How this skill is triggered — by the user, by Claude, or both
Slash command
/cps-hlt:hltThe summary Claude sees in its skill listing — used to decide when to auto-load this skill
---
Code: HLT Full Name: Healthcare Digital Solutions Fee Modifier: 1.20 Description: Clinical workflow optimization, HIS implementation (HL7/FHIR), HIPAA compliance
| # | Skill | Command | Purpose |
|---|---|---|---|
| 1 | Clinical Workflow Analysis | /hlt-workflow | Analyze and optimize clinical workflows |
| 2 | HIS Requirements | /hlt-his-req | Gather HIS implementation requirements |
| 3 | HL7/FHIR Mapping | /hlt-hl7-fhir | Map data to healthcare interoperability standards |
| 4 | HIPAA Gap Analysis | /hlt-hipaa-gap | HIPAA compliance gap analysis |
| 5 | Patient Journey Mapping | /hlt-patient-journey | Map patient journey touchpoints |
| 6 | Interoperability Assessment | /hlt-interop | Assess healthcare system interoperability |
| 7 | Clinical KPI Framework | /hlt-clinical-kpis | Define clinical performance metrics |
| 8 | Telehealth Readiness | /hlt-telehealth | Assess telehealth readiness |
/hlt-workflowAnalyze existing clinical workflows to identify inefficiencies, bottlenecks, and optimization opportunities while ensuring patient safety and care quality.
organization_name: "Hospital/Clinic Name"
department: "Emergency|Inpatient|Outpatient|Surgery|Radiology|Lab|Pharmacy"
workflow_scope:
- name: "Patient Registration"
- name: "Triage Assessment"
- name: "Physician Consultation"
current_state:
paper_based: true|false
ehr_system: "Epic|Cerner|Meditech|Other|None"
integration_level: "none|partial|full"
pain_points:
- "Long wait times"
- "Documentation burden"
- "Communication gaps"
| Category | Examples | Key Metrics |
|---|---|---|
| Patient Flow | Registration, triage, discharge | Throughput, wait times |
| Clinical Documentation | Notes, orders, results | Time to document, completeness |
| Medication Management | Prescribing, dispensing, admin | Error rates, turnaround |
| Diagnostic Services | Lab, imaging, pathology | TAT, accuracy |
| Care Coordination | Referrals, handoffs, transitions | Communication delays |
Time Analysis
Quality Analysis
Resource Analysis
Patient Experience
# Clinical Workflow Analysis Report
## [Organization Name] - [Department]
### Assessment Date: [Date]
## Executive Summary
[High-level findings and key recommendations]
## Current State Analysis
### Workflow Map
[Process flow diagram] Patient Arrival → Registration → Triage → [Wait] → Consultation → [Wait] → Diagnostics → [Wait] → Treatment → Discharge
### Time Analysis
| Step | Avg Duration | Wait Time | Value-Added | Bottleneck |
|------|--------------|-----------|-------------|------------|
| Registration | 15 min | 5 min | 10 min | No |
| Triage | 10 min | 20 min | 10 min | Yes |
### Efficiency Metrics
| Metric | Current | Benchmark | Gap |
|--------|---------|-----------|-----|
| Door-to-Doctor | 45 min | 30 min | +50% |
| Length of Stay | 4.2 hrs | 3.0 hrs | +40% |
| Documentation Time | 35% | 25% | +10% |
## Pain Points Identified
| # | Pain Point | Impact | Root Cause | Priority |
|---|------------|--------|------------|----------|
| 1 | [Issue] | [Impact] | [Cause] | Critical |
## Recommendations
### Quick Wins (0-3 months)
| # | Recommendation | Expected Impact | Effort |
|---|----------------|-----------------|--------|
| 1 | [Recommendation] | [Impact] | Low |
### Process Redesign (3-6 months)
| # | Recommendation | Expected Impact | Effort |
|---|----------------|-----------------|--------|
| 1 | [Recommendation] | [Impact] | Medium |
### Technology Enablement (6-12 months)
| # | Recommendation | Expected Impact | Effort |
|---|----------------|-----------------|--------|
| 1 | [Recommendation] | [Impact] | High |
## Future State Workflow
[Optimized process flow diagram]
## Implementation Roadmap
[Phased approach with milestones]
/hlt-his-reqGather and document comprehensive requirements for Hospital Information System (HIS) selection or implementation.
