med-pdf

name	med-pdf
description	Reads medical PDFs (labs, radiology, MyChart/Epic exports, discharge summaries, pathology) and turns them into structured JSON Tula can reason over. Personal data is referenced from an external profile file, never embedded. USE FOR: the user sharing a health-related PDF, image, or screenshot, or asking to compare results across visits. DO NOT USE FOR: non-medical PDFs, generating new clinical reports, or sending PHI outside the workspace.
metadata	{"openclaw":{"emoji":"🩺","requires":{"bins":["node"]}}}

med-pdf

When to Use

✅ Use when:

• The user sends a medical PDF (labs, radiology, discharge, pathology)
• The user shares a screenshot/image of clinical results
• The user asks to compare results across visits or trend a value
• A MyChart/Epic export needs parsing before reasoning

When NOT to Use

❌ Don't use when:

• The PDF is non-medical (insurance, EOB, billing)
• The user wants to author a clinical message -> use epic-note
• Anything that would send PHI outside the workspace

Setup

Profile. Resolve from the precedence in references/profile-schema.md (skill config -> env var -> ~/.openclaw/workspace/memory/profile.yaml). Use identity.short_name when addressing the user in summaries. The skill never contains the profile.

Workflow

1. Extract - node {baseDir}/scripts/extract.mjs <input.pdf> <outDir>

   • outDir must be inside ~/.openclaw/workspace/. Suggested: ~/.openclaw/workspace/.med-pdf-cache/<slug>/.
   • Outputs text.txt, pageN.png, meta.json. Stdout JSON has numPages, hasText, textChars.

2. Branch on hasText:

   • true -> skip OCR, feed text.txt to parsers.
   • false -> image-only (MyChart/Epic). Use the image tool on pageN.png for verbatim transcription. Save as text.txt, continue.

3. Parse:

   • Imaging -> node {baseDir}/scripts/parse_imaging.mjs <outDir>
   • Labs -> node {baseDir}/scripts/parse_labs.mjs <outDir>
   • Both can run on a mixed document.

4. Reason. Pull abnormal flags, compare to prior values, surface what matters for healthspan - see references/healthspan-priorities.md. Don't just summarize.

5. Persist. Append to ~/.openclaw/workspace/memory/YYYY-MM-DD.md and update trends in MEMORY.md. PHI stays in workspace memory only.

Scripts

See references/scripts.md for per-script flags, output schemas, and dictionary maintenance for parse_labs.mjs.

Examples

See references/examples.md for end-to-end runs (text-extractable Quest/LabCorp PDF, image-only MyChart CT export).

Privacy

Medical PDFs contain PHI (name, DOB, MRN, providers).

• Cache stays under ~/.openclaw/workspace/.med-pdf-cache/. Don't copy out.
• Never send raw PDFs or PHI to web search or external services.
• The image tool is acceptable - same trust boundary as the assistant.
• Redact MRN if a summary might leave the workspace.

Troubleshooting

• parse_labs.mjs returns mostly unmatchedLines -> text wasn't transcribed well. Re-run extract.mjs with --scale=3.0 and re-OCR.
• A labeled value sits in unmatchedLines -> add an alias to the dictionary in parse_labs.mjs. See references/scripts.md.
• hasText: true but parsing yields garbage -> PDF has hidden Unicode ligatures; force OCR with --images-only.