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 langcare/langcare-mcp-fhir --skill transition-of-care-summarygit clone --depth 1 https://github.com/langcare/langcare-mcp-fhirWrote 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/langcare/langcare-mcp-fhir/transition-of-care-summary)<a href="https://agentmods.dev/skills/langcare/langcare-mcp-fhir/transition-of-care-summary"><img src="https://agentmods.dev/badge/skills/langcare/langcare-mcp-fhir/transition-of-care-summary/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/langcare/langcare-mcp-fhir/transition-of-care-summary"><img src="https://agentmods.dev/badge/skills/langcare/langcare-mcp-fhir/transition-of-care-summary.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 | $0.00106 | $0.03836 |
| Opus 5 | $0.00053 | $0.01918 |
| Sonnet 5 | $0.00021 | $0.00767 |
| Haiku 4.5 | $0.00011 | $0.00384 |
Grade A, and why
transition-of-care-summary 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 — 392 lines — stays where its author put it; the contents beside it link to each section on GitHub.
Transition of Care Summary
Overview
Generate a comprehensive transition of care document containing all required C-CDA sections for patient handoff. Pull all relevant FHIR resources to create a complete clinical picture. Output a structured summary organized by Joint Commission TOC requirements. Create a DocumentReference FHIR resource linking to the generated summary.
FHIR Resources Used
| Resource | Purpose | Key Fields |
|---|---|---|
| Patient | Demographics and identifiers | name, birthDate, gender, identifier, address, telecom |
| Encounter | Current/recent encounter details | status, class, period, reasonCode, participant, hospitalization |
| Condition | Active problems and hospital diagnoses | code, clinicalStatus, verificationStatus, onsetDateTime, category |
| MedicationRequest | Discharge/current prescriptions | medicationCodeableConcept, dosageInstruction, status, intent |
| MedicationStatement | Home medication list | medicationCodeableConcept, status, dosage |
| AllergyIntolerance | Allergies and adverse reactions | code, reaction, clinicalStatus, criticality |
| Procedure | Procedures performed during stay | code, performedDateTime, status, outcome |
| Observation | Labs, vitals, functional status | code, valueQuantity, effectiveDateTime, interpretation |
| DiagnosticReport | Imaging and pathology results | code, conclusion, effectiveDateTime, status |
| Immunization | Immunization history | vaccineCode, occurrenceDateTime, status |
| CarePlan | Active care plans | status, category, activity, goal |
| Consent | Advance directives, code status | category, status, provision |
| DocumentReference | Store the generated TOC | type, content, context |
| ServiceRequest | Pending orders and referrals | status, code, intent |
| Goal | Treatment goals | lifecycleStatus, description, target |
Instructions
Step 1: Retrieve Patient Demographics
Tool: fhir_read
resourceType: "Patient"
id: "[patient-id]"
Extract: full legal name, DOB, age, gender, MRN, address, phone, preferred language, emergency contacts (from contact array or RelatedPerson search).
What ships with it
2 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 · 392 lines · 106 tokens per session scan A c912922d01ad
transition-of-care-summary is a skill published in the GitHub repository langcare/langcare-mcp-fhir (55 stars, last pushed 5mo ago), licensed MIT. It adds 106 tokens to every session and 3,836 once invoked, about $0.0005 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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