openmed

Suggests candidate ICD-10-CM diagnosis codes (and ICD-10-PCS procedure codes) for diagnoses and procedures extracted by OpenMed, with rationale and a human-coder caveat. Use when the user wants to code a problem list, map a diagnosis span to a billable ICD-10-CM code, route a finding to the right chapter, cross-walk ICD-9 via GEMs, or pre-fill an encounter for coder review. Trigger keywords: ICD-10-CM, ICD-10-PCS, diagnosis coding, billable code, GEMs, problem list coding, encounter diagnosis, chapter range, CMS code lookup. references/icd10-chapters.md holds the chapter/section ranges. Pairs after OpenMed NER: consume Disease/Pathology entities from openmed.analyze_text and propose codes a certified coder validates. ICD-10-CM/PCS files are public domain from CMS — no license barrier (unlike CPT, which is restricted and out of scope).

Maps chronic conditions extracted by OpenMed to CMS-HCC V28 risk-adjustment categories and estimates a RAF (Risk Adjustment Factor) score as decision support. Use when the user wants to surface risk-adjustable diagnoses from notes, map ICD-10-CM codes to HCC categories, estimate or reconcile a patient/panel RAF, find suspected-but-undocumented HCCs, or check MEAT documentation support. Trigger keywords: HCC, CMS-HCC, V28, RAF score, risk adjustment, Medicare Advantage, hierarchical condition category, MEAT, recapture, suspect HCC, RADV. Pairs after OpenMed NER + ICD-10 coding: consume Disease/Pathology entities from openmed.analyze_text, code them (see coding-icd10), then roll up to HCCs. CMS-HCC mappings and weights are public from CMS. This is a coding-support aid for human review, never autonomous risk-adjustment coding.

Discover and pick the right OpenMed model for a clinical or biomedical task, domain, or language. Use when the user asks which OpenMed model to use, wants to list model categories, find a Disease vs Oncology vs Privacy/PII model, get a PII model for a specific language, search models by size or task, or inspect a model's labels and metadata before loading. Covers list_model_categories, get_models_by_category, get_pii_models_by_language, get_default_pii_model, search_models(ModelQuery(...)), get_model_info, and the openmed models CLI. Pairs with loading-openmed-models.

Runs a HIPAA Privacy and Security Rule checklist over a data pipeline and produces a gap report before deploying OpenMed on PHI. Use when the user is about to process protected health information, needs a pre-deployment compliance review, wants to know which administrative, physical, and technical safeguards apply, is scoping a Business Associate Agreement, or must document minimum-necessary and de-identification controls. Trigger keywords: HIPAA, Privacy Rule, Security Rule, 45 CFR 164, PHI, BAA, business associate, minimum necessary, safeguards, Safe Harbor, Expert Determination, gap analysis, compliance review. Pairs adjacent to OpenMed: the checklist shows where openmed.deidentify and signed audit reports satisfy the de-identification and audit-control requirements. The control list lives in references/hipaa-checklist.md. This is a structured self-assessment aid, not legal advice.

Orient and bootstrap any project that uses OpenMed, the on-device clinical and biomedical NLP library, for named-entity recognition, PHI de-identification, FHIR export, and evaluation. Use when the user mentions OpenMed, wants to install it, asks which OpenMed capability or model fits a task, or is starting to build a clinical/medical text pipeline and needs the right entry point.

Assemble a chronological patient timeline from OpenMed-extracted clinical events, normalizing dates and resolving relative time expressions on-device. Use when the user wants to build a patient timeline, order events from clinical notes, reconstruct a longitudinal history, plot a course of illness, or turn analyze_text/deidentify output into a sorted sequence of dated encounters, diagnoses, medications, and procedures. Covers temporal normalization (absolute and relative), event modeling toward FHIR Encounter/Condition.onsetDateTime, anchoring to a document/admission date, and handling undated or ambiguous events. Consumes OpenMed analyze_text entities plus clinical temporality (resolving-clinical-context); produces a sorted event list ready for charting or FHIR export.

