                        Clear
-                    </Button>
-                </Grid>
-                <Grid className={classes.communicationDescription} item xs={12}>
-                    {communication.payload[0].contentString}
-                </Grid>
-            </Grid>
-        </div>
-    );
+  return (
+    <div>
+      <Grid container>
+        <Grid className={classes.communicationHeader} item xs={2}>
+          {`ID: ${communication.id}`}
+        </Grid>
+        <Grid className={classes.communicationHeader} item xs={8.7}>
+          {`Received: ${convertTimeStamp(communication.received)}`}
+        </Grid>
+        <Grid className={classes.communicationHeaderButton} item xs={1.3}>
+          <Button
+            fullWidth
+            variant="contained"
+            color="error"
+            startIcon={<DeleteIcon />}
+            onClick={() => {
+              deleteCommunication(communication.id);
+            }}
+          >
+            Clear
+          </Button>
+        </Grid>
+        <Grid className={classes.communicationDescription} item xs={12}>
+          {communication.payload[0].contentString}
+        </Grid>
+      </Grid>
+    </div>
+  );
 };
 
-export default Communication;
\ No newline at end of file
+export default Communication;
diff --git a/src/components/RequestDashboard/CommunicationsDialog.jsx b/src/components/RequestDashboard/CommunicationsDialog.jsx
index ba7d7ef..cfe387a 100644
--- a/src/components/RequestDashboard/CommunicationsDialog.jsx
+++ b/src/components/RequestDashboard/CommunicationsDialog.jsx
@@ -6,7 +6,7 @@ import Badge from '@mui/material/Badge';
 import Dialog from '@mui/material/Dialog';
 import DialogTitle from '@mui/material/DialogTitle';
 import DialogContent from '@mui/material/DialogContent';
-import { Refresh } from '@mui/icons-material'
+import { Refresh } from '@mui/icons-material';
 
 import { styled } from '@mui/material/styles';
 import Paper from '@mui/material/Paper';
@@ -23,25 +23,23 @@ const CommunicationsDialog = props => {
     open: false
   });
 
-  const debugLog = (message) => {
+  const debugLog = message => {
     console.log('CommunicationsDialog: ' + message);
   };
 
   useEffect(() => {
     // reload on page load and dialog open
     if (state.initialLoad) {
-      setState(prevState => ({ ...prevState, initialLoad: false}));
+      setState(prevState => ({ ...prevState, initialLoad: false }));
       getCommunications();
     }
 
     const interval = setInterval(() => {
       // page load...
       getCommunications();
-
-    }, 1000 * 5) // reload every 5 seconds
+    }, 1000 * 5); // reload every 5 seconds
 
     return () => clearInterval(interval);
-
   });
 
   const getCommunications = () => {
@@ -56,9 +54,9 @@ const CommunicationsDialog = props => {
           loadCommunications(bundle);
         });
     }
-  }
+  };
 
-  const deleteCommunication = (id) => {
+  const deleteCommunication = id => {
     debugLog('deleteCommunication: ' + id);
     if (id) {
       state.client.delete(`Communication/${id}`).then(() => {
@@ -66,15 +64,15 @@ const CommunicationsDialog = props => {
         getCommunications();
       });
     }
-  }
+  };
 
-  const loadCommunications = (bundle) => {
+  const loadCommunications = bundle => {
     let count = bundle.length;
-    setState(prevState => ({ ...prevState, communicationCount: count, communications: bundle}));
+    setState(prevState => ({ ...prevState, communicationCount: count, communications: bundle }));
   };
 
   const handleClose = () => {
-    setState(prevState => ({ ...prevState, open: false}));
+    setState(prevState => ({ ...prevState, open: false }));
   };
 
   const Item = styled(Paper)(({ theme }) => ({
@@ -82,59 +80,64 @@ const CommunicationsDialog = props => {
     ...theme.typography.body2,
     padding: theme.spacing(1),
     textAlign: 'left',
-    color: theme.palette.text.secondary,
+    color: theme.palette.text.secondary
   }));
 
