Getting it into your agent
One page per mod, every tool's command on it. A separate URL per tool would split the same page into five that compete with each other.
npx skills add aks-builds/healthcareskills --skill tefca-hiegit clone --depth 1 https://github.com/aks-builds/healthcareskillsWrote this? Show the measurements
A badge with what this costs and how it scanned, read live from this page, so it follows the numbers instead of freezing them. Markdown for a README, HTML for a documentation site or a project page.
[](https://agentmods.dev/skills/aks-builds/healthcareskills/tefca-hie)<a href="https://agentmods.dev/skills/aks-builds/healthcareskills/tefca-hie"><img src="https://agentmods.dev/badge/skills/aks-builds/healthcareskills/tefca-hie/github.svg" alt="Measured on agentmods" height="20"></a>Or the 80×15 button, for a site that already has a row of RSS and ATOM ones. Only the verdict fits; the numbers stay here.
<a href="https://agentmods.dev/skills/aks-builds/healthcareskills/tefca-hie"><img src="https://agentmods.dev/badge/skills/aks-builds/healthcareskills/tefca-hie.svg" alt="Reviewed on agentmods" width="80" height="20"></a>What it costs to keep this loaded
Counted locally with the o200k_base tokenizer, which is exact for GPT models; Claude uses its own tokenizer and its counts differ. Treat this as one consistent yardstick across the catalogue rather than a bill. Prices are per million input tokens.
| Model | Per session | Once invoked |
|---|---|---|
| Fable 5.1 | $0.00179 | $0.03249 |
| Opus 5 | $0.00089 | $0.01625 |
| Sonnet 5 | $0.00036 | $0.00650 |
| Haiku 4.5 | $0.00018 | $0.00325 |
Grade A, and why
tefca-hie scanned grade A with 0 findings against 26 rules in 11 categories — prompt injection, anti-refusal, data exfiltration, privilege escalation, supply chain, agent snooping, system-prompt leakage, SSRF and excessive agency — measured 12d ago.
A static scan of the body, not an audit. Every finding is printed with the line that produced it so you can judge whether it matters here. A mod is markdown that instructs an agent; that is exactly why what it instructs is worth reading.
Nothing flagged
None of the 26 patterns this scan looks for appear in this file: no shell pipes, no recursive deletes, no credential paths, no hidden text, no instruction-override or anti-refusal phrasing, no agent-config snooping. That is not a guarantee, it is the absence of the things that are checkable.
How it starts
The opening of the file, as written. The whole thing — 253 lines — stays where its author put it; the contents beside it link to each section on GitHub.
TEFCA and Health Information Exchange
You are an expert in the Trusted Exchange Framework and Common Agreement (TEFCA) and the broader US health information exchange landscape. Your goal is to help engineers, product leaders, and compliance teams understand how QHINs, Participants, Sub-Participants, and Individual Access Services fit together — and how to integrate against TEFCA technically and contractually. Treat TEFCA as a fast-moving area: verify QHIN designations, Common Agreement version, and Standard Operating Procedures (SOPs) against the current ONC and RCE (Recognized Coordinating Entity) publications before committing.
Initial Assessment
Read .agents/healthcare-context.md (fallback: .claude/healthcare-context.md) first. Look for:
- Organization type: provider, payer, public health agency, IAS provider, vendor.
- Existing network membership: Carequality, CommonWell, eHealth Exchange, regional HIEs, Direct HISP.
- EHR vendor and which QHIN it routes through (e.g., Epic via Nexus, Cerner via CommonWell historically, etc.).
- Goal: join as QHIN, Participant, Sub-Participant, or just consume.
- Use case: treatment, payment, healthcare operations, public health, government benefits, IAS.
Verify current QHIN list and any recently published SOPs with the user — this list changes.
What TEFCA Is
TEFCA is a federally mandated framework (under the 21st Century Cures Act) that establishes nationwide, interoperable health information exchange in the US. ONC designates a Recognized Coordinating Entity (RCE) — currently The Sequoia Project — which administers the Common Agreement, accepts and oversees QHINs, and publishes Standard Operating Procedures (SOPs) and the QHIN Technical Framework (QTF).
Three layers:
- Common Agreement (CA) — the legal/policy contract that all QHINs sign. The CA establishes Exchange Purposes, privacy/security obligations, dispute resolution, and the network of networks model. CA v2.0 introduced FHIR-based exchange as a first-class capability.
- QHIN Technical Framework (QTF) — the technical specifications QHINs must implement (transactions, security, identity).
- Standard Operating Procedures (SOPs) — operational rules issued by the RCE covering things like cybersecurity, IAS, Required Information for Coverage, patient matching, identity assurance, and Exchange Purpose-specific behavior.
What ships with it
3 files beside SKILL.md in the same directory: the scripts, references and assets a skill reads on demand. Not counted in the per-session cost; read them before you install if any of them is executable.
What this file has done since we first saw it
Hashed on every crawl. A supply-chain change to an agent config is a question of when, not whether, so the history is kept rather than the latest state alone.
- 12d ago First seen · 253 lines · 179 tokens per session scan A 1d703d3dbc61
tefca-hie is a skill published in the GitHub repository aks-builds/healthcareskills (1 stars, last pushed 2d ago), licensed MIT. It adds 179 tokens to every session and 3,249 once invoked, about $0.0009 per session on Opus 5. A static security scan graded it A with 0 findings. No closer match exists in the catalogue, so it is treated as the original; first seen 2026-08-31.
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