diff --git a/.github/workflows/test.yaml b/.github/workflows/test.yaml
index 0fef0aed..0bc79cc5 100644
--- a/.github/workflows/test.yaml
+++ b/.github/workflows/test.yaml
@@ -6,7 +6,7 @@ on: [push]
 jobs:
   test:
     runs-on: ubuntu-latest
-    container: python:3.7
+    container: python:3.11
     # Service containers to run with `container-job`
     services:
       # Label used to access the service container
diff --git a/Dockerfile b/Dockerfile
index 17672847..5c84d1c2 100644
--- a/Dockerfile
+++ b/Dockerfile
@@ -1,4 +1,4 @@
-FROM python:3.7
+FROM python:3.11
 
 WORKDIR /opt/app
 
diff --git a/isacc_messaging/api/isacc_record_creator.py b/isacc_messaging/api/isacc_record_creator.py
index 346af7c9..e72f5ea1 100644
--- a/isacc_messaging/api/isacc_record_creator.py
+++ b/isacc_messaging/api/isacc_record_creator.py
@@ -1,14 +1,15 @@
 from datetime import datetime, timedelta
+from flask import current_app
 import re
+import requests
 from typing import List, Tuple
 
 from fhirclient.models.communication import Communication
-from flask import current_app
 from twilio.base.exceptions import TwilioRestException
 
 from isacc_messaging.api.email_notifications import send_message_received_notification
-from isacc_messaging.api.ml_utils import predict_score
 from isacc_messaging.audit import audit_entry
+from isacc_messaging.exceptions import IsaccTwilioSIDnotFound
 from isacc_messaging.models.fhir import (
     HAPI_request,
     first_in_bundle,
@@ -47,11 +48,6 @@ def case_insensitive_replace(text, old, new):
     return c
 
 
-class IsaccTwilioError(Exception):
-    """Raised when Twilio SMS are not functioning as required for ISACC"""
-    pass
-
-
 class IsaccRecordCreator:
     def __init__(self):
         pass
@@ -210,7 +206,7 @@ def on_twilio_message_status_update(self, values):
                 extra={"message_sid": message_sid},
                 level='error'
             )
-            raise IsaccTwilioError(f"ERROR! {error}: {message_sid}")
+            raise IsaccTwilioSIDnotFound(f"ERROR! {error}: {message_sid}")
 
         cr = CommunicationRequest(cr)
         patient = resolve_reference(cr.recipient[0].reference)
@@ -303,12 +299,20 @@ def on_twilio_message_received(self, values):
         )
 
     def score_message(self, message):
-        model_path = current_app.config.get('TORCH_MODEL_PATH')
-        if not model_path:
+        ml_service_address = current_app.config.get('ML_SERVICE_ADDRESS')
+        if not ml_service_address:
             return "routine"
 
         try:
-            score = predict_score(message, model_path)
+            url = f'{ml_service_address}/predict_score'
+            response = requests.post(url, json={"message": message})
+            response.raise_for_status()
+            audit_entry(
+                f"predict_score call response: {response.json()}",
+                level='info'
+            )
+
+            score = response.json().get('score')
             if score == 1:
                 return "stat"
         except Exception as e:
@@ -321,11 +325,11 @@ def score_message(self, message):
 
     def execute_requests(self) -> Tuple[List[dict], List[dict]]:
         """
-        For all due CommunicationRequests, generate SMS, create Communication resource, and update CommunicationRequest
+        For all due CommunicationRequests (up to throttle limit), generate SMS, create Communication resource, and update CommunicationRequest
         """
         successes = []
         errors = []
-
+        throttle_limit = 30  # conservative value based on heuristics from logs
         now = datetime.now().astimezone()
         cutoff = now - timedelta(days=2)
 
@@ -335,6 +339,7 @@ def execute_requests(self) -> Tuple[List[dict], List[dict]]:
             "occurrence": f"le{now.isoformat()}",
         })
 
