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Healthcare data domain

Skill hollandkevint/data-product-operator/skills/healthcare-data-domain

Healthcare data domain context covering FHIR, HL7, OMOP CDM, real-world evidence, and clinical terminology systems. Use when working on clinical data pipelines, EHR integrations, claims data products, HIPAA-governed data, OMOP transformations, or when the conversation involves PHI, ICD-10, SNOMED, CPT, LOINC, or RxNorm. Skip this skill for non-healthcare data products.From its SKILL.md

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npx -y skills add hollandkevint/data-product-operator --skill healthcare-data-domain

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SKILL.md

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When This Skill Applies

Activate when the data product involves: electronic health records (EHR), claims/billing data, clinical terminology, patient-level data, OMOP CDM, FHIR/HL7, or any data governed by HIPAA.

Do NOT activate for: general analytics, marketing data, financial data, or non-clinical datasets.

Core Standards

FHIR (Fast Healthcare Interoperability Resources) - Modern API standard for health data exchange. Resource-based (Patient, Observation, MedicationRequest, Condition, Encounter). Use for real-time integrations and patient-facing apps.

HL7 v2 - Legacy messaging standard still dominant in hospital systems. Pipe-delimited segments (MSH, PID, OBX). Expect to encounter this in any EHR integration project.

OMOP CDM (Common Data Model) - Research-optimized schema for observational health data. Core tables: PERSON, VISIT_OCCURRENCE, CONDITION_OCCURRENCE, DRUG_EXPOSURE, MEASUREMENT, OBSERVATION, PROCEDURE_OCCURRENCE. Use for analytics and real-world evidence studies.

Clinical Terminology Systems

SystemWhat It CodesExample
ICD-10-CMDiagnosesF32.1 (Major depressive disorder, single episode, moderate)
CPTProcedures99213 (Office visit, established patient)
SNOMED CTClinical concepts73211009 (Diabetes mellitus)
LOINCLab tests/observations2345-7 (Glucose, serum/plasma)
RxNormMedications197361 (Sertraline 50mg tablet)
NDCDrug packagesNational Drug Code for specific manufacturer/package

ALWAYS use standard terminology codes rather than free-text descriptions. Map to the appropriate code system for the use case.

OMOP Analytics Patterns

The 30-40 normalized OMOP tables are wrong for analytics dashboards. Transform to star schema with strategic denormalization:

  • Fact tables: Drug exposures, visits, conditions (events become facts)
  • Dimension tables: Patient, drug, diagnosis
  • Pre-calculated cohort definitions for common queries
  • NEVER fully denormalize (One Big Table). Healthcare's many-to-many relationships cause exponential row growth.

See domain-reference.md for detailed OMOP table relationships and FHIR resource mappings.

FHIR Gotchas

Common mistakes when working with FHIR resources:

GotchaWhat Trips You UpFix
Coding vs CodeableConceptCoding is a single code. CodeableConcept wraps multiple codings with a display text. Most FHIR fields use CodeableConcept.Always access .coding[0].code, not .code directly.
Patient.identifier vs Patient.id.id is the FHIR server's internal ID. .identifier holds MRNs, SSNs, and other business identifiers.Query by .identifier.value with the correct .identifier.system.
Observation.value[x]Polymorphic field. Could be valueQuantity, valueString, valueCodeableConcept, or others.Check the resource profile or test data to know which type your source sends.
Bundle paginationSearch results return pages of 20-50 resources. The full result set requires following Bundle.link where relation = "next".Always paginate. NEVER assume a single Bundle contains all results.

FHIR-to-OMOP Mapping

When transforming FHIR resources into OMOP CDM:

FHIR ResourceOMOP TableKey Mapping Notes
PatientpersonMap Patient.birthDateyear_of_birth. Gender codes differ between systems.
Conditioncondition_occurrenceCondition.codecondition_concept_id via SNOMED-to-OMOP vocabulary mapping.
ObservationmeasurementLab results map here. Use LOINC code from Observation.code for measurement_concept_id.
MedicationRequestdrug_exposureMap RxNorm codes. MedicationRequest.dosageInstructiondose_value/dose_unit.
Encountervisit_occurrenceEncounter.classvisit_concept_id. Map inpatient/outpatient/emergency.

Common LOINC Codes for Vitals

Vital SignLOINC CodeUnits
Blood pressure, systolic8480-6mmHg
Blood pressure, diastolic8462-4mmHg
Heart rate8867-4/min
Body temperature8310-5Cel
Body weight29463-7kg
Body height8302-2cm

HIPAA Awareness

CRITICAL: Any data product handling patient data must consider the 18 HIPAA identifiers. See domain-reference.md for the full list. De-identification is required before data leaves a HIPAA-governed environment.

This skill provides general domain context, not compliance advice. Involve your privacy officer and legal team for HIPAA compliance decisions.

What ships with it: 1 file

3.5 KB alongside SKILL.md

Gives 0 of the 12 instructions most healthcare skills give in ~1.1k tokens

Counted across 147 of the 152 authors here whose files we hold, read 2026-08-07

  • Export trial data to CSV formatin 11 of 147, across 2 files
  • Retrieve trial details using an NCT IDin 11 of 147, across 2 files
  • Split clinical datasets strictly by patientin 11 of 147, across 3 files
  • Use the ClinicalTrials.gov API v2in 10 of 147, across 1 file
  • Search trials by condition, drug, location, status or phasein 10 of 147, across 1 file
  • Use maximum page size for bulk data retrievalin 10 of 147, across 1 file
  • Extract and summarize key study informationin 10 of 147, across 1 file
  • Combine multiple filters for targeted searchesin 10 of 147, across 1 file
  • Print and review dataset statistics before modelingin 8 of 147, across 1 file
  • Start model development with simple baselinesin 8 of 147, across 1 file
  • Match preprocessing processors directly to data typesin 8 of 147, across 1 file
  • Monitor validation metrics for task type and class imbalancein 8 of 147, across 1 file

Said here and by no other author read

  • activate for electronic health records, claims, terminology, or HIPAA-governed data
  • use standard terminology codes rather than free-text descriptions
  • map healthcare codes to the appropriate code system
  • transform normalized OMOP tables to a star schema
  • create fact tables for healthcare events
  • pre-calculate cohort definitions for common queries

Grouped from the skills themselves: near-identical wordings counted once, and counted by distinct author, so one author publishing three of these counts once. Length counted with cl100k_base; the agent that loads this file may tokenize it differently.

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