   const renderCommunications = () => {
     return (
-        <Grid container spacing={2} sx={{ mt: 2 }}>
+      <Grid container spacing={2} sx={{ mt: 2 }}>
         {state.communications.map(communication => {
           return (
             <Grid item xs={12} sm={12}>
-              <Item><Communication communication={communication} deleteCommunication={deleteCommunication}/></Item>
+              <Item>
+                <Communication
+                  communication={communication}
+                  deleteCommunication={deleteCommunication}
+                />
+              </Item>
             </Grid>
           );
         })}
-        </Grid>
+      </Grid>
     );
-  }
+  };
 
   return (
     <span>
-    <span onClick={() => {
-      setState(prevState => ({ ...prevState, open: true, initialLoad: true}));
-    }} >
-    <Badge badgeContent={state.communicationCount} color="primary">
-      <NotificationsIcon sx={{ fontSize: 26, verticalAlign: 'middle' }} />
-    </Badge></span>
-    <Dialog fullWidth maxWidth='md' onClose={handleClose} open={state.open}>
-      <DialogTitle>
-        <Grid container>
-          <Grid item xs={10}>
-            <NotificationsIcon sx={{ fontSize: 26, verticalAlign: 'middle' }} />
-            Communications ({state.communicationCount})
-          </Grid>
-          <Grid item xs={2}>
-            <Button
-              variant="contained"
-              startIcon={<Refresh />}
-              onClick={() => {
-                getCommunications();
-              }}
-            >
-              Refresh
-            </Button>
+      <span
+        onClick={() => {
+          setState(prevState => ({ ...prevState, open: true, initialLoad: true }));
+        }}
+      >
+        <Badge badgeContent={state.communicationCount} color="primary">
+          <NotificationsIcon sx={{ fontSize: 26, verticalAlign: 'middle' }} />
+        </Badge>
+      </span>
+      <Dialog fullWidth maxWidth="md" onClose={handleClose} open={state.open}>
+        <DialogTitle>
+          <Grid container>
+            <Grid item xs={10}>
+              <NotificationsIcon sx={{ fontSize: 26, verticalAlign: 'middle' }} />
+              Communications ({state.communicationCount})
+            </Grid>
+            <Grid item xs={2}>
+              <Button
+                variant="contained"
+                startIcon={<Refresh />}
+                onClick={() => {
+                  getCommunications();
+                }}
+              >
+                Refresh
+              </Button>
+            </Grid>
           </Grid>
-        </Grid>
-      </DialogTitle>
-
-      <DialogContent>
-        { renderCommunications() }
-      </DialogContent>
+        </DialogTitle>
 
-    </Dialog>
+        <DialogContent>{renderCommunications()}</DialogContent>
+      </Dialog>
     </span>
   );
 };
 
-export default CommunicationsDialog;
\ No newline at end of file
+export default CommunicationsDialog;
diff --git a/src/components/RequestDashboard/Home.jsx b/src/components/RequestDashboard/Home.jsx
index 61b538c..ba322ec 100644
--- a/src/components/RequestDashboard/Home.jsx
+++ b/src/components/RequestDashboard/Home.jsx
@@ -12,7 +12,6 @@ import PatientSection from './PatientSection';
 import SettingsSection from './SettingsSection';
 import TasksSection from './TasksSection';
 
-
 import { logout } from '../../util/auth';
 