+        sent = 0
         for cr_json in next_in_bundle(result):
             cr = CommunicationRequest(cr_json)
             # as that message was likely the next-outgoing for the patient,
@@ -385,7 +390,7 @@ def execute_requests(self) -> Tuple[List[dict], List[dict]]:
             try:
                 cr.status = "completed"
                 cr.persist()
-                comm_status, comm_statusReason = self.process_cr(cr, successes)
+                comm_status, comm_statusReason = self.process_cr(cr)
                 dispatched_comm = comm.change_status(status=comm_status)
                 audit_entry(
                     f"Updated status of Communication/{comm.id} to {comm_status}",
@@ -415,8 +420,15 @@ def execute_requests(self) -> Tuple[List[dict], List[dict]]:
                     level='exception'
                 )
 
+            # Flooding system on occasions such as a holiday message to all,
+            # leads to an overwhelmed system.  Restrict the flood by processing
+            # only throttle_limit per run.
+            sent += 1
+            if sent > throttle_limit:
+                break
+
         return successes, errors
 
-    def process_cr(self, cr: CommunicationRequest, successes: list):
+    def process_cr(self, cr: CommunicationRequest):
         status, statusReason = self.dispatch_cr(cr=cr)
         return status, statusReason
diff --git a/isacc_messaging/api/ml_utils.py b/isacc_messaging/api/ml_utils.py
deleted file mode 100644
index e4151fc1..00000000
--- a/isacc_messaging/api/ml_utils.py
+++ /dev/null
@@ -1,84 +0,0 @@
-import torch
-from transformers import AutoTokenizer
-import pandas as pd
-from torch.utils.data import TensorDataset
-from torch.utils.data import SequentialSampler, DataLoader
-from scipy.special import expit as sigmoid
-import numpy as np
-
-
-def predict_score(message, model_path):
-    if torch.cuda.is_available():
-        model = torch.load(model_path)
-    else:
-        model = torch.load(model_path, map_location=torch.device('cpu'))
-
-    dl = get_dataloader([message])
-
-    result = predict(model, dl)
-    return np.argmax(result[0])
-
-def encode_sentences(sentences, labels, tokenizer):
-    input_ids = []
-    input_labels = []
-    attention_masks = []
-
-    for i, sentence in enumerate(sentences):
-        encoded_dict = tokenizer.encode_plus(
-            sentence,
-            add_special_tokens=True,
-            max_length=512,
-            padding='max_length',
-            return_tensors='pt',
-            return_attention_mask=True,
-            truncation=True
-        )
-
-        input_ids.append(encoded_dict['input_ids'])
-        attention_masks.append(encoded_dict['attention_mask'])
-        input_labels.append(labels[i])
-
-    input_ids = torch.cat(input_ids, dim=0)
-    attention_masks = torch.cat(attention_masks, dim=0)
-    labels = torch.tensor(labels)
-
-    # Combine the training inputs into a TensorDataset.
-    return TensorDataset(input_ids, attention_masks, labels.float())
-
-def encode_labels(labels: pd.Series):
-    return pd.get_dummies(labels).values
-
-def get_dataloader(test_sentences):
-    tokenizer = AutoTokenizer.from_pretrained("publichealthsurveillance/PHS-BERT", do_lower_case=True)
-    test_labels = [0] * len(test_sentences)
-    labels = encode_labels(test_labels)
-    test_dataset = encode_sentences(test_sentences, labels, tokenizer)
-    sampler = SequentialSampler(test_dataset)
-    test_dataloader = DataLoader(test_dataset, sampler=sampler, batch_size=8)
-    return test_dataloader
-
-def predict(model, dataloader):
-    device = get_device()
-    print(f'Predicting labels for {len(dataloader.dataset)} documents...')
-    model.eval()
-    predictions = []
-    for batch in dataloader:
-        batch = tuple(t.to(device) for t in batch)
-        batch_input_ids, batch_input_mask, batch_labels = batch
-        with torch.no_grad():
-            outputs = model(batch_input_ids, token_type_ids=None,
-                            attention_mask=batch_input_mask)
-            logits = outputs[0]
-            logits = logits.detach().cpu().numpy()
-            predictions = predictions + list(logits)
-    print('DONE.')
-    return sigmoid(predictions)
-
-def get_device(index=0):
-    if torch.cuda.is_available():
-        print('There are %d GPU(s) available.' % torch.cuda.device_count())
-        print('We will use the GPU:', torch.cuda.get_device_name(index), "at index:", index)
-        return torch.device(index)
-    else:
-        print('No GPU available, using the CPU instead.')
-        return torch.device("cpu")
diff --git a/isacc_messaging/api/views.py b/isacc_messaging/api/views.py
index 5ed3d8c1..3f63b9b8 100644
--- a/isacc_messaging/api/views.py
+++ b/isacc_messaging/api/views.py
@@ -2,12 +2,16 @@
 import click
 import logging
 from datetime import datetime
+from time import sleep
 from flask import Blueprint, jsonify, request
 from flask import current_app
+from flask.cli import with_appcontext
+from twilio.request_validator import RequestValidator
 
