Tangl is a telehealth brand delivering dermatologist-prescribed hair loss treatments for women directly to their door — with prescription approval from a licensed doctor and dispensary fulfillment built into every order.
Our contribution
- UX/UI design improvements
- Subscription Flow Optimization with Recharge
- Make.com automation flows for prescription order processing
- Shopify × MDI Platform × ChemRX API integration
- Automated order hold, approval, fulfillment, and tracking logic
- Automatic rejection handling with order cancellation and refund triggers
- Prescription refill compliance tracking via Shopify customer metafields
- Strategic guidance on telehealth operations and scalability
Tech stack
- Shopify API
- Automation with Make.com
- Subscriptions by ReCharge
- MDI API
- CHEMRX API
The Challenge
Tangl operates in a regulated space. Every order requires a doctor to review and approve the customer’s prescription before the dispensary can ship the treatment. Before the automation project, this entire process was handled manually: a team member would collect the customer’s data, compile it into a PDF, and send it to both MDI (the medical platform) and ChemRX (the dispensary) by hand. For every order.
This created compounding problems:
- Manual steps introduced delays between purchase and fulfillment, leaving customers waiting on their treatments
- Every additional order required proportionally more human effort — growth meant hiring, not efficiency
- Mistakes in data transfer between systems were unavoidable at scale
- Rejected prescriptions required manual intervention to cancel orders and process refunds
- Recurring orders past the 11th refill needed a new prescription, with no automated way to trigger that process
- There was no system to handle orders that stayed pending for months without a decision
Scaling without automation wasn’t a software problem — it was a business ceiling.
The Journey
We approached this as a multi-system integration project, mapping the full order lifecycle across Shopify, MDI, and ChemRX before writing a single line of automation. The goal was to remove every manual touchpoint between a customer placing an order and their treatment being shipped — while staying within prescription compliance requirements.
Discovery & System Architecture
We started with a comprehensive system diagram covering all order states and integration points between Shopify, Recharge, MDI, and ChemRX. This included API investigation of both MDI and ChemRX to validate what data could be exchanged, in what format, and via which triggers. The discovery confirmed Make.com as the right automation layer — flexible enough to handle branching logic across multiple scenarios, without requiring a custom-built app.
Prescription Approval Flow
When a customer places their first order, they complete a medical intake form routed through MDI. Once MDI processes the prescription, a webhook fires to our Make.com flow. If the prescription is approved, we capture the patient data, store it in Shopify customer and order metafields, generate the required PDF, and send everything to ChemRX for dispensing. When ChemRX confirms the order is ready, the Shopify order is fulfilled automatically and the tracking number is added — the customer receives their standard Shopify shipping notification with no manual step in between.
Prescription Rejection Handling
If MDI rejects a prescription, a separate flow catches that webhook, identifies the related Shopify order, and cancels it automatically. The customer receives a cancellation notification via Shopify’s default notification system. Refunds are processed by the Tangl team as a deliberate manual checkpoint — keeping financial decisions in human hands while removing every other step from the queue.
Recurring Order & Refill Management
Subsequent orders use data already stored in the customer’s Shopify metafields, so no new intake form is needed — until the 11th refill. For recurring orders under the limit, the flow checks the refill count, generates a fresh PDF from the stored patient data, and sends it directly to ChemRX. For the 11th order specifically, the flow sends the customer a notification with the form link to initiate a prescription renewal with MDI before the next shipment. This ensures compliance with refill limits without anyone at Tangl needing to track it manually.
Pending Order Management
For cases where MDI neither approves nor rejects a prescription within 3 months, a Shopify Flow runs a daily check for orders tagged as MDI Pending. Any order placed more than 3 months prior is automatically cancelled, and the customer is notified. This eliminated a class of permanently stuck orders that previously required manual review and decision.
Key Outcomes
- 20 hours of manual work eliminated per week — data collection, PDF generation, and cross-system transfer now fully automated
- Fulfillment speed improved: the time between prescription approval and tracking number on Shopify is now measured in minutes, not hours or days
- Prescription compliance enforced automatically — refill counts tracked via customer metafields, renewal process triggered at the correct threshold
- Rejected prescriptions handled end-to-end without manual intervention (cancel + notify)
- Pending orders resolved automatically after 3 months — no stuck order backlog
- The business can now grow order volume without adding headcount to operations
Can Shopify support a prescription-based ecommerce business?
Yes — with the right automation layer. Shopify handles the storefront, subscriptions, and order management, while external systems (medical platforms, dispensaries) are connected via API. The key is building logic that holds orders for approval, routes prescription data correctly, and handles rejections automatically. We’ve built this for Tangl using Make.com as the integration layer.
How do you automate order fulfillment when each order needs doctor approval before shipping?
Orders are placed and held in Shopify while prescription data is sent to the medical platform for review. When the doctor approves, a webhook triggers fulfillment automatically — the order is sent to the dispensary, tracked, and the customer is notified without any manual step. If rejected, the order is cancelled and the customer notified automatically.
Is it possible to manage prescription refill limits automatically in Shopify?
Yes. Patient prescription data can be stored in Shopify customer metafields and checked on every recurring order. When a customer approaches their refill limit, the system triggers a prescription renewal process automatically — so compliance is enforced without your team needing to track anything manually.
How do you scale a telehealth brand on Shopify without growing your operations team?
The key is removing every manual handoff between systems. When order processing, prescription routing, fulfillment, and rejection handling are all automated, order volume can grow without adding headcount. For Tangl, automation eliminated approximately 20 hours of manual work per week — work that would have grown linearly with order volume without it.
Can Shopify integrate with pharmacy dispensary systems?
Yes, through API integration and webhook-based automation. We connect Shopify to dispensary platforms by routing the right patient and prescription data at the right trigger points — approval, rejection, recurring refill, or renewal. The exact integration depends on what APIs the dispensary exposes, which we validate during a discovery phase before scoping the build.
What makes Shopify a viable platform for regulated health and wellness products?
Shopify handles the commerce layer — subscriptions, checkout, customer accounts, notifications — while compliance logic lives in the automation flows connecting it to medical and dispensary systems. This separation keeps the Shopify setup clean and maintainable, while allowing precise control over how regulated data moves between platforms.
Check out some more showcases
Feel inspired by our clients