organization_type: "hospital|clinic|health_system|specialty"
bed_count: 250
annual_patient_volume: 50000
current_systems:
- name: "Current HIS"
vendor: "Vendor"
age_years: 10
satisfaction: "low|medium|high"
departments_in_scope:
- "Registration"
- "Clinical"
- "Billing"
- "Pharmacy"
- "Laboratory"
- "Radiology"
integration_requirements:
- "Lab Information System"
- "PACS"
- "Pharmacy System"
| Module | Sub-modules | Priority |
|---|---|---|
| Patient Management | ADT, Scheduling, Registration | Critical |
| Clinical | EMR, CPOE, Clinical Documentation | Critical |
| Revenue Cycle | Billing, Claims, Collections | Critical |
| Ancillary | Lab, Radiology, Pharmacy | High |
| Administrative | HR, Finance, Supply Chain | Medium |
| Analytics | Reporting, BI, Population Health | Medium |
| Req ID | Module | Requirement | Priority | MoSCoW |
|---|---|---|---|---|
| FR-001 | ADT | Real-time bed management | Critical | Must |
| FR-002 | EMR | Problem list with ICD-10 | Critical | Must |
| FR-003 | CPOE | Drug-drug interaction alerts | Critical | Must |
| Category | Requirement | Target |
|---|---|---|
| Performance | Response time | < 2 seconds |
| Availability | Uptime | 99.9% |
| Scalability | Concurrent users | 500+ |
| Security | Authentication | MFA required |
| Compliance | Standards | HIPAA, HL7, FHIR |
# HIS Requirements Specification
## [Organization Name]
### Version: 1.0 | Date: [Date]
## 1. Introduction
### 1.1 Purpose
[Purpose of this requirements document]
### 1.2 Scope
| Attribute | Value |
|-----------|-------|
| Organization Type | [Type] |
| Bed Count | [Count] |
| Annual Volume | [Volume] |
| Users | [Count] |
### 1.3 Departments In Scope
- [Department 1]
- [Department 2]
## 2. Current State Assessment
### 2.1 Existing Systems
| System | Vendor | Function | Replace/Integrate |
|--------|--------|----------|-------------------|
| [System] | [Vendor] | [Function] | [Decision] |
### 2.2 Pain Points
| # | Issue | Impact | Priority |
|---|-------|--------|----------|
| 1 | [Issue] | [Impact] | [Priority] |
## 3. Functional Requirements
### 3.1 Patient Management
| ID | Requirement | Priority | Notes |
|----|-------------|----------|-------|
| PM-001 | Patient registration with demographics | Must | |
| PM-002 | Insurance verification | Must | |
| PM-003 | Appointment scheduling | Must | |
### 3.2 Clinical Documentation
| ID | Requirement | Priority | Notes |
|----|-------------|----------|-------|
| CD-001 | Structured clinical notes | Must | |
| CD-002 | Voice recognition support | Should | |
### 3.3 Computerized Provider Order Entry (CPOE)
| ID | Requirement | Priority | Notes |
|----|-------------|----------|-------|
| CP-001 | Medication orders | Must | |
| CP-002 | Lab orders | Must | |
| CP-003 | Clinical decision support | Must | |
### 3.4 Pharmacy
| ID | Requirement | Priority | Notes |
|----|-------------|----------|-------|
| PH-001 | Drug dispensing workflow | Must | |
| PH-002 | Formulary management | Must | |
### 3.5 Laboratory
| ID | Requirement | Priority | Notes |
|----|-------------|----------|-------|
| LB-001 | Order management | Must | |
| LB-002 | Results reporting | Must | |
### 3.6 Radiology
| ID | Requirement | Priority | Notes |
|----|-------------|----------|-------|
| RD-001 | RIS functionality | Must | |
| RD-002 | PACS integration | Must | |
### 3.7 Revenue Cycle
| ID | Requirement | Priority | Notes |
|----|-------------|----------|-------|
| RC-001 | Charge capture | Must | |
| RC-002 | Claims management | Must | |
## 4. Non-Functional Requirements
### 4.1 Performance
| Requirement | Target |
|-------------|--------|
| Page load time | < 2 sec |
| Report generation | < 30 sec |
| Concurrent users | 500+ |
### 4.2 Security & Compliance
| Requirement | Target |
|-------------|--------|
| HIPAA compliance | Full |
| Access control | RBAC |
| Audit logging | Complete |
| Encryption | AES-256 |
### 4.3 Integration
| System | Protocol | Priority |
|--------|----------|----------|
| Lab System | HL7 2.x | Must |
| PACS | DICOM | Must |
| HIE | FHIR R4 | Should |
## 5. Vendor Evaluation Criteria
| Criterion | Weight | Description |
|-----------|--------|-------------|
| Functionality | 30% | Feature coverage |
| Usability | 20% | User experience |
| Integration | 15% | Interoperability |
| Vendor Stability | 15% | Market position |
| Cost | 20% | TCO |
## 6. Implementation Considerations
### 6.1 Timeline Expectations
| Phase | Duration |
|-------|----------|
| Selection | 3-4 months |
| Implementation | 12-18 months |
| Go-Live | Phased |
### 6.2 Resource Requirements
| Role | FTE | Duration |
|------|-----|----------|
| Project Manager | 1.0 | Full |
| Clinical Lead | 0.5 | Full |
| IT Lead | 1.0 | Full |
/hlt-hl7-fhirMap healthcare data to HL7 v2.x or FHIR R4 standards for interoperability between systems.
mapping_direction: "source_to_hl7|source_to_fhir|hl7_to_fhir"
source_system:
name: "Source System"
data_format: "proprietary|hl7v2|fhir|csv|xml"
target_standard: "HL7v2.5|HL7v2.7|FHIR_R4"
data_domains:
- "Patient Demographics"
- "Encounters"
- "Orders"
- "Results"
- "Medications"
- "Allergies"
- "Problems"
use_case: "ADT|ORM|ORU|MDM|SIU|Custom"
| Type | Name | Use Case |
|---|---|---|
| ADT | Admit/Discharge/Transfer | Patient movements |
| ORM | Order Message | Lab/Rad orders |
| ORU | Observation Result | Lab results |