 from isacc_messaging.api.isacc_record_creator import IsaccRecordCreator
 from isacc_messaging.audit import audit_entry
-from twilio.request_validator import RequestValidator
+from isacc_messaging.exceptions import IsaccTwilioSIDnotFound
+from isacc_messaging.robust_request import serialize_request, queue_request, pop_request
 
 base_blueprint = Blueprint('base', __name__, cli_group=None)
 
@@ -88,22 +92,43 @@ def auditlog_addevent():
 
 
 @base_blueprint.route("/MessageStatus", methods=['POST'])
-def message_status_update():
+def message_status_update(callback_req=None, attempt_count=0):
+    """Registered callback for Twilio to transmit updates
+
+    As Twilio occasionally hits this callback prior to local data being
+    available, it is also called subsequently from a job queue.  The
+    parameters are only defined in the retry state.
+
+    :param req: request from a job queue
+    :param attempt_count: the number of failed attemts thus far, only
+        defined from job queue
+    """
+    use_request = request
+    if callback_req:
+        use_request = callback_req
+
     audit_entry(
         f"Call to /MessageStatus webhook",
-        extra={'request.values': dict(request.values)},
+        extra={'use_request.values': dict(use_request.values)},
         level='debug'
     )
 
     record_creator = IsaccRecordCreator()
     try:
-        record_creator.on_twilio_message_status_update(request.values)
+        record_creator.on_twilio_message_status_update(use_request.values)
     except Exception as ex:
         audit_entry(
             f"on_twilio_message_status_update generated error {ex}",
             level='error'
         )
-        return ex, 200
+        # Couldn't locate the message, most likely means twilio was quicker
+        # to call back, than HAPI could persist and find.  Push to REDIS
+        # for another attempt later
+        if isinstance(ex, IsaccTwilioSIDnotFound):
+            req = serialize_request(use_request, attempt_count=attempt_count)
+            queue_request(req)
+
+        return str(ex), 200
     return '', 204
 
 
@@ -155,8 +180,8 @@ def incoming_sms():
             level="error")
         return stackstr, 200
     if result is not None:
-        # Occurs when message is incoming from unknown phone 
-        # or request is coming from a subscribed phone number, but 
+        # Occurs when message is incoming from unknown phone
+        # or request is coming from a subscribed phone number, but
         # internal logic renders it invalid
         audit_entry(
             f"on_twilio_message_received generated error {result}",
@@ -213,6 +238,25 @@ def execute_requests():
     ])
 
