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medirecords-integration

@majiayu000/claude-skill-registry
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Complete MediRecords FHIR/REST API integration guide for Dr. Sophia AI consultations. Covers two-phase workflow (FHIR Encounter creation + REST notes append), patient search, SOAP note formatting, and troubleshooting. Use when integrating MediRecords API, creating consultations, debugging FHIR/REST endpoints, or saving AI consultations to patient records.

Install Skill

Shared

Installs to .agents/skills, used by Codex, Amp, Warp, Cursor, OpenCode, and more.

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Available across projects.

$npx skills-installer add @majiayu000/claude-skill-registry/medirecords-integration --client shared
Project

Writes to .agents/skills.

$npx skills-installer add @majiayu000/claude-skill-registry/medirecords-integration -p --client shared
Note: Review the skill instructions before using it.

SKILL.md

name medirecords-integration
description Complete MediRecords FHIR/REST API integration guide for Dr. Sophia AI consultations. Covers two-phase workflow (FHIR Encounter creation + REST notes append), patient search, SOAP note formatting, and troubleshooting. Use when integrating MediRecords API, creating consultations, debugging FHIR/REST endpoints, or saving AI consultations to patient records.

MediRecords Integration Guide

Overview

Access the complete guide for integrating Dr. Sophia AI consultations with MediRecords EHR system using FHIR v1 and REST v1 APIs. This skill provides the two-phase workflow, API credentials, FHIR schemas, troubleshooting guide, and test scripts.

Keywords: MediRecords, FHIR API, REST API, consultation creation, SOAP notes, encounter, EHR integration, patient records, clinical documentation

Status: ✅ Fully tested and working (verified Oct 22, 2025)

When to Use This Skill

  • Creating consultations in MediRecords
  • Integrating AI consultation workflow
  • Debugging FHIR/REST API issues
  • Saving SOAP notes to patient records
  • Understanding two-phase consultation process
  • Troubleshooting HTTP 409/500/400 errors

The Two-Phase Process

MediRecords requires TWO separate API calls to create a complete consultation:

Phase 1: FHIR API - Create Encounter

  • Endpoint: POST https://api.medirecords.com/fhir/v1/Encounter
  • Token: FHIR token (see references/api-credentials.md)
  • Purpose: Create consultation structure
  • Result: Encounter ID for Phase 2

Phase 2: REST API - Append Notes

  • Endpoint: POST https://api.medirecords.com/v1/patients/{id}/consults/{encounterId}/consultnote/append
  • Token: REST token (different from FHIR!)
  • Purpose: Add clinical documentation (SOAP notes)
  • Result: Consultation visible in MediRecords UI

Critical Requirements

Must create encounter with status: "finished" (not "in-progress") ✅ Must include serviceProvider field (practice ID) ✅ Must append notes within 1 hour of encounter endTimeUse FHIR token for Phase 1, REST token for Phase 2 (different tokens!)

Quick Start Workflow

Step 1: Search for Patient

const searchResponse = await fetch(
  'https://api.medirecords.com/fhir/v1/Patient?email=patient@example.com',
  {
    headers: {
      'Authorization': `Bearer ${FHIR_TOKEN}`,
      'Content-Type': 'application/fhir+json'
    }
  }
);
const patientData = await searchResponse.json();
const patientId = patientData.entry[0].resource.id;

Step 2: Create Finished Encounter (Phase 1)

const encounterResponse = await fetch(
  'https://api.medirecords.com/fhir/v1/Encounter',
  {
    method: 'POST',
    headers: {
      'Authorization': `Bearer ${FHIR_TOKEN}`,
      'Content-Type': 'application/fhir+json'
    },
    body: JSON.stringify({
      resourceType: 'Encounter',
      status: 'finished',  // ✅ MUST be "finished"
      class: {
        system: 'http://terminology.hl7.org/CodeSystem/v3-ActCode',
        code: 'AMB',
        display: 'ambulatory'
      },
      subject: { reference: `Patient/${patientId}` },
      participant: [{
        individual: { reference: `Practitioner/${DR_SOPHIA_ID}` }
      }],
      serviceProvider: {  // ✅ REQUIRED!
        reference: `Organization/${PRACTICE_ID}`
      },
      period: {
        start: new Date(Date.now() - 30*60000).toISOString(),
        end: new Date().toISOString()
      }
    })
  }
);
const encounter = await encounterResponse.json();
const encounterId = encounter.id;