| RDE | Pharmacy Encoded Order | Medication orders |
| MDM | Medical Document | Documents |
| SIU | Scheduling | Appointments |
| DFT | Detailed Financial | Charges |
| Resource | HL7v2 Equivalent | Use Case |
|---|---|---|
| Patient | PID segment | Demographics |
| Encounter | PV1 segment | Visits |
| Observation | OBX segment | Results |
| MedicationRequest | RXE segment | Prescriptions |
| DiagnosticReport | ORU message | Reports |
| AllergyIntolerance | AL1 segment | Allergies |
| Condition | DG1 segment | Diagnoses |
# Healthcare Interface Specification
## [Interface Name]
### Version: 1.0 | Date: [Date]
## 1. Interface Overview
| Attribute | Value |
|-----------|-------|
| Source System | [System Name] |
| Target System | [System Name] |
| Standard | [HL7v2.x / FHIR R4] |
| Direction | [Inbound/Outbound/Bidirectional] |
| Trigger | [Event/Scheduled/On-Demand] |
## 2. Message/Resource Scope
### Messages Supported
| Message Type | Event | Direction | Frequency |
|--------------|-------|-----------|-----------|
| ADT^A01 | Admit | Outbound | Real-time |
| ADT^A08 | Update | Outbound | Real-time |
| ORU^R01 | Results | Inbound | Real-time |
## 3. Detailed Mapping
### ADT^A01 - Patient Admit
#### MSH Segment (Message Header)
| Field | Element | Source Field | Transform | Example |
|-------|---------|--------------|-----------|---------|
| MSH-3 | Sending App | Config | Static | "HIS" |
| MSH-4 | Sending Facility | Config | Static | "FACILITY1" |
| MSH-7 | Message DateTime | System | yyyyMMddHHmmss | "20260202120000" |
| MSH-9 | Message Type | Config | Static | "ADT^A01" |
| MSH-10 | Control ID | System | UUID | "MSG123456" |
#### PID Segment (Patient Identification)
| Field | Element | Source Field | Transform | Example |
|-------|---------|--------------|-----------|---------|
| PID-3 | Patient ID | patient.mrn | Direct | "MRN12345" |
| PID-5 | Patient Name | patient.name | XPN format | "DOE^JOHN^M" |
| PID-7 | DOB | patient.dob | yyyyMMdd | "19800115" |
| PID-8 | Sex | patient.gender | Lookup | "M" |
| PID-11 | Address | patient.address | XAD format | "123 MAIN ST^^CITY^ST^12345" |
#### PV1 Segment (Patient Visit)
| Field | Element | Source Field | Transform | Example |
|-------|---------|--------------|-----------|---------|
| PV1-2 | Patient Class | visit.type | Lookup | "I" (Inpatient) |
| PV1-3 | Location | visit.location | PL format | "UNIT1^ROOM101^BED-A" |
| PV1-7 | Attending Dr | visit.physician | XCN format | "12345^SMITH^JOHN^MD" |
| PV1-44 | Admit DateTime | visit.admit_dt | yyyyMMddHHmmss | "20260202120000" |
### FHIR Alternative: Patient Resource
```json
{
"resourceType": "Patient",
"id": "[patient.id]",
"identifier": [{
"system": "urn:oid:2.16.840.1.113883.19.5",
"value": "[patient.mrn]"
}],
"name": [{
"family": "[patient.lastName]",
"given": ["[patient.firstName]", "[patient.middleName]"]
}],
"gender": "[patient.gender -> male|female|other|unknown]",
"birthDate": "[patient.dob -> YYYY-MM-DD]",
"address": [{
"line": ["[patient.address.street]"],
"city": "[patient.address.city]",
"state": "[patient.address.state]",
"postalCode": "[patient.address.zip]"
}]
}
| Source | HL7 | FHIR | Description |
|---|---|---|---|
| Male | M | male | Male |
| Female | F | female | Female |
| Unknown | U | unknown | Unknown |
| Source | HL7 PV1-2 | Description |
|---|---|---|
| Inpatient | I | Inpatient |
| Outpatient | O | Outpatient |
| Emergency | E | Emergency |
| Rule ID | Field | Validation | Action |
|---|---|---|---|
| VAL-001 | PID-3 | Required, non-empty | Reject |
| VAL-002 | PID-5 | Required, valid XPN | Reject |
| VAL-003 | PID-7 | Valid date format | Default |
| Error Code | Description | Action |
|---|---|---|
| AE | Application Error | Log, retry |
| AR | Application Reject | Log, alert |
| CR | Commit Reject | Log, escalate |
| # | Scenario | Input | Expected |
|---|---|---|---|
| 1 | Valid admit | Complete ADT^A01 | ACK^A01 AA |
| 2 | Missing MRN | ADT^A01 no PID-3 | ACK^A01 AE |
---
## Skill 4: HIPAA Gap Analysis
### Command: `/hlt-hipaa-gap`
### Purpose
Assess compliance with HIPAA Privacy Rule, Security Rule, and Breach Notification Rule requirements.
### Inputs Required
```yaml
organization_type: "covered_entity|business_associate|hybrid"
organization_size: "small|medium|large"
assessment_scope: "full|privacy|security|breach"
current_state:
risk_assessment_date: "2025-01-15"
policies_last_updated: "2024-06-01"
training_completed: true
incidents_last_year: 2
baa_inventory: true
ephi_locations:
- "EHR System"
- "Email"
- "Mobile Devices"
- "Paper Records"
| Rule | Focus | Key Requirements |
|---|---|---|
| Privacy Rule | PHI Use/Disclosure | Notice, Authorization, Minimum Necessary |
| Security Rule | ePHI Safeguards | Administrative, Physical, Technical |
| Breach Notification | Incident Response | Notification timelines, documentation |
Administrative Safeguards (§164.308)
| Standard | Implementation Specifications |
|---|---|
| Security Management | Risk analysis, Risk management, Sanctions, Review |
| Assigned Responsibility | Security official designation |
| Workforce Security | Authorization, Clearance, Termination |
| Information Access | Access authorization, Access management |
| Security Awareness | Training, Login monitoring, Password management |
| Security Incidents | Response procedures |
