Some background: McKesson first suggested doing a peer-to-peer communication as both sides’ interfaces were designed to talk directly to each other, but each side had no way of monitoring whether the interface was down or up; thus enter the interface engine.
I tried doing the same thing, but the messages were not consistent coming from Meds Manager to Care Manager for AdminRX and vise-versa. This is why I had to set the IE up as a pass-through. I hope this helps.