 const Home = props => {
@@ -86,9 +85,7 @@ const Home = props => {
           {section ? (
             <Grid className={classes.spacer} item xs={5}>
               <span className={classes.loginIcon}>
-                <CommunicationsDialog 
-                  client={props.client} token={token}
-                />
+                <CommunicationsDialog client={props.client} token={token} />
                 &nbsp;&nbsp;
                 <AccountBoxIcon sx={{ fontSize: 48, verticalAlign: 'middle' }} /> {token.name}
                 <Button variant="outlined" className={classes.whiteButton} onClick={logout}>
@@ -121,7 +118,7 @@ const Home = props => {
             <TasksSection client={props.client} userName={token.name} userId={token.userId} />
           </div>
           <div className={settingsRenderClass}>
-            <SettingsSection client={props.client} />
+            <SettingsSection client={props.client} userId={token.userId} />
           </div>
         </div>
       );
diff --git a/src/components/RequestDashboard/SettingsSection.jsx b/src/components/RequestDashboard/SettingsSection.jsx
index e1a031e..15bc014 100644
--- a/src/components/RequestDashboard/SettingsSection.jsx
+++ b/src/components/RequestDashboard/SettingsSection.jsx
@@ -1,4 +1,4 @@
-import React, { memo, useEffect } from 'react';
+import React, { memo, useEffect, useRef } from 'react';
 import {
   Button,
   Checkbox,
@@ -33,15 +33,20 @@ import {
   ENCOUNTER_START,
   REMS_ETASU
 } from '../../util/data';
+import { getPatientFirstAndLastName } from '../../util/util';
 import { actionTypes } from '../../containers/ContextProvider/reducer';
 import { SettingsContext } from '../../containers/ContextProvider/SettingsProvider';
 
 const ENDPOINT = [ORDER_SIGN, ORDER_SELECT, PATIENT_VIEW, ENCOUNTER_START, REMS_ETASU];
 
 const SettingsSection = props => {
+  const { client, userId } = props;
+
   const [state, dispatch, updateSetting, readSettings, saveSettings] =
     React.useContext(SettingsContext);
 
+  const lastPacioTimestamp = useRef(null);
+
   const fieldHeaders = Object.keys(headerDefinitions)
     .map(key => ({ ...headerDefinitions[key], key }))
     // Display the fields in descending order of type. If two fields are the same type,
@@ -95,35 +100,62 @@ const SettingsSection = props => {
         });
     };
 
-  const clearResource =
-    ({ ehrUrl, access_token }, type) =>
-    () => {
-      console.log('Clear ' + type + 's from the EHR: ' + ehrUrl);
-      const client = FHIR.client({
-        serverUrl: ehrUrl,
-        ...(access_token ? { tokenResponse: access_token } : {})
-      });
-      client
-        .request(type, { flat: true })
-        .then(result => {
-          console.log(result);
-          result.forEach(resource => {
-            console.log('Delete ' + type + ': ' + resource.id);
-            client
-              .delete(type + '/' + resource.id)
-              .then(result => {
-                console.log(result);
-              })
-              .catch(e => {
-                console.log('Failed to delete ' + type + ' ' + resource.id);
-                console.log(e);
-              });
-          });
-        })
-        .catch(e => {
-          console.log('Failed to retrieve list of ' + type + 's');
+  const clearResourceWithParams = async (type, params) => {
+    console.log('Clear ' + type + 's from the EHR');
+    let query = type;
+    if (params != '') {
+      query = type + params;
+      console.log('    -> with params ' + params);
+    }
+
+    try {
+      const result = await client.request(query, { flat: true });
+      console.log(result);
+
+      // Delete all resources in parallel and wait for all to complete
+      const deletePromises = result.map(async resource => {
+        console.log('Delete ' + type + ': ' + resource.id);
+        try {
+          const deleteResult = await client.delete(type + '/' + resource.id);
+          console.log(deleteResult);
+        } catch (e) {
+          console.log('Failed to delete ' + type + ' ' + resource.id);
           console.log(e);
-        });
+        }
+      });
+
+      await Promise.all(deletePromises);
+      console.log(`Finished deleting all ${type}s`);
+    } catch (e) {
+      console.log('Failed to retrieve list of ' + type + 's');
+      console.log(e);
+    }
+  };
+
+  const clearResource =
+    ({}, type) =>
+    async () => {
+      // Delete all resources of type type
+      return await clearResourceWithParams(type, '');
+    };
+
+  const clearPatient =
+    ({ patientOfInterest }) =>
+    async () => {
+      console.log(`clear patient ${patientOfInterest}`);
+
+      try {
+        // Delete related resources first
+        await clearResourceWithParams('MedicationRequest', `?subject=${patientOfInterest}`);
+        await clearResourceWithParams('Communication', `?subject=${patientOfInterest}`);
+        await clearResourceWithParams('Coverage', `?beneficiary=${patientOfInterest}`);
+
+        // Finally delete the patient
+        const result = await client.delete(`Patient/${patientOfInterest}`);
+        console.log('Successfully deleted patient:', result);
+      } catch (e) {
+        console.log('Failed to delete patient:', e);
+      }
     };
 