| Contingency Plan | Data backup, Disaster recovery, Emergency mode |
| Evaluation | Periodic evaluation |
| BAA | Business associate contracts |
Physical Safeguards (§164.310)
| Standard | Implementation Specifications |
|---|---|
| Facility Access | Contingency operations, Facility security, Access control |
| Workstation Use | Workstation use policies |
| Workstation Security | Physical safeguards |
| Device Controls | Disposal, Media re-use, Accountability, Backup |
Technical Safeguards (§164.312)
| Standard | Implementation Specifications |
|---|---|
| Access Control | Unique user ID, Emergency access, Auto logoff, Encryption |
| Audit Controls | Audit logs and examination |
| Integrity | Mechanism to authenticate ePHI |
| Authentication | Person or entity authentication |
| Transmission Security | Integrity controls, Encryption |
# HIPAA Compliance Gap Analysis
## [Organization Name]
### Assessment Date: [Date]
## Executive Summary
**Overall Compliance Score:** [X]%
**Risk Level:** [High|Medium|Low]
**Critical Gaps:** [Count]
**High Priority Gaps:** [Count]
### Compliance by Rule
| Rule | Score | Status |
|------|-------|--------|
| Privacy Rule | [X]% | [Status] |
| Security Rule | [X]% | [Status] |
| Breach Notification | [X]% | [Status] |
## Assessment Scope
| Attribute | Value |
|-----------|-------|
| Organization Type | [Type] |
| Assessment Date | [Date] |
| Last Risk Assessment | [Date] |
| ePHI Locations | [Count] |
## Detailed Findings
### Privacy Rule Compliance
#### Notice of Privacy Practices
| Requirement | Status | Gap | Priority |
|-------------|--------|-----|----------|
| NPP available to patients | [Met/Gap] | [Description] | [H/M/L] |
| NPP acknowledgment documented | [Met/Gap] | [Description] | [H/M/L] |
#### Authorization Requirements
| Requirement | Status | Gap | Priority |
|-------------|--------|-----|----------|
| Valid authorization elements | [Met/Gap] | [Description] | [H/M/L] |
| Authorization tracking | [Met/Gap] | [Description] | [H/M/L] |
### Security Rule Compliance
#### Administrative Safeguards
| Standard | Requirement | Status | Gap | Priority |
|----------|-------------|--------|-----|----------|
| §164.308(a)(1) | Risk Analysis | [Met/Gap] | [Desc] | [H/M/L] |
| §164.308(a)(1) | Risk Management | [Met/Gap] | [Desc] | [H/M/L] |
| §164.308(a)(2) | Security Official | [Met/Gap] | [Desc] | [H/M/L] |
| §164.308(a)(3) | Workforce Security | [Met/Gap] | [Desc] | [H/M/L] |
| §164.308(a)(4) | Access Management | [Met/Gap] | [Desc] | [H/M/L] |
| §164.308(a)(5) | Security Training | [Met/Gap] | [Desc] | [H/M/L] |
| §164.308(a)(6) | Incident Procedures | [Met/Gap] | [Desc] | [H/M/L] |
| §164.308(a)(7) | Contingency Plan | [Met/Gap] | [Desc] | [H/M/L] |
| §164.308(a)(8) | Evaluation | [Met/Gap] | [Desc] | [H/M/L] |
| §164.308(b)(1) | BAA Contracts | [Met/Gap] | [Desc] | [H/M/L] |
#### Physical Safeguards
| Standard | Requirement | Status | Gap | Priority |
|----------|-------------|--------|-----|----------|
| §164.310(a)(1) | Facility Access | [Met/Gap] | [Desc] | [H/M/L] |
| §164.310(b) | Workstation Use | [Met/Gap] | [Desc] | [H/M/L] |
| §164.310(c) | Workstation Security | [Met/Gap] | [Desc] | [H/M/L] |
| §164.310(d)(1) | Device Controls | [Met/Gap] | [Desc] | [H/M/L] |
#### Technical Safeguards
| Standard | Requirement | Status | Gap | Priority |
|----------|-------------|--------|-----|----------|
| §164.312(a)(1) | Access Control | [Met/Gap] | [Desc] | [H/M/L] |
| §164.312(b) | Audit Controls | [Met/Gap] | [Desc] | [H/M/L] |
| §164.312(c)(1) | Integrity | [Met/Gap] | [Desc] | [H/M/L] |
| §164.312(d) | Authentication | [Met/Gap] | [Desc] | [H/M/L] |
| §164.312(e)(1) | Transmission Security | [Met/Gap] | [Desc] | [H/M/L] |
### Breach Notification Compliance
| Requirement | Status | Gap | Priority |
|-------------|--------|-----|----------|
| Breach detection procedures | [Met/Gap] | [Desc] | [H/M/L] |
| Risk assessment process | [Met/Gap] | [Desc] | [H/M/L] |
| Individual notification (60 days) | [Met/Gap] | [Desc] | [H/M/L] |
| HHS notification | [Met/Gap] | [Desc] | [H/M/L] |
| Media notification (>500) | [Met/Gap] | [Desc] | [H/M/L] |
## Remediation Plan
### Critical Priority (0-30 days)
| # | Gap | Remediation | Owner | Due Date |
|---|-----|-------------|-------|----------|
| 1 | [Gap] | [Action] | [Owner] | [Date] |
### High Priority (30-90 days)
| # | Gap | Remediation | Owner | Due Date |
|---|-----|-------------|-------|----------|
| 1 | [Gap] | [Action] | [Owner] | [Date] |
### Medium Priority (90-180 days)
| # | Gap | Remediation | Owner | Due Date |
|---|-----|-------------|-------|----------|
| 1 | [Gap] | [Action] | [Owner] | [Date] |
## Risk Register
| Risk | Likelihood | Impact | Score | Mitigation |
|------|------------|--------|-------|------------|
| [Risk] | [H/M/L] | [H/M/L] | [Score] | [Action] |
## Appendix: Evidence Checklist
| Item | Required | Provided | Status |
|------|----------|----------|--------|
| Risk Assessment Report | Yes | [Y/N] | [Status] |
| Policies & Procedures | Yes | [Y/N] | [Status] |
| Training Records | Yes | [Y/N] | [Status] |
| BAA Inventory | Yes | [Y/N] | [Status] |
| Incident Log | Yes | [Y/N] | [Status] |
/hlt-patient-journeyMap the complete patient journey across touchpoints to identify experience gaps and improvement opportunities.
