A connection to Nuance DAX, an ambient clinical-documentation system that turns encounter audio or transcripts into draft medical notes for clinician review.

Use it to submit encounter material, check note-generation status, retrieve drafts, update note segments, and access specialty note templates.

It reduces manual note preparation while keeping the clinician responsible for reviewing and approving the draft.

nuance-dax — Skill for Claude Code and Codex by iblai

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 iblai/medical-healthcare-agents --skill nuance-dax

Clone the repo

git clone --depth 1 https://github.com/iblai/medical-healthcare-agents

Made for: Claude Code, Codex.

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.

README.md

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Your own site

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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.

Your own site · 80×15

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Per session 37 Skills are progressive disclosure: only the name and description are preloaded; the body loads when the skill is used.

When invoked 653 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.

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.

Model	Per session	Once invoked
Fable 5.1	$0.00037	$0.00653
Opus 5.5	$0.00015	$0.00261
Sonnet 5.5	$0.00007	$0.00131
Haiku 4.5	$0.00004	$0.00065

Measured 2mo ago against content hash b8cef4c3bf99, method: parsed. Prices are Anthropic first-party input rates as of 2026-10-07, from the pricing page.

Security

Grade A, and why

nuance-dax 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 2mo 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/nuance-dax/SKILL.md · 39 lines

How it starts

The opening of the file, as written. The whole thing — 39 lines — stays where its author put it; the contents beside it link to each section on GitHub.

Nuance DAX

What it is

Nuance DAX (Dragon Ambient eXperience) is Microsoft's leading ambient AI documentation platform used by over 550 US health systems. It converts real-time encounter audio into structured clinical note drafts (SOAP, H&P, progress notes, procedure notes) that surface in the EHR In-Basket for clinician review and approval before any note is finalized. DAX Copilot is the current SaaS iteration, integrated natively into Epic and Cerner workflows.

When to use this skill

Retrieve a completed DAX ambient note draft after a clinical encounter
Check note generation status for a given encounter ID
Submit a corrected or amended note segment back into the DAX review queue
Pull specialty-specific note template configurations (e.g., cardiology H&P vs. primary care SOAP)
Integrate DAX output with EHR draft note APIs (Epic In-Basket, Cerner PowerNote)

Credentials

This skill authenticates using variables declared in the metadata above. Copy ~/.openclaw/.env.example to ~/.openclaw/.env and fill in real values. Required variables:

NUANCE_DAX_API_KEY - API key issued by Nuance/Microsoft for the facility integration
NUANCE_DAX_BASE_URL - DAX API base URL (facility-specific endpoint provided at onboarding)
NUANCE_DAX_FACILITY_ID - facility identifier assigned during DAX deployment

Key operations

GET /encounters/{encounter_id}/note-draft — retrieve generated note draft by encounter ID
GET /encounters/{encounter_id}/status — check processing status (queued/processing/complete/failed)
POST /encounters/{encounter_id}/corrections — submit clinician correction segment for reprocessing
GET /templates — list available specialty note templates
GET /templates/{template_id} — fetch template structure (sections, fields, default text)
POST /encounters — register a new encounter session before audio capture begins

Notes

Note drafts are returned as structured JSON with section-level text; convert to HL7 CDA or FHIR DocumentReference before writing to EHR.
DAX operates under a BAA with Microsoft/Nuance; all audio and transcription data is encrypted at rest and in transit.
Audio capture is handled by the DAX mobile app or EHR plugin — this API skill covers server-side note retrieval and integration, not audio streaming.
Typical processing latency: 2-5 minutes post-encounter; implement polling with exponential backoff.
Sandbox / test environment credentials are separate from production; never use production keys in development.

Read the full file on GitHub · 39 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.

2mo ago First seen · 39 lines · 37 tokens per session scan A b8cef4c3bf99

Subscribe to this mod's changes

nuance-dax is a skill published in the GitHub repository iblai/medical-healthcare-agents (10 stars, last pushed 5mo ago), licensed MIT. It adds 37 tokens to every session and 653 once invoked, about $0.0001 per session on Opus 5.5. 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.

Documents agentic-ai ai-agents anthropic claude clinical conversational-ai

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