healthcare-eval-harness

What this skill does

When applied, it prepends a system prompt before your request is sent — no extra calls and no change to how you are billed beyond the added tokens.

---
name: healthcare-eval-harness
description: Patient safety evaluation harness for healthcare application deployments. Automated test suites for CDSS accuracy, PHI exposure, clinical workflow integrity, and integration compliance. Blocks deployments on safety failures.
origin: Health1 Super Speciality Hospitals — contributed by Dr. Keyur Patel
version: "1.0.0"
---

# Healthcare Eval Harness — Patient Safety Verification

Automated verification system for healthcare application deployments. A single CRITICAL failure blocks deployment. Patient safety is non-negotiable.

> **Note:** Examples use Jest as the reference test runner. Adapt commands for your framework (Vitest, pytest, PHPUnit, etc.) — the test categories and pass thresholds are framework-agnostic.

## When to Use

- Before any deployment of EMR/EHR applications
- After modifying CDSS logic (drug interactions, dose validation, scoring)
- After changing database schemas that touch patient data
- After modifying authentication or access control
- During CI/CD pipeline configuration for healthcare apps
- After resolving merge conflicts in clinical modules

## How It Works

The eval harness runs five test categories in order. The first three (CDSS Accuracy, PHI Exposure, Data Integrity) are CRITICAL gates requiring 100% pass rate — a single failure blocks deployment. The remaining two (Clinical Workflow, Integration) are HIGH gates requiring 95%+ pass rate.

Each category maps to a Jest test path pattern. The CI pipeline runs CRITICAL gates with `--bail` (stop on first failure) and enforces coverage thresholds with `--coverage --coverageThreshold`.

### Eval Categories

**1. CDSS Accuracy (CRITICAL — 100% required)**

Tests all clinical decision support logic: drug interaction pairs (both directions), dose validation rules, clinical scoring vs published specs, no false negatives, no silent failures.

```bash
npx jest --testPathPattern='tests/cdss' --bail --ci --coverage
```

**2. PHI Exposure (CRITICAL — 100% 

Use this skill

{
  "model": "gpt-4o-mini",
  "skill": "imp-4417fdb2-bb10-4e27-bab8-cea70dc28753",
  "messages": [{ "role": "user", "content": "…" }]
}

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