journey_type: "emergency|elective|chronic|preventive"
patient_persona:
name: "Persona Name"
age: 45
condition: "Cardiac"
tech_savvy: "low|medium|high"
journey_scope:
start: "Symptom onset"
end: "Follow-up care"
touchpoints_included:
- "Pre-visit"
- "Arrival"
- "Registration"
- "Clinical care"
- "Discharge"
- "Post-visit"
data_sources:
- "Patient surveys"
- "Process observations"
- "Staff interviews"
| Stage | Description | Key Touchpoints |
|---|---|---|
| Awareness | Recognition of need | Symptoms, research |
| Access | Finding care | Scheduling, referral |
| Arrival | Facility entry | Parking, wayfinding |
| Intake | Registration | Forms, verification |
| Care Delivery | Clinical services | Exams, procedures |
| Transition | Moving between | Handoffs, transfers |
| Departure | Leaving facility | Discharge, instructions |
| Follow-up | Ongoing care | Results, appointments |
| Dimension | Description | Metrics |
|---|---|---|
| Functional | Getting the job done | Wait times, outcomes |
| Emotional | How patients feel | Anxiety, confidence |
| Accessibility | Ease of access | Availability, barriers |
| Communication | Information exchange | Clarity, timeliness |
# Patient Journey Map
## [Journey Name]: [Patient Type]
### Date: [Date]
## Journey Overview
**Journey Type:** [Type]
**Duration:** [Start] to [End]
**Key Pain Points:** [Count]
**Opportunities:** [Count]
## Patient Persona
| Attribute | Value |
|-----------|-------|
| Name | [Persona Name] |
| Age | [Age] |
| Condition | [Condition] |
| Tech Comfort | [Level] |
| Goals | [What patient wants to achieve] |
| Concerns | [What patient worries about] |
## Journey Map
### Stage 1: Awareness & Research
Timeline: [Duration] Touchpoints: Website, Dr. Google, Phone
| Touchpoint | Action | Thinking | Feeling | Pain Points | Opportunities |
|------------|--------|----------|---------|-------------|---------------|
| Symptom onset | Notices symptoms | "What's wrong?" | Worried | Uncertainty | Symptom checker |
| Online search | Researches condition | "Is this serious?" | Anxious | Conflicting info | Trusted content |
### Stage 2: Access & Scheduling
| Touchpoint | Action | Thinking | Feeling | Pain Points | Opportunities |
|------------|--------|----------|---------|-------------|---------------|
| Phone call | Calls for appointment | "How soon can I be seen?" | Impatient | Long hold times | Online scheduling |
| Scheduling | Books appointment | "Will this time work?" | Relieved | Limited availability | Self-service portal |
### Stage 3: Arrival & Registration
| Touchpoint | Action | Thinking | Feeling | Pain Points | Opportunities |
|------------|--------|----------|---------|-------------|---------------|
| Parking | Finds parking | "Where do I go?" | Frustrated | Confusing signage | Mobile wayfinding |
| Registration | Checks in | "Not this again" | Annoyed | Redundant forms | Pre-registration |
### Stage 4: Clinical Care
| Touchpoint | Action | Thinking | Feeling | Pain Points | Opportunities |
|------------|--------|----------|---------|-------------|---------------|
| Waiting room | Waits | "How much longer?" | Anxious | No updates | Wait time display |
| Exam room | Sees provider | "Will they listen?" | Hopeful | Rushed feeling | Extended time slots |
| Testing | Gets tests | "What are they looking for?" | Nervous | No explanation | Real-time education |
### Stage 5: Discharge & Follow-up
| Touchpoint | Action | Thinking | Feeling | Pain Points | Opportunities |
|------------|--------|----------|---------|-------------|---------------|
| Discharge | Receives instructions | "What do I do next?" | Overwhelmed | Information overload | Digital instructions |
| Results | Gets results | "What does this mean?" | Anxious | Delay in communication | Patient portal alerts |
## Emotional Journey Curve
High | *
Emotion | * /
| / \ / \ *
| / \ / \ /
| * / \ / _/ ___
Low |*__/_________________
Awareness Arrival Care Discharge Follow-up
## Pain Point Analysis
| # | Pain Point | Stage | Severity | Impact | Root Cause |
|---|------------|-------|----------|--------|------------|
| 1 | Long wait without updates | Care | High | Anxiety | No system |
| 2 | Redundant paperwork | Arrival | Medium | Frustration | No integration |
## Opportunities
| # | Opportunity | Stage | Effort | Impact | Quick Win |
|---|-------------|-------|--------|--------|-----------|
| 1 | Digital check-in | Arrival | Medium | High | No |
| 2 | Wait time display | Care | Low | High | Yes |
## Recommendations
### Immediate (0-3 months)
1. [Recommendation]
### Short-term (3-6 months)
1. [Recommendation]
### Long-term (6-12 months)
1. [Recommendation]
## Metrics to Track
| Metric | Current | Target | Frequency |
|--------|---------|--------|-----------|
| Patient Satisfaction | [Score] | [Target] | Monthly |
| Net Promoter Score | [Score] | [Target] | Quarterly |
| Wait Time (avg) | [Time] | [Target] | Weekly |
/hlt-interopAssess healthcare organization's interoperability capabilities and readiness for health information exchange.
organization_name: "Organization Name"
systems_inventory:
- name: "System Name"
type: "EHR|LIS|RIS|PIS|ADT"
vendor: "Vendor"
hl7_capable: true|false
fhir_capable: true|false
current_exchanges:
- partner: "Partner Name"
type: "HIE|Direct|Custom"
direction: "bidirectional|send|receive"
regulatory_requirements:
- "CMS Interoperability"
- "Information Blocking"
- "TEFCA"
| Level | Name | Characteristics |
|---|---|---|
| 1 | Foundational | Non-electronic, fax/mail |
| 2 | Structural | Standard formats (HL7 2.x) |
| 3 | Semantic | Coded data, common vocabularies |
| 4 | Organizational | Governance, trust frameworks |
| 5 | Optimized | Real-time, patient-mediated |