 
+@base_blueprint.cli.command("retry_requests")
+@with_appcontext
+def retry_requests():
+    """Look for any failed requests and retry now"""
+    while True:
+        failed_request = pop_request()
+        if not failed_request:
+            break
+
+        # Only expecting one route at this time
+        if (
+                failed_request.url.endswith("/MessageStatus") and
+                failed_request.method.upper() == 'POST'):
+            with current_app.test_request_context():
+                response, response_code = message_status_update(
+                    failed_request, failed_request.attempt_count + 1)
+                if response_code != 204:
+                    sleep(1)  # give system a moment to catch up before retry
+
 @base_blueprint.cli.command("send-system-emails")
 @click.argument("category", required=True)
 @click.option("--dry-run", is_flag=True, default=False, help="Simulate execution; generate but don't send email")
@@ -301,4 +345,3 @@ def deactivate_patient(patient_id):
         f"Patient {patient_id} active set to false",
         level='info'
     )
-
diff --git a/isacc_messaging/config.py b/isacc_messaging/config.py
index 34fe9e14..b2b7a9d7 100644
--- a/isacc_messaging/config.py
+++ b/isacc_messaging/config.py
@@ -29,7 +29,7 @@
 TWILIO_ACCOUNT_SID = os.getenv("TWILIO_ACCOUNT_SID")
 TWILIO_AUTH_TOKEN = os.getenv("TWILIO_AUTH_TOKEN")
 TWILIO_PHONE_NUMBER = os.getenv("TWILIO_PHONE_NUMBER")
-TORCH_MODEL_PATH = os.getenv("TORCH_MODEL_PATH")
+ML_SERVICE_ADDRESS = os.getenv("ML_SERVICE_ADDRESS")
 
 ISACC_NOTIFICATION_EMAIL_SENDER_ADDRESS = os.getenv("ISACC_NOTIFICATION_EMAIL_SENDER_ADDRESS")
 ISACC_NOTIFICATION_EMAIL_PASSWORD = os.getenv("ISACC_NOTIFICATION_EMAIL_PASSWORD")
@@ -40,4 +40,3 @@
 ISACC_APP_URL = os.getenv("ISACC_APP_URL")
 EMAIL_PORT = os.getenv("EMAIL_PORT", 465)
 EMAIL_SERVER = os.getenv("EMAIL_SERVER", "smtp.gmail.com")
-
diff --git a/isacc_messaging/exceptions.py b/isacc_messaging/exceptions.py
new file mode 100644
index 00000000..e6da6300
--- /dev/null
+++ b/isacc_messaging/exceptions.py
@@ -0,0 +1,10 @@
+"""Module to define exceptions used by isacc_messaging."""
+
+class IsaccTwilioSIDnotFound(Exception):
+    """Raised when Twilio calls with SID that can't be found"""
+    pass
+
+
+class IsaccRequestRetriesExhausted(Exception):
+    """Raised when max retries have been tried w/o success"""
+    pass
diff --git a/isacc_messaging/models/isacc_communication.py b/isacc_messaging/models/isacc_communication.py
index 13a99c07..b08e27ab 100644
--- a/isacc_messaging/models/isacc_communication.py
+++ b/isacc_messaging/models/isacc_communication.py
@@ -39,12 +39,15 @@ def change_status(self, status):
     def about_patient(patient):
         """Query for "outside" Communications about the patient
 
+        This includes the dummy Communications added when staff resolve
+        a message without a response (category:isacc-message-resolved-no-send)
+
         NB: only `sent` or `received` will have a valueDateTime depending on
         direction of outside communication.  `sent` implies communication from
         practitioner, `received` implies communication from patient.
         """
         return HAPI_request("GET", "Communication", params={
-            "category": "isacc-non-sms-message",
+            "category": "isacc-non-sms-message,isacc-message-resolved-no-send",
             "subject": f"Patient/{patient.id}",
             "_sort": "-sent",
         })
diff --git a/isacc_messaging/models/isacc_fhirdate.py b/isacc_messaging/models/isacc_fhirdate.py
index a115adaf..c5a4371b 100644
--- a/isacc_messaging/models/isacc_fhirdate.py
+++ b/isacc_messaging/models/isacc_fhirdate.py
@@ -36,4 +36,4 @@ def __repr__(self):
 