Scaffold a synthetic gold-standard annotation project for evaluating OpenMed NER and de-identification models — label schema, annotation guidelines, BRAT or Label Studio config, and disjoint train/dev/test splits. Use when the user wants to create eval fixtures, set up annotation, define a label set, write guidelines, configure an annotation tool, or build a held-out gold set for the OpenMed eval harness. Trigger on "gold corpus", "annotation project", "label schema", "annotation guidelines", "BRAT", "Label Studio", "train dev test split", or "build eval fixtures" for OpenMed. Committed gold must be synthetic; licensed (i2b2/n2c2/MIMIC) data is eval-only and never committed.

Combine OpenMed clinical NLP with Microsoft Presidio, spaCy, or LangChain through OpenMed's built-in interop adapter registry (openmed.interop). Covers the lazy adapter registry (available_adapters, get_adapter, adapter_spec), the presidio/spacy/langchain pip extras, and the verified callables — Presidio to_canonical/from_canonical/merge_with_openmed, the spaCy openmed_deid pipeline factory, and the LangChain create_redaction_runnable. Use when the user wants to add Presidio recognizers, embed OpenMed PII detection in a spaCy pipeline, or use OpenMed de-identification as a LangChain runnable. Pairs adjacent to the OpenMed PII skills.

Score an OpenMed clinical or biomedical NER model against a user-supplied gold corpus with entity-level precision, recall, and F1, then break errors down per label. Use when the user wants a seqeval-style scorecard, strict vs partial (relaxed) span matching, a per-label confusion matrix, false-negative / false-positive examples, or to debug why a model misses entities. Trigger on "evaluate NER", "entity-level F1", "seqeval", "precision recall F1", "confusion matrix", "error analysis", "strict vs partial match", or "score against gold" in an OpenMed context. The gold corpus is user-supplied; OpenMed bundles no i2b2/n2c2/MIMIC data.

Run large-scale batch NER, PII extraction, or de-identification over many clinical notes on-device with OpenMed, with sharding, checkpointing, resumability, and append-only JSONL output. Use when the user needs to process a corpus or folder of notes, de-identify a dataset, run NER over thousands of documents, build a resumable batch pipeline, or stream results to JSONL without holding everything in memory. Covers process_batch / BatchProcessor / BatchItem / BatchResult, the operation= selector (analyze_text | extract_pii | deidentify), iter_process streaming, the PHI-safe on_progress callback, chunking long documents, and no-PHI logging. Produces a resumable batch runner over an OpenMed model.

Generate a model card for an OpenMed clinical NER or de-identification model documenting intended use, quantitative metrics, subgroup performance, limitations, and a medical-device disclaimer for clinical AI governance. Use when the user wants to write or update a model card, a README model section, or governance documentation, or to turn OpenMed eval outputs (release gate report, fairness_report, error_report) into the card's metrics and limitations sections. Trigger on "model card", "intended use", "model documentation", "governance", "limitations section", "datasheet", or "FDA/ONC transparency" for an OpenMed model.

Audit an OpenMed NER or de-identification model for performance disparities across demographic subgroups (sex, age band, race/ethnicity when available) using openmed.eval.fairness_report. Use when the user wants per-subgroup recall and leakage, wants to check whether de-identification under-protects a group, wants to surface a documentation gap where subgroup data is missing, or needs equalized-odds-style disparity numbers for a clinical model. Trigger on "fairness", "subgroup", "bias audit", "disparity", "equalized odds", "under-protected group", "per-group recall", or "STANDING Together" for an OpenMed model.