| Dimension | Focus Areas |
|---|---|
| Technical | Standards support, APIs, connectivity |
| Semantic | Vocabularies, code sets, data quality |
| Process | Workflows, governance, monitoring |
| Policy | Consent, privacy, data sharing agreements |
# Healthcare Interoperability Assessment
## [Organization Name]
### Assessment Date: [Date]
## Executive Summary
**Interoperability Maturity Level:** [1-5] - [Name]
**Overall Readiness Score:** [X/100]
**Critical Gaps:** [Count]
## Current State Analysis
### System Inventory
| System | Type | Vendor | HL7 v2 | FHIR | APIs |
|--------|------|--------|--------|------|------|
| [Name] | [Type] | [Vendor] | [Y/N] | [Y/N] | [Y/N] |
### Current Exchanges
| Partner | Type | Direction | Standards | Volume |
|---------|------|-----------|-----------|--------|
| [Name] | [HIE/Direct] | [Dir] | [HL7/FHIR] | [/day] |
## Maturity Assessment
### Technical Interoperability
| Criterion | Score | Evidence |
|-----------|-------|----------|
| HL7 v2 messaging | [X/10] | [Details] |
| FHIR R4 capability | [X/10] | [Details] |
| API availability | [X/10] | [Details] |
| Security protocols | [X/10] | [Details] |
### Semantic Interoperability
| Criterion | Score | Evidence |
|-----------|-------|----------|
| ICD-10 adoption | [X/10] | [Details] |
| SNOMED CT usage | [X/10] | [Details] |
| LOINC for labs | [X/10] | [Details] |
| RxNorm for meds | [X/10] | [Details] |
### Process Interoperability
| Criterion | Score | Evidence |
|-----------|-------|----------|
| Data governance | [X/10] | [Details] |
| Interface monitoring | [X/10] | [Details] |
| Error handling | [X/10] | [Details] |
| Change management | [X/10] | [Details] |
## Regulatory Compliance
### CMS Interoperability Rule
| Requirement | Status | Gap |
|-------------|--------|-----|
| Patient access API | [Met/Gap] | [Details] |
| Provider directory API | [Met/Gap] | [Details] |
| Payer-to-payer exchange | [Met/Gap] | [Details] |
### Information Blocking
| Exception | Applicable | Documented |
|-----------|------------|------------|
| Preventing harm | [Y/N] | [Y/N] |
| Privacy | [Y/N] | [Y/N] |
| Security | [Y/N] | [Y/N] |
| Infeasibility | [Y/N] | [Y/N] |
### TEFCA Readiness
| Requirement | Status | Gap |
|-------------|--------|-----|
| QHIN connectivity | [Status] | [Gap] |
| Common Agreement | [Status] | [Gap] |
## Gap Analysis
| # | Gap | Category | Impact | Priority |
|---|-----|----------|--------|----------|
| 1 | [Gap] | [Technical/Semantic/Process] | [Impact] | [H/M/L] |
## Roadmap
### Phase 1: Foundation (0-6 months)
- [ ] [Action item]
### Phase 2: Enhancement (6-12 months)
- [ ] [Action item]
### Phase 3: Optimization (12-18 months)
- [ ] [Action item]
/hlt-clinical-kpisDesign a comprehensive clinical KPI framework covering quality, safety, efficiency, and patient experience.
organization_type: "hospital|clinic|health_system"
focus_areas:
- "Quality"
- "Safety"
- "Efficiency"
- "Patient Experience"
- "Financial"
departments:
- "Emergency"
- "Inpatient"
- "Surgery"
- "Outpatient"
regulatory_programs:
- "CMS Quality Programs"
- "Joint Commission"
- "Leapfrog"
current_reporting:
dashboards: true|false
frequency: "daily|weekly|monthly"
| Category | Focus | Example Metrics |
|---|---|---|
| Quality | Clinical outcomes | Mortality, readmissions, complications |
| Safety | Patient harm prevention | Falls, infections, medication errors |
| Efficiency | Resource utilization | LOS, throughput, OR utilization |
| Experience | Patient satisfaction | HCAHPS, NPS, complaints |
| Access | Care availability | Wait times, appointment availability |
| Financial | Cost management | Cost per case, revenue cycle |
# Clinical KPI Framework
## [Organization Name]
### Version: 1.0 | Date: [Date]
## Framework Overview
### Balanced Scorecard Approach
| Perspective | Focus | Weight |
|-------------|-------|--------|
| Quality & Safety | Clinical outcomes, patient harm | 35% |
| Patient Experience | Satisfaction, engagement | 25% |
| Efficiency | Operations, throughput | 25% |
| Financial | Sustainability | 15% |
## KPI Catalog
### Quality Metrics
| KPI | Definition | Formula | Target | Frequency |
|-----|------------|---------|--------|-----------|
| 30-Day Readmission Rate | % patients readmitted within 30 days | (Readmissions / Discharges) x 100 | < 15% | Monthly |
| Mortality Rate | Deaths per 1000 discharges | (Deaths / Discharges) x 1000 | < Benchmark | Monthly |
| Surgical Site Infection | SSI per 100 procedures | (SSI / Procedures) x 100 | < 1% | Monthly |
| Sepsis Bundle Compliance | % sepsis patients with bundle | (Compliant / Total Sepsis) x 100 | > 95% | Monthly |
### Safety Metrics
| KPI | Definition | Formula | Target | Frequency |
|-----|------------|---------|--------|-----------|
| Patient Falls | Falls per 1000 patient days | (Falls / Patient Days) x 1000 | < 3.0 | Monthly |
| Falls with Injury | Injury falls per 1000 patient days | (Injury Falls / Patient Days) x 1000 | < 0.5 | Monthly |
| CLABSI Rate | Central line infections per 1000 line days | (CLABSI / Line Days) x 1000 | 0 | Monthly |
| CAUTI Rate | Catheter infections per 1000 catheter days | (CAUTI / Cath Days) x 1000 | 0 | Monthly |
| Medication Errors | Errors per 1000 doses | (Errors / Doses) x 1000 | < 1.0 | Monthly |
### Efficiency Metrics
| KPI | Definition | Formula | Target | Frequency |
|-----|------------|---------|--------|-----------|
| Average Length of Stay | Mean inpatient days | Total Days / Discharges | < Benchmark | Weekly |
| ED Throughput | Time from arrival to disposition | Median minutes | < 180 min | Daily |
| OR Utilization | % of scheduled OR time used | (Actual / Scheduled) x 100 | > 80% | Weekly |
