healthex-export

HealthClaw HealthEx Export

scripts/export_healthex.py automates the full pipeline from local HealthClaw FHIR store → de-identified, Curatr-pre-tagged FHIR R4 transaction Bundle.

Replaces the manual Claude session pull for personal health data export.

Quick Start

# Basic export — all clinical resource types for a tenant
python scripts/export_healthex.py --tenant-id ev-personal

# Export + immediately import into a second tenant
python scripts/export_healthex.py \
    --tenant-id ev-personal \
    --import \
    --import-tenant ev-archive \
    --step-up-secret $STEP_UP_SECRET

# Preview what would be exported (no file written)
python scripts/export_healthex.py --tenant-id ev-personal --dry-run

# Export specific resource types
python scripts/export_healthex.py \
    --tenant-id ev-personal \
    --types Condition Observation AllergyIntolerance Immunization MedicationRequest

Output

Bundle written to exports/healthex-<YYYY-MM-DD>.json by default. Override with --output /path/to/file.json.

Format: FHIR R4 transaction Bundle ("type": "transaction") with PUT entries, ready for POST /Bundle/$ingest-context or direct use with import_healthex.py.

Resource Types Exported (default)

Type	Notes
Patient	De-identified: name/address/telecom removed, EHR identifiers stripped
Condition	Full — diagnoses, clinical/verification status, onset/abatement
Observation	Full — labs, vitals, social history (smoking, BMI, etc.)
AllergyIntolerance	Full
Immunization	Full
MedicationRequest	Full
Procedure	Full
DiagnosticReport	Full
CarePlan	Full
Coverage	Full
Encounter	Full

Pass --types <ResourceType> ... to limit to a subset.

De-identification

Applied automatically (skip with --no-deidentify).

Removed from Patient:

• name — full name
• address — street, city, state, zip
• telecom — phone, email
• photo — base64 images
• contact — emergency contacts
• OID-namespaced identifiers (EHR-internal MRNs, Epic IDs, CEID, EID, EMPI, etc.)

Preserved:

• birthDate — full date (patient-controlled export; use $deidentify for Safe Harbor)
• gender
• communication — language preferences
• A synthetic urn:healthclaw:patient/<uuid> identifier is injected

Other resource types are exported as-is — they contain clinical observations and codes, not patient demographics.

For HIPAA Safe Harbor de-identification (birthDate truncated to year, zip to 3 digits), call POST /r6/fhir/Patient/:id/$deidentify before export, or use the phi-redaction skill after import.

Curatr Pre-Tags

Applied automatically (skip with --no-pretag).

Scans the export bundle for known data quality patterns and injects FHIR extensions — without modifying stored resources. The tags exist only in the exported bundle and serve as hints for a subsequent Curatr evaluation.

Tag code	Trigger	Action recommended
smoking_contradiction	LOINC 72166-2 observations with conflicting SNOMED codes (e.g. "Never smoked" + "Ex-smoker" in same tenant)	Run curatr_apply_fix with patient attestation
h_flag_titer	Observation with interpretation.code of H/HH/HU, or valueString starting with "H"	Clinical review; consider flagging for provider
missing_result	Observation with no value[x] element	Verify whether result is pending, cancelled, or truly missing

Pre-tags are FHIR extensions at: https://healthclaw.example.org/fhir/StructureDefinition/curatr-pretag

Each extension carries a valueCodeableConcept with the tag code and display text.

Reading Pre-Tags After Import

# Find all observations with Curatr pre-tags
curl -s "http://localhost:5000/r6/fhir/Observation?_count=200" \
  -H "X-Tenant-ID: ev-archive" \
  | python3 -c "
import json, sys
b = json.load(sys.stdin)
url = 'https://healthclaw.example.org/fhir/StructureDefinition/curatr-pretag'
for e in b.get('entry', []):
    r = e['resource']
    tags = [
        ext['valueCodeableConcept']['coding'][0]['code']
        for ext in r.get('extension', [])
        if ext.get('url') == url
    ]
    if tags:
        print(r['id'][:40], tags)
"

Full Pipeline: HealthEx → Local FHIR Store

The complete automated flow replaces the previous manual Claude session pull:

1. Patient data arrives via Fasten Connect webhook → ingested to tenant T
2. export_healthex.py --tenant-id T --import --import-tenant T-archive
   ├── Fetches all resources via REST API (paginated)
   ├── Strips EHR identifiers + PII (de-identification)
   ├── Pre-tags Curatr issue patterns
   └── POSTs bundle to /Bundle/$ingest-context for tenant T-archive
3. AI agent (MCP) queries T-archive for Curatr evaluation
4. curatr_apply_fix applied for patient-approved corrections
5. AuditEvent trail shows full chain: ingest → redact → evaluate → fix

Arguments Reference

Flag	Default	Description
--tenant-id	desktop-demo	Source tenant to export from
--base-url	http://localhost:5000/r6/fhir	HealthClaw FHIR base URL
--types	Full clinical set	Space-separated list of FHIR resource types
--output	exports/healthex-<date>.json	Output bundle file path
--import	off	Run import_healthex.py after export
--import-tenant	same as --tenant-id	Tenant to import the bundle into
--step-up-secret	$STEP_UP_SECRET env	HMAC secret (required with --import)
--no-deidentify	off	Skip de-identification
--no-pretag	off	Skip Curatr pre-tagging
--dry-run	off	Print counts only, do not write file

Related Scripts

Script	Purpose
scripts/import_healthex.py	Import a FHIR bundle into HealthClaw with step-up auth
scripts/convert_fasten.py	Convert Fasten Health export format to FHIR transaction Bundle

Related Skills

• fhir-r6-guardrails — Stack setup and MCP tool reference
• curatr — Evaluate and fix data quality issues in exported records
• phi-redaction — HIPAA Safe Harbor de-identification (stricter than patient-controlled)
• fasten-connect — Patient-authorized EHR ingestion (upstream of this export)