Verify OpenMed de-identified output against all 18 HIPAA Safe Harbor identifier categories and report residual re-identification risk. Use when the user must confirm a note meets HIPAA Safe Harbor (45 CFR 164.514(b)(2)), needs a coverage checklist mapping detected entities to the 18 categories, wants to flag gaps like ages over 89, rare geography, fax vs phone, or biometrics, or asks whether masking was complete. Maps OpenMed CANONICAL_LABELS to the 18 HIPAA classes and uses extract_pii / deidentify to check coverage. Pairs with OpenMed deidentifying-clinical-text and auditing-deidentification-runs.

Generates and verifies 21 CFR Part 11-style audit trails — who/what/when, electronic signatures, and tamper-evidence — for OpenMed pipelines in GxP and clinical-trial (GCP) settings. Use when the user runs OpenMed in a regulated/validated environment and needs an attributable, time-stamped, tamper-evident record of each processing action, electronic-signature manifestations, or computer-system-validation (CSV) evidence. Trigger keywords: 21 CFR Part 11, Part 11, audit trail, electronic signature, e-signature, GxP, GCP, GLP, GMP, CSV, computer system validation, data integrity, ALCOA, tamper-evident, contemporaneous. Pairs adjacent to OpenMed: maps directly onto OpenMed deidentify(audit=True) -> signed AuditReport with .sign(key)/.verify(key), whose repro_hash + HMAC give the tamper-evidence and attribution Part 11 expects. This is a compliance-enablement aid, not a validation certification.

Produce a signed, reproducible, no-PHI audit trail for an OpenMed de-identification run via deidentify(audit=True). Use when the user needs compliance evidence, a tamper-evident record of what was redacted and why, to verify nothing was changed, to retain proof for HIPAA/GDPR audits, or to review de-id decisions without exposing plaintext PHI. Covers the AuditReport / AuditSignature / AuditSpan / DetectorInfo fields, why audits store offsets+hashes+provenance+residual-risk and never plaintext, signing with .sign(key), and verifying with .verify(key). Pairs with OpenMed deidentifying-clinical-text and auditing-safe-harbor-checklist.

Adversarially scan already-de-identified clinical text for residual identifiers and emit a leakage report that blocks release on any hit. Use after OpenMed de-identification when the user asks to verify a redaction, prove no PHI/PII leaked, gate a dataset before sharing, or run a second-pass detector. Covers format and checksum detectors (SSN, Luhn for card numbers, MRN/account patterns, emails, phones, dates), entropy heuristics for high-randomness tokens, severity scoring, and a hard block-on-leak rule. This is the verification half of OpenMed's leakage-first ethos. Hand-off: re-run openmed.extract_pii on the de-id output and diff against expectations. License-free, local-first. Pairs after deidentifying-clinical-text.

Package multiple FHIR R4 resources produced from OpenMed output into a single valid transaction Bundle ready to POST to an EHR, using OpenMed's verified bundle assembler openmed.clinical.exporters.fhir.to_bundle. Covers deterministic urn:uuid fullUrls, automatic in-Bundle reference rewriting, request blocks (method/url) for transaction vs batch, and conditional create. Use after exporting-to-fhir when the user has several Condition/Observation/MedicationStatement resources and wants one transaction Bundle, mentions Bundle, transaction, references, or posting to a FHIR server. Builds on exporting-to-fhir; pairs after.

Annotates VCF variants and normalizes HGVS nomenclature with public, license-free annotators (Ensembl VEP REST, VEP/SnpEff/ANNOVAR offline) and links variants to gnomAD population frequencies and the clinical context OpenMed extracts. Use when the user wants to predict variant consequences, map HGVS to genomic coordinates, annotate a VCF, attach allele frequencies, or pair variants with phenotype/oncology context. Trigger keywords: VCF, HGVS, variant annotation, VEP, SnpEff, ANNOVAR, consequence, missense, gnomAD, allele frequency, GRCh38, rsID, transcript. Pairs adjacent to OpenMed: combine annotated variants with Genomics/Oncology entities and phenotype from openmed.analyze_text. Tools used are free; restricted clinical databases are user-supplied.