# Langcare Langcare MCP Fhir Clinical Summary Generator > Clinical Summary Generator - Skill: `tomevault-io/langcare-langcare-mcp-fhir-clinical-summary-generator` (Agent Skill, multi-file: 2 files) - Install (CLI): `npx skillmds@latest add tomevault-io/langcare-langcare-mcp-fhir-clinical-summary-generator` - Raw SKILL.md: https://api.skillmd.com/api/skills/tomevault-io/langcare-langcare-mcp-fhir-clinical-summary-generator/raw - Safety review: pending (external: skill-scanner PASS, skillspector PASS) - Works with: Claude Code, Claude.ai, OpenAI Codex - Category: AI & ML - Author: tomevault-io (https://skillmd.com/u/tomevault-io) - Updated: 2026-09-17 - Page: https://skillmd.com/skills/tomevault-io/langcare-langcare-mcp-fhir-clinical-summary-generator --- # Clinical Summary Generator ## Overview Generate a comprehensive Continuity of Care Document (CCD)-style summary by pulling data from multiple FHIR resource types. Organize output following US Core required sections and C-CDA document structure. This skill aggregates active problems, current medications, allergies, recent labs, recent procedures, immunizations, and vital signs into a single consolidated view suitable for care transitions, referrals, or chart review. ## FHIR Resources Used | Resource | Purpose | Search Parameters | |----------|---------|-------------------| | Patient | Demographics header | Direct read by ID | | Condition | Active problem list | patient, clinical-status=active | | MedicationRequest | Current medications | patient, status=active | | AllergyIntolerance | Allergy list | patient, clinical-status=active | | Observation | Labs and vitals | patient, category, date | | Procedure | Recent procedures | patient, date | | Immunization | Vaccination history | patient, status=completed | | Encounter | Recent visits | patient, date | | CarePlan | Active care plans | patient, status=active | ## Instructions ### Step 1: Retrieve Patient Demographics ``` Tool: fhir_read resourceType: "Patient" id: "[patient-id]" ``` Extract: full name, DOB, age, gender, race/ethnicity (US Core extensions), preferred language, MRN. ### Step 2: Pull Active Conditions ``` Tool: fhir_search resourceType: "Condition" queryParams: "patient=[patient-id]&clinical-status=active" ``` For each Condition: - Extract `code.coding` (prefer SNOMED CT display, fall back to ICD-10 `code.coding` where `system` = `http://hl7.org/fhir/sid/icd-10-cm`) - Record `onsetDateTime` or `onsetPeriod.start` - Note `verificationStatus` (confirmed, unconfirmed, provisional, differential) - Group by category: chronic vs acute, problem-list-item vs encounter-diagnosis ### Step 3: Pull Current Medications ``` Tool: fhir_search resourceType: "MedicationRequest" queryParams: "patient=[patient-id]&status=active" ``` For each MedicationRequest: - Medication name from `medicationCodeableConcept.coding` (RxNorm preferred) or resolve `medicationReference` - Dosage from `dosageInstruction[0]`: `doseAndRate[0].doseQuantity`, `route`, `timing` - Prescriber from `requester` reference - Date written from `authoredOn` If MedicationRequest returns sparse data, supplement with: ``` Tool: fhir_search resourceType: "MedicationStatement" queryParams: "patient=[patient-id]&status=active" ``` ### Step 4: Pull Allergies ``` Tool: fhir_search resourceType: "AllergyIntolerance" queryParams: "patient=[patient-id]&clinical-status=active" ``` For each AllergyIntolerance: - Substance from `code.coding` (RxNorm for drugs, SNOMED for non-drugs) - Category: `category` (food, medication, environment, biologic) - Criticality: `criticality` (low, high, unable-to-assess) - Reactions from `reaction[].manifestation[].coding[].display` - Severity from `reaction[].severity` (mild, moderate, severe) ### Step 5: Pull Recent Lab Results (Last 90 Days) ``` Tool: fhir_search resourceType: "Observation" queryParams: "patient=[patient-id]&category=laboratory&date=ge[90-days-ago]&_sort=-date&_count=50" ``` For each Observation: - Test name from `code.coding` (LOINC preferred) - Value from `valueQuantity` (numeric) or `valueCodeableConcept` (coded) or `valueString` - Reference range from `referenceRange[0]` (low/high) - Interpretation from `interpretation[0].coding[0].code` (N=normal, H=high, L=low, HH=critical high, LL=critical