 
 DEEP_PAST = IsaccFHIRDate("1975-01-01T00:00:00Z")
-DEEP_FUTURE = IsaccFHIRDate("2025-01-01T00:00:00Z")
+DEEP_FUTURE = IsaccFHIRDate("2025-01-01T00:00:00Z")
\ No newline at end of file
diff --git a/isacc_messaging/models/isacc_patient.py b/isacc_messaging/models/isacc_patient.py
index 88c3bc59..02f06795 100644
--- a/isacc_messaging/models/isacc_patient.py
+++ b/isacc_messaging/models/isacc_patient.py
@@ -235,7 +235,7 @@ def mark_followup_extension(self, persist_on_change=True):
         for c in next_in_bundle(Communication.for_patient(self, category="isacc-manually-sent-message")):
             most_recent_followup = FHIRDate(c["sent"])
             break
-        # also possible a followup was recorded as `outside communication`
+        # also possible a followup was recorded as `outside communication` or resolved
         for c in next_in_bundle(Communication.about_patient(self)):
             # only consider outside communications reported to have been `sent`
             if "sent" in c:
diff --git a/isacc_messaging/robust_request.py b/isacc_messaging/robust_request.py
new file mode 100644
index 00000000..4acdf8d6
--- /dev/null
+++ b/isacc_messaging/robust_request.py
@@ -0,0 +1,44 @@
+"""Functions used for robust handling of failed requests
+
+Basic model: a request fails.  Rather than give up, push the request
+to a job queue and try again from a consumer.
+"""
+import json
+import redis
+from flask import current_app
+
+from isacc_messaging.exceptions import IsaccRequestRetriesExhausted
+
+
+def serialize_request(req, attempt_count=1, max_retries=3):
+    """Given a request object, returns a serialized form
+
+    :param req: The request object
+    :param attempt_count: Increment from previous failure on each call
+    :param max_retries: Maximum number of retries before giving up
+
+    Need a serialized form of the request to push into a job queue.
+    This also maintains and enforces the number of attempts doesn't
+    exceed the maximum.
+    """
+    serialized_form = json.dumps({
+        "method": req.method,
+        "url": req.url,
+        "headers": dict(req.headers),
+        "body": req.get_data(as_text=True),
+        "attempt_count": attempt_count,
+        "max_retries": max_retries
+    })
+    if attempt_count > max_retries:
+        raise IsaccRequestRetriesExhausted(serialized_form)
+    return serialized_form
+
+def queue_request(serialized_request):
+    redis_client = redis.StrictRedis.from_url(current_app.config.get("REQUEST_CACHE_URL"))
+    redis_client.lpush("http_request_queue", serialized_request)
+
+
+def pop_request():
+    redis_client = redis.StrictRedis.from_url(current_app.config.get("REQUEST_CACHE_URL"))
+    return redis_client.rpop("http_request_queue")
+
diff --git a/requirements.dev.txt b/requirements.dev.txt
index f34a8aaf..77f24b07 100644
--- a/requirements.dev.txt
+++ b/requirements.dev.txt
@@ -1,25 +1,167 @@
 #
-# This file is autogenerated by pip-compile
-# To update, run:
+# This file is autogenerated by pip-compile with Python 3.9
+# by the following command:
 #
-#    pip-compile
+#    pip-compile --extra=dev --output-file=requirements.dev.txt setup.cfg