   const reconnectEhr =
@@ -137,6 +169,295 @@ const SettingsSection = props => {
       });
     };
 
+  const createCommunication = (patientId, practitionerId, message) => {
+    const ts = Date.now();
+    const currentDate = new Date(ts);
+
+    const communication = {
+      resourceType: 'Communication',
+      status: 'in-progress',
+      category: [
+        {
+          coding: [
+            {
+              system: 'http://acme.org/messagetypes',
+              code: 'Alert'
+            }
+          ],
+          text: 'Alert'
+        }
+      ],
+      subject: {
+        reference: 'Patient/' + patientId
+      },
+      sent: currentDate.toISOString(),
+      received: currentDate.toISOString(),
+      recipient: [
+        {
+          reference: 'Practitioner/' + practitionerId
+        }
+      ],
+      sender: {
+        reference: 'Device/f001'
+      },
+      payload: [
+        {
+          contentString: message
+        }
+      ]
+    };
+
+    return communication;
+  };
+
+  const addCommunication = (patientId, message) => {
+    // add a communication notifying the practitioner that the resources were created
+    const communication = createCommunication(patientId, userId, message);
+
+    client
+      .create(communication)
+      .then(result => {
+        //console.log(result);
+      })
+      .catch(e => {
+        console.log('Failed to add Communication to EHR');
+        console.log(e);
+      });
+  };
+
+  const parsePacioToc = async pacioToc => {
+    console.log('    Parse PACIO TOC Bundle');
+    let medicationStatementList = [];
+    let patient = null;
+
+    pacioToc?.entry.forEach(tocEntry => {
+      const tocResource = tocEntry?.resource;
+
+      switch (tocResource?.resourceType) {
+        case 'Patient':
+          // find the patient
+          console.log('      Found Patient');
+          patient = tocResource;
+          break;
+        case 'Bundle':
+          console.log('      Process TOC Bundle');
+          tocResource?.entry.forEach(bundleEntry => {
+            const bundleEntryResource = bundleEntry?.resource;
+            switch (bundleEntryResource?.resourceType) {
+              case 'MedicationStatement':
+                // find the MedicationStatements
+                console.log('        Found MedicationStatement');
+                medicationStatementList.push(bundleEntryResource);
+                break;
+            }
+          });
+          break;
+      }
+    });
+
+    if (!patient) {
+      console.log('PACIO TOC missing Patient');
+      return;
+    }
+
+    // Get prescriber from settings
+    const newPrescriberId = state.pacioNewPrescriberId;
+    console.log(
+      `    Converting MedicationStatements to MedicationRequests with prescriber: ${newPrescriberId}`
+    );
+
+    let targetPatient = null;
+    console.log('    Creating new patient from TOC bundle');
+    try {
+      targetPatient = await client.create(patient);
+      console.log(
+        `    Created new patient: ${getPatientFirstAndLastName(targetPatient)} (${targetPatient.id})`
+      );
+      addCommunication(
+        targetPatient.id,
+        `Added new patient (${getPatientFirstAndLastName(targetPatient)}) from transfer of care`
+      );
+    } catch (e) {
+      console.log('    Failed to create patient:', e);
+      return;
+    }
+
+    // Convert MedicationStatements to MedicationRequests
+    const patientId = targetPatient.id;
+    const patientName = getPatientFirstAndLastName(targetPatient);
+    console.log(`    Creating MedicationRequests for patient ${patientName} (${patientId})`);
+
+    for (const medicationStatement of medicationStatementList) {
+      // Create a new MedicationRequest from the MedicationStatement
+      const medicationRequest = {
+        resourceType: 'MedicationRequest',
+        meta: {
+          profile: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest']
+        },
+        status: 'active',
+        intent: 'order',
+        subject: {
+          reference: `Patient/${patientId}`,
+          display: patientName
+        },
+        authoredOn: new Date().toISOString().split('T')[0],
+        requester: {
+          reference: `Practitioner/${newPrescriberId}`,
+          display: 'Transfer Prescriber'
+        }
+      };
+
+      // Copy medication information
+      if (medicationStatement.medicationCodeableConcept) {
+        medicationRequest.medicationCodeableConcept = medicationStatement.medicationCodeableConcept;
+      } else if (medicationStatement.medicationReference) {
+        medicationRequest.medicationReference = medicationStatement.medicationReference;
+      }
+
+      // Copy dosage if available
+      if (medicationStatement.dosage && medicationStatement.dosage.length > 0) {
+        medicationRequest.dosageInstruction = medicationStatement.dosage.map((dosage, index) => ({
+          sequence: index + 1,
+          text: dosage.text,
+          timing: dosage.timing,
+          route: dosage.route,
+          doseAndRate: dosage.doseAndRate
+        }));
+      }
+
+      // Add note about transfer