Step 3: Append SOAP Notes (Phase 2)

const soapNotes = `
<div id="stamp">
  <div><strong>${new Date().toLocaleString('en-AU')}</strong></div>
  <div><strong>Dr. Sophia AI - Consultation Notes</strong></div>
</div>
<p><strong>Chief Complaint:</strong> Headaches for 3 months</p>
<p><strong>Subjective:</strong> Patient reports...</p>
<p><strong>Objective:</strong> BP 145/92...</p>
<p><strong>Assessment:</strong> Uncontrolled hypertension</p>
<p><strong>Plan:</strong> Adjust medication...</p>
`;

const noteResponse = await fetch(
  `https://api.medirecords.com/v1/patients/${patientId}/consults/${encounterId}/consultnote/append`,
  {
    method: 'POST',
    headers: {
      'Authorization': `Bearer ${REST_TOKEN}`,  // ✅ Different token!
      'Content-Type': 'application/json'
    },
    body: JSON.stringify({ consultNote: soapNotes })
  }
);

What Works vs What Doesn't

Feature Status Details
Create finished consultation ✅ Works Use FHIR API with status: "finished"
Append notes (unlimited) ✅ Works Use REST API within 1 hour
HTML formatting in notes ✅ Works Supports p, strong, div, ul, li, br, table
Multiple appends ✅ Works Can append multiple times within 1 hour
Create "in-progress" consult ❌ Blocked API returns HTTP 409 error
Update consult status ❌ No endpoint Cannot change status after creation
Update/replace notes ❌ No endpoint Can only append, not edit

Detailed Documentation

For complete API credentials, FHIR schemas, and troubleshooting guide, see:

Testing

Run integration test script:

cd .claude/skills/medirecords-integration
./scripts/test-consultation.sh willie@adaptation.io

Expected output:

✅ Encounter created: [encounter-id]
✅ Notes appended: [note-id]
✅ Consultation visible in MediRecords UI

Integration with Dr. Sophia AI

Add to backend consultation handler (/backend/backend-proxy-enhanced-current.js):

// After consultation completes and SOAP notes extracted
if (req.body.patientIdentifier && shouldSaveToMedirecords(aiResponse)) {
  try {
    const consultationData = {
      chiefComplaint: extractedData.chiefComplaint,
      subjective: extractedData.subjective,
      objective: extractedData.objective,
      assessment: extractedData.assessment,
      plan: extractedData.plan,
      prescriptions: extractedData.prescriptions
    };

    const result = await createDrSophiaConsultationWithNotes(
      req.body.patientIdentifier,
      consultationData
    );

    console.log(`✅ Consultation saved: ${result.encounterId}`);
  } catch (error) {
    console.error('❌ Failed to save consultation:', error);
    // Don't fail the response - consultation still worked
  }
}

Common Issues Quick Reference

Error Cause Fix
HTTP 409 Status "in-progress" Change to "finished"
HTTP 500 Missing serviceProvider Add practice Organization reference
HTTP 400 (notes) >1 hour since endTime Use recent timestamps
Notes don't appear Wrong token for append Use REST token (not FHIR)
HTML not rendering Unsupported tags Use only: p, strong, div, ul, li, br, table

Verified Test Results

Patient: Willie Prosek (willie@adaptation.io) Last Verified: October 22, 2025 at 8:17 PM Encounters Created: 3+ consultations Notes Appended: Multiple times per consultation UI Verification: ✅ All consultations visible in MediRecords HTML Formatting: ✅ Preserved correctly Character Limit: ✅ Tested up to 1,975 characters


Status: Production-ready, fully tested API Version: FHIR v1 + REST v1 Test Patient: willie@adaptation.io Last Updated: October 22, 2025