Connect to real FHIR servers through the MCP guardrail proxy. Use when: (1) Connecting to HAPI FHIR, SMART Health IT, or Epic sandbox servers, (2) Proxying AI agent requests to production EHR systems with guardrails, (3) Ensuring upstream server URLs never leak to clients, (4) Understanding how redaction, audit, and step-up auth apply to upstream data.
npx claudepluginhub aks129/healthclawguardrails --plugin healthclaw-guardrailsThis skill uses the workspace's default tool permissions.
Connect to real FHIR servers while keeping the full MCP guardrail stack active.
HealthClaw Guardrails (healthclaw.io) — FHIR agent guardrails for clinical data access via MCP. Supports FHIR R4 US Core v9 (stable) and FHIR R6 ballot3 (experimental). Use when: (1) Reading patient data through MCP tools with automatic PHI redaction, (2) Writing clinical resources with two-phase propose/commit and step-up authorization, (3) Querying observation statistics or recent lab results, (4) Evaluating R6 Permission resources for access control decisions, (5) Auditing agent access to healthcare data. 14 MCP tools.
Guides FHIR R4 API development: REST endpoints for Patient/Observation/Encounter/Condition/MedicationRequest, resource validation with HTTP status codes, SMART on FHIR OAuth, Bundles/transactions/search.
Sets up local Abridge dev environment with HAPI FHIR server via Docker, synthetic patient data, and TypeScript config for clinical AI/EHR workflow testing.
Share bugs, ideas, or general feedback.
Connect to real FHIR servers while keeping the full MCP guardrail stack active.
Client -> MCP Server -> Flask (guardrails) -> Upstream FHIR Server
|
redaction, audit, step-up,
tenant isolation, disclaimers,
URL rewriting
Set the FHIR_UPSTREAM_URL environment variable to enable proxy mode:
# HAPI FHIR R4 (open, no auth)
FHIR_UPSTREAM_URL=https://hapi.fhir.org/baseR4 python main.py
# SMART Health IT (open, no auth)
FHIR_UPSTREAM_URL=https://r4.smarthealthit.org python main.py
# HAPI FHIR R5 (open, no auth)
FHIR_UPSTREAM_URL=https://hapi.fhir.org/baseR5 python main.py
# Local HAPI instance
FHIR_UPSTREAM_URL=http://localhost:8080/fhir python main.py
# Docker Compose with upstream
FHIR_UPSTREAM_URL=https://hapi.fhir.org/baseR4 docker-compose up -d --build
| Variable | Default | Description |
|---|---|---|
FHIR_UPSTREAM_URL | (empty) | Upstream FHIR server base URL. Enables proxy when set. |
FHIR_UPSTREAM_TIMEOUT | 15 | HTTP timeout for upstream requests (seconds) |
FHIR_LOCAL_BASE_URL | (empty) | Local server URL for URL rewriting in responses |
Fetched from upstream, then redacted + audited + disclaimers added. The agent never sees unredacted upstream data.
All query parameters forwarded to upstream. Results redacted per entry. Upstream's full search capabilities are available (chaining, _include, etc.).
Validated locally first (structural checks), then forwarded to upstream with step-up auth verification. Both local and upstream audit records created.
All upstream server URLs in responses are replaced with local proxy URLs. The agent and client never see the upstream server's hostname or paths.
/r6/fhir/health reports upstream connection status including FHIR version
and server software name.
Network errors return proper FHIR OperationOutcome responses, not stack traces.
| Server | URL | Auth | Status |
|---|---|---|---|
| HAPI FHIR R4 | https://hapi.fhir.org/baseR4 | None | Tested |
| SMART Health IT | https://r4.smarthealthit.org | None | Tested |
| HAPI FHIR R5 | https://hapi.fhir.org/baseR5 | None | Tested |
| Local HAPI | http://localhost:8080/fhir | None | Tested |
| Epic Sandbox | https://open.epic.com/Interface/FHIR | OAuth 2.0 | Limited |
The proxy uses httpx for HTTP client operations with:
application/fhir+json accept headerHealthClaw-Guardrails/1.0.0URL rewriting is recursive — it traverses the entire response JSON tree and replaces all occurrences of the upstream URL with the local proxy URL.