 #
---requirement requirements.txt
-attrs==21.2.0             # via pytest
-importlib-metadata==4.8.1  # via pluggy, pytest
-iniconfig==1.1.1          # via pytest
-mirakuru==2.4.1           # via pytest-redis
-packaging==21.0           # via pytest
-pluggy==1.0.0             # via pytest
-port-for==0.6.1           # via pytest-redis
-psutil==5.8.0             # via mirakuru
-py==1.10.0                # via pytest
-pyparsing==2.4.7          # via packaging
-pytest-datadir==1.3.1     # via pytest-datadir
-pytest-mock==3.6.1        # via isacc_messaging (setup.py)
-pytest-redis==2.1.1       # via isacc_messaging (setup.py)
-pytest==6.2.5             # via pytest-mock, pytest-redis, isacc_messaging (setup.py)
-requests-mock==1.9.3      # via isacc_messaging (setup.py)
-toml==0.10.2              # via pytest
-typing-extensions==3.10.0.2  # via importlib-metadata
-zipp==3.5.0               # via importlib-metadata
+aiohappyeyeballs==2.4.0
+    # via aiohttp
+aiohttp==3.10.5
+    # via
+    #   aiohttp-retry
+    #   twilio
+aiohttp-retry==2.8.3
+    # via twilio
+aiosignal==1.3.1
+    # via aiohttp
+async-timeout==4.0.3
+    # via
+    #   aiohttp
+    #   redis
+attrs==24.2.0
+    # via
+    #   aiohttp
+    #   cattrs
+    #   requests-cache
+authlib==1.3.1
+    # via isacc_messaging (setup.cfg)
+blinker==1.8.2
+    # via flask
+cachelib==0.13.0
+    # via flask-session
+cattrs==23.2.3
+    # via requests-cache
+certifi==2024.7.4
+    # via requests
+cffi==1.17.0
+    # via cryptography
+charset-normalizer==3.3.2
+    # via requests
+click==8.1.7
+    # via flask
+cryptography==43.0.0
+    # via
+    #   authlib
+    #   python-jose
+ecdsa==0.19.0
+    # via python-jose
+exceptiongroup==1.2.2
+    # via
+    #   cattrs
+    #   pytest
+fhirclient==4.1.0
+    # via isacc_messaging (setup.cfg)
+flask==3.0.3
+    # via
+    #   flask-cors
+    #   flask-session
+    #   isacc_messaging (setup.cfg)
+flask-cors==4.0.1
+    # via isacc_messaging (setup.cfg)
+flask-session==0.8.0
+    # via isacc_messaging (setup.cfg)
+frozenlist==1.4.1
+    # via
+    #   aiohttp
+    #   aiosignal
+gunicorn==23.0.0
+    # via isacc_messaging (setup.cfg)
+idna==3.7
+    # via
+    #   requests
+    #   yarl
+importlib-metadata==8.4.0
+    # via flask
+iniconfig==2.0.0
+    # via pytest
+itsdangerous==2.2.0
+    # via flask
+jinja2==3.1.4
+    # via flask
+markupsafe==2.1.5
+    # via
+    #   jinja2
+    #   werkzeug
+mirakuru==2.5.2
+    # via pytest-redis
+msgspec==0.18.6
+    # via flask-session
+multidict==6.0.5
+    # via
+    #   aiohttp
+    #   yarl
+packaging==24.1
+    # via
+    #   gunicorn
+    #   pytest
+platformdirs==4.2.2
+    # via requests-cache
+pluggy==1.5.0
+    # via pytest
+port-for==0.7.2
+    # via pytest-redis
+psutil==6.0.0
+    # via mirakuru
+pyasn1==0.6.0
+    # via
+    #   python-jose
+    #   rsa
+pycparser==2.22
+    # via cffi
+pyjwt==2.9.0
+    # via twilio
+pytest==8.3.2
+    # via
+    #   isacc_messaging (setup.cfg)
+    #   pytest-mock
+    #   pytest-redis
+pytest-mock==3.14.0
+    # via isacc_messaging (setup.cfg)
+pytest-redis==3.1.2
+    # via isacc_messaging (setup.cfg)
+pytest-datadir==1.3.1     
