fhir-r6-guardrails

fhir-r6-guardrails is a skill for Claude Code from aks129/HealthClawGuardrails. It costs 132 tokens per session (1,472 once invoked), scanned A, original, MIT.

A safety layer for AI agents that read and write clinical data using FHIR, a standard format for exchanging health records, through MCP.

In plain words
What is it for?
Use it to read, search, validate, or write FHIR records with automatic redaction, audit trails, authorization checks, and support for FHIR R4 and experimental R6.
Why use it?
It helps prevent exposure of protected health information and controls risky changes to patient records. It also records access and keeps data separated between organizations.

Skill for Claude Code

Written for Claude Code: shipped in a Claude Code plugin.

Part of the healthclaw-guardrails plugin — 14 skills, 3 MCP servers shipped together

Good fit Use it to read, search, validate, or write FHIR records with automatic redaction, audit trails, authorization checks, and support for FHIR R4 and experimental R6.

Compare 6 skills from other repositories ↓
Install with agentmods
npx agentmods add skills/aks129/healthclawguardrails/fhir-r6-guardrails
Install

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.

Any agent
npx skills add aks129/HealthClawGuardrails --skill fhir-r6-guardrails
Clone the repo
git clone --depth 1 https://github.com/aks129/HealthClawGuardrails

Made for: Claude Code.

Or install healthclaw-guardrails, the plugin that ships this one along with the rest of its 14 skills, 3 MCP servers.

Wrote 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.

agentmods badge for fhir-r6-guardrails

README.md
[![agentmods](https://agentmods.dev/badge/skills/aks129/healthclawguardrails/fhir-r6-guardrails/github.svg)](https://agentmods.dev/skills/aks129/healthclawguardrails/fhir-r6-guardrails)
Your own site
<a href="https://agentmods.dev/skills/aks129/healthclawguardrails/fhir-r6-guardrails"><img src="https://agentmods.dev/badge/skills/aks129/healthclawguardrails/fhir-r6-guardrails/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.

agentmods 80×15 button for fhir-r6-guardrails

Your own site · 80×15
<a href="https://agentmods.dev/skills/aks129/healthclawguardrails/fhir-r6-guardrails"><img src="https://agentmods.dev/badge/skills/aks129/healthclawguardrails/fhir-r6-guardrails.svg" alt="Reviewed on agentmods" width="80" height="20"></a>
Per session 132 Skills are progressive disclosure: only the name and description are preloaded; the body loads when the skill is used.
When invoked 1,472 The whole file, excluding the scripts and references it only reads on demand.
Security scan A 0 findings. A grade says what 26 rules found in the file — not that it is safe. Third-party audits
  • NVIDIA SkillSpector pass 7 Sept 2026
How audits are shown
Origin original No closer match found in the catalogue.
Token cost

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.

ModelPer sessionOnce invoked
Fable 5.1 $0.00132 $0.01472
Opus 5 $0.00066 $0.00736
Sonnet 5 $0.00026 $0.00294
Haiku 4.5 $0.00013 $0.00147

Measured 6d ago against content hash b5c0e8e1d56f, method: parsed. Prices are Anthropic first-party input rates as of 2026-09-12, from the pricing page.

Security

Grade A, and why

fhir-r6-guardrails 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 6d 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.

skills/fhir-r6-guardrails/SKILL.md · 152 lines

How it starts

The opening of the file, as written. The whole thing — 152 lines — stays where its author put it; the contents beside it link to each section on GitHub.

HealthClaw Guardrails

A healthclaw.io open source project. Reference implementation of security and compliance patterns for AI agent access to FHIR data via MCP.

Supports FHIR R4 US Core v9 (stable) and FHIR R6 v6.0.0-ballot3 (experimental).

This is a runtime guardrail layer, not a knowledge skill. It sits between any AI agent and FHIR data (local or upstream), enforcing PHI redaction, audit trails, step-up authorization, and tenant isolation on every request.

When to Use This Skill

  • You need to read, search, or write FHIR clinical resources through MCP
  • You need PHI to be automatically redacted before the agent sees it
  • You need an immutable audit trail of all agent access
  • You need step-up authorization gates on write operations
  • You need to evaluate R6 Permission resources for access control

MCP Tools Available (12)

Read Tools (no step-up required)

Tool Purpose
context.get Retrieve a pre-built context envelope with patient-centric resources
fhir.read Read a single FHIR resource by type and ID (auto-redacted)
fhir.search Search resources with patient, code, status, date filters
fhir.validate Structural validation of a proposed resource
fhir.stats Observation statistics: count, min, max, mean over valueQuantity
fhir.lastn Most recent N observations per code
fhir.permission_evaluate Evaluate R6 Permission for permit/deny with reasoning
fhir.subscription_topics List available SubscriptionTopics
curatr.evaluate Evaluate a FHIR resource for data quality issues

Write Tools (require step-up token)

Tool Purpose
fhir.propose_write Validate and preview a write without committing
fhir.commit_write Commit a proposed write (requires X-Step-Up-Token)
curatr.apply_fix Apply patient-approved data quality fixes with Provenance

Two-Phase Write Pattern

Writes always follow propose-then-commit:

Read the full file on GitHub · 152 lines

Changes

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.

  1. 6d ago Changed b5c0e8e1d56f
  2. 12d ago First seen · 152 lines · 132 tokens per session scan A be34a24972a2

Subscribe to this mod's changes

fhir-r6-guardrails is a skill published in the GitHub repository aks129/HealthClawGuardrails (30 stars, last pushed today), licensed MIT. It adds 132 tokens to every session and 1,472 once invoked, about $0.0007 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 2026-08-30.

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