| Bed Turnover | Discharges per bed | Discharges / Beds | > 4.0/mo | Monthly |
| Door-to-Balloon | STEMI treatment time | Median minutes | < 90 min | Monthly |
### Patient Experience Metrics
| KPI | Definition | Formula | Target | Frequency |
|-----|------------|---------|--------|-----------|
| Overall Rating | HCAHPS 9/10 rating | % Top Box | > 75% | Quarterly |
| Recommend Hospital | HCAHPS definitely recommend | % Top Box | > 75% | Quarterly |
| Communication - Nurses | HCAHPS nurse communication | % Top Box | > 80% | Quarterly |
| Communication - Doctors | HCAHPS doctor communication | % Top Box | > 80% | Quarterly |
| Pain Management | HCAHPS pain well controlled | % Top Box | > 70% | Quarterly |
| Net Promoter Score | Likelihood to recommend | (Promoters - Detractors) | > 50 | Monthly |
### Access Metrics
| KPI | Definition | Formula | Target | Frequency |
|-----|------------|---------|--------|-----------|
| ED Wait Time | Arrival to provider | Median minutes | < 30 min | Daily |
| Appointment Availability | Days to next available | Median days | < 7 days | Weekly |
| No-Show Rate | Missed appointments | (No-shows / Scheduled) x 100 | < 10% | Weekly |
### Financial Metrics
| KPI | Definition | Formula | Target | Frequency |
|-----|------------|---------|--------|-----------|
| Cost per Case | Average cost per discharge | Total Cost / Discharges | < Budget | Monthly |
| Revenue per Adjusted Discharge | Revenue per case mix adjusted discharge | Revenue / Adj Discharges | > Budget | Monthly |
| Days in AR | Average collection time | AR / (Revenue/365) | < 45 days | Monthly |
## Department-Specific KPIs
### Emergency Department
| KPI | Target | Frequency |
|-----|--------|-----------|
| Door-to-Doctor | < 30 min | Daily |
| Left Without Being Seen | < 2% | Daily |
| ED Boarding Hours | < 2 hrs | Daily |
### Surgical Services
| KPI | Target | Frequency |
|-----|--------|-----------|
| Case Cancellation Rate | < 5% | Weekly |
| First Case On-Time Start | > 90% | Daily |
| Surgical Site Infection | < 1% | Monthly |
## Dashboard Design
### Executive Dashboard (Monthly)
- Quality composite score
- Safety event trends
- Financial performance
- Patient experience trends
### Operational Dashboard (Daily/Weekly)
- ED throughput metrics
- Bed availability
- OR utilization
- Staffing levels
### Quality Dashboard (Monthly)
- Core measure performance
- Infection rates
- Readmission rates
- Mortality indices
## Data Sources & Governance
| Metric Category | Primary Source | Secondary Source | Owner |
|-----------------|----------------|------------------|-------|
| Quality | EHR/Clinical | Claims | CMO |
| Safety | Incident System | EHR | CNO |
| Efficiency | ADT/Operations | EHR | COO |
| Experience | Survey Vendor | Complaints | CNO |
| Financial | Revenue Cycle | GL | CFO |
## Implementation Roadmap
### Phase 1: Foundation (Months 1-3)
- [ ] Validate data sources
- [ ] Build core dashboards
- [ ] Train leadership
### Phase 2: Expansion (Months 4-6)
- [ ] Department-level KPIs
- [ ] Automated reporting
- [ ] Benchmark integration
### Phase 3: Optimization (Months 7-12)
- [ ] Predictive analytics
- [ ] Real-time alerts
- [ ] Performance improvement integration
/hlt-telehealthAssess organizational readiness for telehealth services including technology, workflow, regulatory, and patient engagement.
organization_name: "Organization Name"
current_state:
telehealth_active: true|false
platforms_used: ["Platform1"]
visit_types: ["Urgent", "Follow-up"]
volume_monthly: 500
planned_expansion:
- "Behavioral health"
- "Chronic care"
- "Specialty consults"
patient_population:
avg_age: 55
rural_percentage: 30
tech_literacy: "low|medium|high"
| Dimension | Focus Areas | Weight |
|---|---|---|
| Technology | Platform, devices, connectivity | 25% |
| Clinical | Workflows, protocols, appropriateness | 25% |
| Operational | Scheduling, billing, support | 20% |
| Regulatory | Licensing, privacy, consent | 15% |
| Patient | Access, engagement, digital literacy | 15% |
# Telehealth Readiness Assessment
## [Organization Name]
### Assessment Date: [Date]
## Executive Summary
**Overall Readiness Score:** [X/100]
**Readiness Level:** [Emerging|Developing|Established|Optimized]
**Key Gaps:** [Count]
**Priority Actions:** [Count]
## Readiness Scores by Dimension
| Dimension | Score | Status |
|-----------|-------|--------|
| Technology | [X/100] | [Status] |
| Clinical | [X/100] | [Status] |
| Operational | [X/100] | [Status] |
| Regulatory | [X/100] | [Status] |
| Patient | [X/100] | [Status] |
## Current State Analysis
### Telehealth Program Status
| Attribute | Value |
|-----------|-------|
| Program Active | [Yes/No] |
| Monthly Volume | [Volume] |
| Visit Types | [Types] |
| Platform(s) | [Names] |
| Provider Participation | [%] |
## Detailed Assessment
### Technology Readiness
| Criterion | Score | Evidence | Gap |
|-----------|-------|----------|-----|
| Video platform | [X/10] | [Details] | [Gap] |
| EHR integration | [X/10] | [Details] | [Gap] |
| Device availability | [X/10] | [Details] | [Gap] |
| Bandwidth/connectivity | [X/10] | [Details] | [Gap] |
| Technical support | [X/10] | [Details] | [Gap] |
### Clinical Readiness
| Criterion | Score | Evidence | Gap |
|-----------|-------|----------|-----|
| Clinical protocols | [X/10] | [Details] | [Gap] |
| Visit appropriateness criteria | [X/10] | [Details] | [Gap] |
| Provider training | [X/10] | [Details] | [Gap] |
| Quality monitoring | [X/10] | [Details] | [Gap] |
| Care coordination | [X/10] | [Details] | [Gap] |
### Operational Readiness
| Criterion | Score | Evidence | Gap |
|-----------|-------|----------|-----|