+    # via pytest-datadir
+python-jose[cryptography]==3.3.0
+    # via isacc_messaging (setup.cfg)
+python-json-logger==2.0.7
+    # via isacc_messaging (setup.cfg)
+redis==5.0.8
+    # via
+    #   isacc_messaging (setup.cfg)
+    #   pytest-redis
+requests==2.32.3
+    # via
+    #   fhirclient
+    #   isacc_messaging (setup.cfg)
+    #   requests-cache
+    #   requests-mock
+    #   twilio
+requests-cache==1.2.1
+    # via isacc_messaging (setup.cfg)
+requests-mock==1.12.1
+    # via isacc_messaging (setup.cfg)
+rsa==4.9
+    # via python-jose
+six==1.16.0
+    # via
+    #   ecdsa
+    #   url-normalize
+tomli==2.0.1
+    # via pytest
+twilio==9.2.3
+    # via isacc_messaging (setup.cfg)
+typing-extensions==4.12.2
+    # via cattrs
+url-normalize==1.4.3
+    # via requests-cache
+urllib3==2.2.2
+    # via
+    #   requests
+    #   requests-cache
+werkzeug==3.0.3
+    # via flask
+yarl==1.9.4
+    # via aiohttp
+zipp==3.20.0
+    # via importlib-metadata
+git+https://github.com/uwcirg/fhir-migrations
\ No newline at end of file
diff --git a/requirements.txt b/requirements.txt
index cbee8aa1..d3efd059 100644
--- a/requirements.txt
+++ b/requirements.txt
@@ -1,43 +1,135 @@
 #
-# This file is autogenerated by pip-compile
-# To update, run:
+# This file is autogenerated by pip-compile with Python 3.9
+# by the following command:
 #
-#    pip-compile --output-file=requirements.txt
+#    pip-compile --output-file=requirements.txt setup.cfg
 #
-authlib==0.14.3           # via isacc_messaging (setup.py)
-certifi==2021.5.30        # via requests
-cffi==1.14.1              # via cryptography
-charset-normalizer==2.0.6  # via requests
-click==8.0.1              # via flask
-cryptography==3.3.2         # via authlib, python-jose
-ecdsa==0.14.1             # via python-jose
-fhirclient==4.1.0         # via isacc_messaging (setup.py)
-flask==1.1.2              # via isacc_messaging (setup.py)
-gunicorn==20.1.0          # via isacc_messaging (setup.py)
-idna==3.2                 # via requests
-importlib-metadata==4.8.1  # via click
-itsdangerous==2.0.1       # via flask
-jinja2==3.0.1             # via flask
-markupsafe==2.0.1         # via jinja2
-pyasn1==0.4.8             # via python-jose, rsa
-pycparser==2.20           # via cffi
-python-jose[cryptography]==3.2.0  # via isacc_messaging (setup.py)
-python-json-logger==0.1.11  # via isacc_messaging (setup.py)
-redis==3.5.3              # via isacc_messaging (setup.py)
-requests-cache==0.6.4     # via isacc_messaging (setup.py)
-requests==2.26.0          # via requests-cache, isacc_messaging (setup.py)
-rsa==4.7                  # via python-jose
-six==1.16.0               # via ecdsa, flask-cors, url-normalize
-typing-extensions==3.10.0.2  # via importlib-metadata
-url-normalize==1.4.3      # via requests-cache
-urllib3==1.26.7           # via requests, requests-cache
-werkzeug==2.0.1           # via flask
-zipp==3.5.0               # via importlib-metadata
-twilio==7.14.1
+aiohappyeyeballs==2.4.0
+    # via aiohttp
+aiohttp==3.10.5
+    # via
+    #   aiohttp-retry
+    #   twilio
+aiohttp-retry==2.8.3
+    # via twilio
+aiosignal==1.3.1
+    # via aiohttp