+      medicationRequest.note = [
+        {
+          text: `Continued from previous care. Original medication statement: ${medicationStatement.id || 'unknown'}`
+        }
+      ];
+
+      const medName =
+        medicationRequest.medicationCodeableConcept?.coding?.[0]?.display || 'Unknown medication';
+
+      try {
+        const medicationRequestResult = await client.create(medicationRequest);
+        console.log(`    Added new MedicationRequest for ${medName} (ID: ${medicationRequestResult.id})`);
+        addCommunication(
+          patientId,
+          `Added new MedicationRequest for ${medName} from transfer of care`
+        );
+      } catch (e) {
+        console.log(`    Failed to add MedicationRequest for ${medName}:`, e);
+      }
+    }
+  };
+
+  const pollPacioNotifications = async () => {
+    const pacioEhrUrl = state.pacioEhrUrl;
+
+    if (!pacioEhrUrl) {
+      return;
+    }
+
+    try {
+      console.log('Polling PACIO discharge notifications...');
+
+      // Build query URL
+      let query = '?type=message&_format=json';
+      if (lastPacioTimestamp.current) {
+        query += `&_lastUpdated=gt${lastPacioTimestamp.current}`;
+        console.log(`  Using timestamp filter: ${lastPacioTimestamp.current}`);
+      } else {
+        console.log('  First poll - no timestamp filter, skipping saving old messages');
+      }
+
+      const pacioFhirClient = FHIR.client({
+        serverUrl: pacioEhrUrl
+      });
+
+      // Fetch discharge notifications
+      const searchBundle = await pacioFhirClient.request(query);
+
+      // ignore the first message, don't save old bundles
+      if (lastPacioTimestamp.current) {  
+        if (searchBundle?.entry && searchBundle.entry.length > 0) {
+          console.log(`  Found ${searchBundle.entry.length} discharge notification(s)`);
+
+          for (const notificationEntry of searchBundle.entry) {
+            const notificationBundle = notificationEntry.resource;
+
+            if (
+              notificationBundle?.resourceType === 'Bundle' &&
+              notificationBundle.type === 'message'
+            ) {
+              console.log(`  Processing notification bundle: ${notificationBundle.id}`);
+
+              // Find DocumentReference in the notification bundle
+              let documentReference = null;
+              if (notificationBundle.entry) {
+                for (const entry of notificationBundle.entry) {
+                  if (entry.resource?.resourceType === 'DocumentReference') {
+                    documentReference = entry.resource;
+                    console.log('    Found DocumentReference (TOC)');
+                    break;
+                  }
+                }
+              }
+
+              if (documentReference?.content?.[0]?.attachment?.url) {
+                const tocBundleUrl = documentReference.content[0].attachment.url;
+                console.log(`    Fetching TOC bundle from: ${tocBundleUrl}`);
+
+                // Fetch and process the TOC bundle
+                try {
+                  const tocBundle = await pacioFhirClient.request(tocBundleUrl);
+                  await parsePacioToc(tocBundle);
+                } catch (e) {
+                  console.log(`    Failed to fetch/process TOC bundle:`, e);
+                }
+              } else {
+                console.log('    No DocumentReference with TOC bundle URL found');
+              }
+            }
+          }
+        } else {
+          console.log('  No new notifications found');
+        }
+      }
+
+      // Update timestamp from server response for next poll
+      if (searchBundle?.meta?.lastUpdated) {
+        const serverTimestamp = searchBundle.meta.lastUpdated;
+        console.log(`  Server timestamp: ${serverTimestamp}`);
+        lastPacioTimestamp.current = serverTimestamp;
+      }
+      
+    } catch (e) {
+      console.log('Failed to poll PACIO notifications:', e);
+    }
+  };
+
+  // Reset timestamp when PACIO URL changes (switching servers)
+  useEffect(() => {
+    if (state.pacioEhrUrl) {
+      console.log('PACIO URL changed, resetting timestamp for fresh poll');
+      lastPacioTimestamp.current = null;
+    }
+  }, [state.pacioEhrUrl]);
+
+  // Setup automatic polling on component mount
+  useEffect(() => {
+    if (!state.pacioEhrUrl) {
+      return;
+    }
+
+    // Poll immediately on mount or URL change
+    pollPacioNotifications();
+
+    // Then poll every 30 seconds
+    const interval = setInterval(() => {
+      pollPacioNotifications();
+    }, 30000); // 30 seconds
+
+    return () => clearInterval(interval);
+  }, [state.pacioEhrUrl]);
+
   const resetHeaderDefinitions = [
     {
       display: 'Reset PIMS Database',
@@ -166,6 +487,11 @@ const SettingsSection = props => {
       reset: clearResource,
       parameter: 'Task'
     },
+    {
+      display: 'Clear EHR Patient',
+      key: 'clearPatient',
+      reset: clearPatient
+    },
     {
       display: 'Reconnect EHR',
       key: 'reconnectEHR',
@@ -419,4 +745,4 @@ const SettingsSection = props => {
   );
 };
 