| Scheduling workflow | [X/10] | [Details] | [Gap] |
| Patient intake | [X/10] | [Details] | [Gap] |
| Billing/coding | [X/10] | [Details] | [Gap] |
| Staff training | [X/10] | [Details] | [Gap] |
| Performance metrics | [X/10] | [Details] | [Gap] |
### Regulatory Readiness
| Criterion | Score | Evidence | Gap |
|-----------|-------|----------|-----|
| State licensure | [X/10] | [Details] | [Gap] |
| HIPAA compliance | [X/10] | [Details] | [Gap] |
| Informed consent | [X/10] | [Details] | [Gap] |
| Prescribing policies | [X/10] | [Details] | [Gap] |
| Documentation standards | [X/10] | [Details] | [Gap] |
### Patient Readiness
| Criterion | Score | Evidence | Gap |
|-----------|-------|----------|-----|
| Digital literacy | [X/10] | [Details] | [Gap] |
| Device access | [X/10] | [Details] | [Gap] |
| Broadband access | [X/10] | [Details] | [Gap] |
| Patient education | [X/10] | [Details] | [Gap] |
| Digital divide solutions | [X/10] | [Details] | [Gap] |
## Gap Analysis
| # | Gap | Dimension | Impact | Priority | Effort |
|---|-----|-----------|--------|----------|--------|
| 1 | [Gap] | [Dim] | [H/M/L] | [H/M/L] | [H/M/L] |
## Recommendations
### Quick Wins (0-30 days)
| # | Recommendation | Owner | Impact |
|---|----------------|-------|--------|
| 1 | [Recommendation] | [Owner] | [Impact] |
### Short-term (1-3 months)
| # | Recommendation | Owner | Impact |
|---|----------------|-------|--------|
| 1 | [Recommendation] | [Owner] | [Impact] |
### Long-term (3-12 months)
| # | Recommendation | Owner | Impact |
|---|----------------|-------|--------|
| 1 | [Recommendation] | [Owner] | [Impact] |
## Implementation Roadmap
### Phase 1: Foundation
- Platform optimization
- Core protocol development
- Provider training
### Phase 2: Expansion
- New visit types
- Specialty programs
- Patient outreach
### Phase 3: Optimization
- Advanced analytics
- AI-assisted triage
- Remote monitoring integration
## Success Metrics
| Metric | Baseline | Target | Timeline |
|--------|----------|--------|----------|
| Monthly visits | [Current] | [Target] | [Date] |
| Provider adoption | [Current] | [Target] | [Date] |
| Patient satisfaction | [Current] | [Target] | [Date] |
| No-show rate | [Current] | [Target] | [Date] |
HLT Base Modifier: 1.20 (applied to standard rates)
| Phase | Duration | Deliverables |
|---|---|---|
| Assessment | 3-4 weeks | Workflow analysis, gap assessments |
| Design | 4-6 weeks | Requirements, journey maps, KPI frameworks |
| Implementation | Variable | System configuration, integration |
| Optimization | Ongoing | Performance monitoring, continuous improvement |
HIS Implementation:
/hlt-workflow → /hlt-his-req → /hlt-hl7-fhir →
/hlt-interop → /esi-migration → /esi-cutover
HIPAA Compliance Program:
/hlt-hipaa-gap → /iso-gap (27001) → /iso-doc-control →
/hlt-workflow → Training
Patient Experience Initiative:
/hlt-patient-journey → /hlt-workflow → /coe-kpi →
/coe-dashboard → /hlt-telehealth
Clinical Quality Program:
/hlt-clinical-kpis → /coe-dashboard → /hlt-workflow →
Quality improvement cycles
| Service Line | Integration Point |
|---|---|
| ESI | HIS implementation, HL7/FHIR integration |
| ISO | ISO 27001 for healthcare security |
| COE | Clinical dashboards, KPI frameworks |
| DIG | Healthcare digital transformation |
| AIG | AI in clinical decision support |
| Regulation | Focus | Applicability |
|---|---|---|
| HIPAA | Privacy & Security | All covered entities |
| HITECH | EHR adoption, breach notification | All covered entities |
| 21st Century Cures | Interoperability, information blocking | All providers |
| CMS CoP | Conditions of Participation | Medicare providers |
| Joint Commission | Accreditation standards | Accredited facilities |
| State regulations | Licensing, telehealth, consent | Varies by state |
| Standard | Use Case |
|---|---|
| ICD-10-CM | Diagnosis coding |
| ICD-10-PCS | Procedure coding (inpatient) |
| CPT | Procedure coding (outpatient) |
| SNOMED CT | Clinical terminology |
| LOINC | Lab and clinical observations |
| RxNorm | Medication terminology |
| NDC | Drug identification |
All HLT deliverables should use standard CPS branding via:
/doc-gen for document generationassets/cps-branding.json for stylingscripts/cps-document-generator.js for automation| Skill | Primary Artifact | Format |
|---|---|---|
| /hlt-workflow | Clinical Workflow Report | DOCX/PDF |
| /hlt-his-req | HIS Requirements Spec | DOCX |
| /hlt-hl7-fhir | Interface Specification | DOCX/PDF |
| /hlt-hipaa-gap | HIPAA Gap Analysis | DOCX/PDF |
| /hlt-patient-journey | Patient Journey Map | PPTX/PDF |
| /hlt-interop | Interoperability Assessment | DOCX/PDF |
| /hlt-clinical-kpis | KPI Framework | XLSX/DOCX |
| /hlt-telehealth | Telehealth Assessment | DOCX/PDF |
/cps-skills:population-health (v4.2.1)Design population health management program: stratification, care management, social determinants.
client:
name: "Client Name"
context:
scope: "in-scope description"
constraints: ["regulatory / commercial constraints"]
/cps:verify-quality.CPS-branded population-health deliverable in 05_Deliverables_Final/.
/cps-skills:value-based-care (v4.2.1)Transition from fee-for-service to value-based-care: contracts, attribution, risk adjustment.
client:
name: "Client Name"
context:
scope: "in-scope description"
constraints: ["regulatory / commercial constraints"]
/cps:verify-quality.CPS-branded value-based-care deliverable in 05_Deliverables_Final/.
Guides creation, editing, and verification of skills for AI coding agents using test-driven development with subagent scenarios. Use when authoring or debugging skills.
npx claudepluginhub hossamdaoud83/cps-plugins-official --plugin cps-hlt