+async-timeout==4.0.3
+    # via
+    #   aiohttp
+    #   redis
+attrs==24.2.0
+    # via
+    #   aiohttp
+    #   cattrs
+    #   requests-cache
+authlib==1.3.1
+    # via isacc_messaging (setup.cfg)
+blinker==1.8.2
+    # via flask
+cachelib==0.13.0
+    # via flask-session
+cattrs==23.2.3
+    # via requests-cache
+certifi==2024.7.4
+    # via requests
+cffi==1.17.0
+    # via cryptography
+charset-normalizer==3.3.2
+    # via requests
+click==8.1.7
+    # via flask
+cryptography==43.0.0
+    # via
+    #   authlib
+    #   python-jose
+ecdsa==0.19.0
+    # via python-jose
+exceptiongroup==1.2.2
+    # via cattrs
 fhirclient==4.1.0
-torch==1.13.0
-transformers==4.24.0
-scipy==1.7.3
-numpy==1.21.5
-pandas==1.3.5
+    # via isacc_messaging (setup.cfg)
+flask==3.0.3
+    # via
+    #   flask-cors
+    #   flask-session
+    #   isacc_messaging (setup.cfg)
+flask-cors==4.0.1
+    # via isacc_messaging (setup.cfg)
+flask-session==0.8.0
+    # via isacc_messaging (setup.cfg)
+frozenlist==1.4.1
+    # via
+    #   aiohttp
+    #   aiosignal
+gunicorn==23.0.0
+    # via isacc_messaging (setup.cfg)
+idna==3.7
+    # via
+    #   requests
+    #   yarl
+importlib-metadata==8.4.0
+    # via flask
+itsdangerous==2.2.0
+    # via flask
+jinja2==3.1.4
+    # via flask
+markupsafe==2.1.5
+    # via
+    #   jinja2
+    #   werkzeug
+msgspec==0.18.6
+    # via flask-session
+multidict==6.0.5
+    # via
+    #   aiohttp
+    #   yarl
+packaging==24.1
+    # via gunicorn
+platformdirs==4.2.2
+    # via requests-cache
+pyasn1==0.6.0
+    # via
+    #   python-jose
+    #   rsa
+pycparser==2.22
+    # via cffi
+pyjwt==2.9.0
+    # via twilio
+python-jose[cryptography]==3.3.0
+    # via isacc_messaging (setup.cfg)
+python-json-logger==2.0.7
+    # via isacc_messaging (setup.cfg)
+redis==5.0.8
+    # via isacc_messaging (setup.cfg)
+requests==2.32.3
+    # via
+    #   fhirclient
+    #   isacc_messaging (setup.cfg)
+    #   requests-cache
+    #   twilio
+requests-cache==1.2.1
+    # via isacc_messaging (setup.cfg)
+rsa==4.9
+    # via python-jose
+six==1.16.0
+    # via
+    #   ecdsa
+    #   url-normalize
+twilio==9.2.3
+    # via isacc_messaging (setup.cfg)
+typing-extensions==4.12.2
+    # via cattrs
+url-normalize==1.4.3
+    # via requests-cache
+urllib3==2.2.2
+    # via
+    #   requests
+    #   requests-cache
+werkzeug==3.0.3
+    # via flask
+yarl==1.9.4
+    # via aiohttp
+zipp==3.20.0
+    # via importlib-metadata
 git+https://github.com/uwcirg/fhir-migrations
\ No newline at end of file
diff --git a/setup.cfg b/setup.cfg
index b09dddf4..6db5c951 100644
--- a/setup.cfg
+++ b/setup.cfg
@@ -12,9 +12,11 @@ include_package_data = True
 # abstract requirements;
 # concrete requirements belong in requirements.txt
 # https://caremad.io/posts/2013/07/setup-vs-requirement/
+# pinned fhirclient to older version to mitigate
+# changes in date requirement introduced in FHIRDate
 install_requires =
     authlib
-    fhirclient
+    fhirclient==4.1.0
     flask
     flask-cors
     flask-session
@@ -25,7 +27,6 @@ install_requires =
     requests
     requests-cache
     twilio
-    fhirclient
 
 [options.extras_require]
 dev =