Borrowing it
Nothing to install: this file belongs to charliehzm/medharness. Take a copy, put it at the same path in your own repository, and replace the rules that are about this project with yours.
curl -O https://raw.githubusercontent.com/charliehzm/medharness/main/.claude/skills/openspec-continue-change/SKILL.mdgit clone --depth 1 https://github.com/charliehzm/medharnessWrote 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/charliehzm/medharness/openspec-continue-change)<a href="https://agentmods.dev/skills/charliehzm/medharness/openspec-continue-change"><img src="https://agentmods.dev/badge/skills/charliehzm/medharness/openspec-continue-change/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/charliehzm/medharness/openspec-continue-change"><img src="https://agentmods.dev/badge/skills/charliehzm/medharness/openspec-continue-change.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 | $0.00157 | $0.00702 |
| Opus 5 | $0.00078 | $0.00351 |
| Sonnet 5 | $0.00031 | $0.00140 |
| Haiku 4.5 | $0.00016 | $0.00070 |
Grade A, and why
openspec-continue-change 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 13d 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.
What it actually says
OpenSpec Continue Change
The "make it implementation-ready" expansion. After openspec-new-change scaffolds, this fills.
Quality bar — when to stop
The change is ready when every PRD in-scope item maps to ≥ 1 spec row, and every spec row has acceptance criteria.
Workflow
- PRD ↔ Spec mapping — list every in-scope item in PRD §3; ensure each has a spec id.
- Design body — technical approach for each spec, in design.md:
- Data model (tables / messages / contracts)
- API/IPC contracts
- Component interaction diagram (mermaid acceptable)
- Failure modes + recovery
- Performance budgets
- Compliance Design — refine the section seeded in
openspec-new-change:- Mark every L3/L4 field's flow path
- Specify desensitization points
- Specify audit log entries this change introduces
- Specs — for each spec row:
- one-line behavior description
- acceptance criteria (Given/When/Then or list)
- test hook (which test type, what data)
- Risks — top 3 risks + mitigation (in design.md)
- Validate — run
openspec validate(oropenspec-ff-changefor fast path) — must pass.
Common failure modes
- PRD item without spec — silent drop. Mitigation: explicit PRD↔Spec matrix at the top of design.md.
- Acceptance criteria as wishes — "the system should be fast". Mitigation: "P99 < 200ms on stage-mock data".
- Compliance afterthought — fill at the end. Mitigation: refine section every time you add a data-touching spec.
- Premature implementation — code samples in design.md > 30 lines. Mitigation: design says what, code says how (later).
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.
- 13d ago First seen · 59 lines · 157 tokens per session scan A db508a020474
openspec-continue-change is a skill published in the GitHub repository charliehzm/medharness (86 stars, last pushed 3mo ago), licensed Apache-2.0. It adds 157 tokens to every session and 702 once invoked, about $0.0008 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.
Other skills, from other repositories
hipaa-review
Performs a HIPAA Security Rule compliance review against all Administrative, Physical, and Technical Safeguards defined in 45 CFR Part 164, Subpart C. Auto-invoked when discussing healthcare data security, ePHI protection, HIPAA audit readiness, or business associate compliance. Evaluates required and addressable…
HIPAA Compliance Testing
Testing HIPAA compliance for healthcare applications including PHI handling, audit logging, access controls, and data encryption verification.
Healthcare Compliance
HIPAA compliance, healthcare regulations, privacy and security standards for medical organizations and providers.
compliance
Use when scoping which regulatory frameworks bind a business — SOC 2, ISO 27001, HIPAA, PCI DSS, EU AI Act, DORA, NIS2 — building a control register with owners and evidence, or standing up the cadence that keeps it audit-ready. NOT drafting privacy-policy/ROPA/DPA or ToS text (that is gdpr-privacy, terms-conditions)…
healthcare-expert
Expert-level healthcare systems, medical informatics, HIPAA compliance, and health data standards. Use when the user mentions medical, HIPAA, HL7, FHIR, or EHR, or when the task involves Healthcare IT, Standards and Protocols, Regulatory Compliance, or Security and Compliance.
performing-soc2-type2-audit-preparation
Automates SOC 2 Type II audit preparation including gap assessment against AICPA Trust Services Criteria (CC1-CC9), evidence collection from cloud providers and identity systems, control testing validation, remediation tracking, and continuous compliance monitoring. Covers all five TSC categories (Security…