-export default memo(SettingsSection);
+export default memo(SettingsSection);
\ No newline at end of file
diff --git a/src/components/SMARTBox/PatientBox.jsx b/src/components/SMARTBox/PatientBox.jsx
index a0d2358..c5ebe9d 100644
--- a/src/components/SMARTBox/PatientBox.jsx
+++ b/src/components/SMARTBox/PatientBox.jsx
@@ -20,7 +20,7 @@ import {
 
 const PatientBox = props => {
   const [globalState] = useContext(SettingsContext);
-  
+
   const [state, setState] = useState({
     request: '',
     deviceRequests: {},
diff --git a/src/util/data.js b/src/util/data.js
index 910383c..4de36ab 100644
--- a/src/util/data.js
+++ b/src/util/data.js
@@ -101,7 +101,20 @@ const headerDefinitions = {
     type: 'check',
     default: false
   },
-
+  pacioEhrUrl: {
+    display: 'PACIO EHR Base URL',
+    type: 'input',
+    default: env.get('VITE_PACIO_EHR_URL').asString()
+  },
+  pacioNewPrescriberId: {
+    display: 'PACIO New Prescriber ID',
+    type: 'input',
+    default: env.get('VITE_PACIO_NEW_PRESCRIBER_ID').asString()
+  },
+  patientOfInterest: {
+    display: 'Patient ID (for Clear)',
+    type: 'input'
+  },
   hookToSend: {
     display: 'Send hook on patient select',
     type: 'dropdown',
@@ -349,4 +362,4 @@ export {
   REMS_ETASU,
   CDS_SERVICE,
   serviceEndpoints
-};
+};
\ No newline at end of file