low) - Date from `effectiveDateTime` Group by panel: CBC, BMP/CMP, Liver, Lipids, Thyroid, HbA1c, Other. ### Step 6: Pull Recent Vital Signs (Last 30 Days) ``` Tool: fhir_search resourceType: "Observation" queryParams: "patient=[patient-id]&category=vital-signs&date=ge[30-days-ago]&_sort=-date" ``` Extract most recent values for: - Blood Pressure (LOINC 85354-9): systolic component 8480-6, diastolic 8462-4 - Heart Rate (LOINC 8867-4) - Respiratory Rate (LOINC 9279-1) - Temperature (LOINC 8310-5) - O2 Saturation (LOINC 2708-6) - Weight (LOINC 29463-7) - Height (LOINC 8302-2) - BMI (LOINC 39156-5) ### Step 7: Pull Recent Procedures (Last 12 Months) ``` Tool: fhir_search resourceType: "Procedure" queryParams: "patient=[patient-id]&date=ge[12-months-ago]&_sort=-date" ``` For each Procedure: - Name from `code.coding` (CPT or SNOMED) - Date from `performedDateTime` or `performedPeriod.start` - Status from `status` - Performer from `performer[0].actor` ### Step 8: Pull Immunization History ``` Tool: fhir_search resourceType: "Immunization" queryParams: "patient=[patient-id]&status=completed&_sort=-date" ``` For each Immunization: - Vaccine name from `vaccineCode.coding` (CVX code system) - Date from `occurrenceDateTime` - Dose number from `protocolApplied[0].doseNumber` - Site and route if available ### Step 9: Pull Recent Encounters (Last 12 Months) ``` Tool: fhir_search resourceType: "Encounter" queryParams: "patient=[patient-id]&date=ge[12-months-ago]&_sort=-date" ``` For each Encounter: - Type from `type[0].coding[0].display` - Date from `period.start` - Status from `status` - Class from `class.code` (AMB=ambulatory, IMP=inpatient, EMER=emergency) - Provider from `participant[0].individual` - Reason from `reasonCode` or `reasonReference` ### Step 10: Assemble and Format the CCD Summary Organize into sections following C-CDA order: ``` CLINICAL SUMMARY Generated: [current timestamp] ===================================== PATIENT ------- Name: [name] MRN: [identifier] DOB: [birthDate] (Age: [age]) Gender: [gender] Race/Ethnicity: [extensions] Language: [preferred language] ACTIVE PROBLEMS --------------- 1. [Condition display] (SNOMED: [code]) - Onset: [date] - [verification status] 2. ... CURRENT MEDICATIONS ------------------- 1. [Drug name] [dose] [route] [frequency] - Prescribed: [date] - By: [prescriber] 2. ... ALLERGIES & INTOLERANCES ------------------------- 1. [Substance] - Category: [category] - Reaction: [manifestation] - Severity: [severity] - Criticality: [criticality] 2. ... (If none documented: "No Known Allergies" or "Allergy status not reviewed") RECENT VITAL SIGNS (Most Recent) --------------------------------- BP: [systolic]/[diastolic] mmHg HR: [value] bpm RR: [value] breaths/min Temp: [value] F/C O2 Sat: [value]% Weight: [value] kg/lb BMI: [value] kg/m2 RECENT LAB RESULTS (Last 90 Days) ---------------------------------- [Panel Name] [Test]: [value] [unit] [flag] (Ref: [low]-[high]) - [date] ... RECENT PROCEDURES (Last 12 Months) ----------------------------------- 1. [Procedure] - [date] - [performer] 2. ... IMMUNIZATIONS ------------- 1. [Vaccine] - [date] - Dose [number] 2. ... RECENT ENCOUNTERS (Last 12 Months) ----------------------------------- 1. [Type] - [date] - [class] - [provider] - Reason: [reason] 2. ... ``` ## Examples ### Example 1: Full Clinical Summary for Referral **User says:** "Generate a comprehensive clinical summary for patient 55555, I need it for a cardiology referral." **Actions:** 1. `fhir_read` Patient/55555 2. `fhir_search` Condition?patient=55555&clinical-status=active 3. `fhir_search` MedicationRequest?patient=55555&status=active 4. `fhir_search` AllergyIntolerance?patient=55555&clinical-status=active 5. `fhir_search` Observation?patient=55555&category=laboratory&date=ge2025-11-07&_sort=-date&_count=50 6. `fhir_search` Observation?patient=55555&category=vital-signs&date=ge2026-01-07&_sort=-date 7. `fhir_search` Procedure?patient=55555&date=ge2025-02-07&_sort=-date 8. `fhir_search` Immunization?patient=55555&status=completed&_sort=-date 9. `fhir_search` Encounter?patient=55555&date=ge2025-02-07&_sort=-date **Result:** ``` CLINICAL SUMMARY Generated: 2026-02-07T14:30:00Z ===================================== PATIENT ------- Name: Robert Chen MRN: MRN-55555 DOB: 1960-08-12 (Age: 65) Gender: Male Race/Ethnicity: Asian Language: English ACTIVE PROBLEMS --------------- 1. Essential hypertension (SNOMED: 59621000) - Onset: 2015-03-01 - Confirmed 2. Type 2 diabetes mellitus (SNOMED: 44054006) - Onset: 2018-06-15 - Confirmed 3. Hyperlipidemia (SNOMED: 55822004) - Onset: 2016-09-20 - Confirmed 4. Atrial fibrillation (SNOMED: 49436004) - Onset: 2025-12-01 - Confirmed CURRENT MEDICATIONS ------------------- 1. Lisinopril 20mg PO daily - Prescribed: 2024-01-10 2. Metformin 1000mg PO BID - Prescribed: 2023-06-01 3. Atorvastatin 40mg PO daily - Prescribed: 2023-06-01 4. Apixaban 5mg PO BID - Prescribed: 2025-12-05 5. Metoprolol succinate 50mg PO daily - Prescribed: 2025-12-05 ALLERGIES & INTOLERANCES ------------------------- 1. Penicillin - Category: medication - Reaction: Hives - Severity: moderate - Criticality: low 2. Sulfa drugs - Category: medication - Reaction: Rash - Severity: mild - Criticality: low [... remainder of sections with data ...] ``` ### Example 2: Summary With Sparse Data **User says:** "Summarize the chart for patient new-pt-001" **Actions:** Same 9 searches as above. **Result:** Most sections return empty or minimal data. Present what exists and clearly mark missing sections: ``` CLINICAL SUMMARY Generated: 2026-02-07T14:35:00Z ===================================== PATIENT ------- Name: Sarah Johnson MRN: MRN-NP001 DOB: 1995-04-20 (Age: 30) Gender: Female ACTIVE PROBLEMS --------------- No active conditions documented. CURRENT MEDICATIONS ------------------- No active medications on file. ALLERGIES & INTOLERANCES ------------------------- ** Allergy status has not been reviewed ** RECENT VITAL SIGNS ------------------- BP: 118/76 mmHg (2026-02-05) HR: 72 bpm Weight: 65 kg BMI: 23.1 kg/m2 RECENT LAB RESULTS ------------------- No laboratory results in the last 90 days. RECENT PROCEDURES ------------------ No procedures in the last 12 months. IMMUNIZATIONS ------------- 1. Influenza vaccine - 2025-10-15 2. COVID-19 mRNA vaccine - 2025-09-01 RECENT ENCOUNTERS ----------------- 1. New Patient Visit - 2026-02-05 - Ambulatory - Dr. Martinez NOTE: This patient has minimal data on file. This may be a new patient or records may not have been transferred. Verify allergy status and medication history with the patient directly. ``` ### Example 3: Transition of Care Summary **User says:** "Create a transition of care summary for patient 88888 being discharged." **Actions:** Same resource pulls, but also include: ``` Tool: fhir_search resourceType: "CarePlan" queryParams: "patient=88888&status=active" ``` Add a "DISCHARGE PLAN / ACTIVE CARE PLANS" section after encounters. Include follow-up instructions, pending labs, and care plan activities from CarePlan resources. ## Troubleshooting ### Search Returns Too Many Results / Times Out - Add `_count=50` to limit result sets - Narrow date ranges: use `date=ge[30-days-ago]` instead of unbounded searches - For labs, search by specific LOINC code panels instead of all laboratory observations ### Medications Appear Duplicated - MedicationRequest and MedicationStatement may overlap. Prefer MedicationRequest for prescribed medications. Use MedicationStatement only if MedicationRequest returns no results. - Deduplicate by RxNorm code (`medicationCodeableConcept.coding` where `system` = `http://www.nlm.nih.gov/research/umls/rxnorm`). - Check `status` field -- stopped or cancelled medications should not appear in active list. ### Missing Sections Despite Known Data - Different FHIR servers use different category codes. If `category=laboratory` returns nothing, try `category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory`. - Some systems store vital signs under `category=exam` instead of `category=vital-signs`. - Immunization records may require `status=completed` to filter out entered-in-error records. ## Related Skills - `patient-demographics-summary` -- for detailed demographic and insurance data - `problem-list-review` -- for clinical analysis of the active problem list - `allergy-adverse-reaction-summary` -- for detailed allergy analysis with cross-reactivity --- > Converted and distributed by [TomeVault](https://tomevault.io/claim/langcare) — claim your Tome and manage your conversions.