MARKET: Healthcare — Patient Intake Processing

examples/40-market-healthcare.halo policies |* parallel |! people
Automate insurance verification, triage, and clinical note generation while enforcing HIPAA compliance
halo
// ============================================================
// MARKET: Healthcare — Patient Intake Processing
// PURPOSE: Automate insurance verification, triage, and clinical
//          note generation while enforcing HIPAA compliance
// ============================================================

// --- Policies (HIPAA-grade) ---
policy HIPAA          : Redact(SSN) & Redact(DateOfBirth) & Redact(MedicalRecordNumber)
policy PHIProtection  : Redact(HealthData) & Redact(InsuranceID)
policy ClinicalSafety : Block(DiagnosisClaim) & Block(PrescriptionAdvice)
policy AuditTrail     : LogViolation("hipaa-audit.log")
policy CostGuard      : MaxSpend(1.00)

// --- Tools ---
tool EHR           : REST("api.epic.com/FHIR/R4", apiKey: Env.EPIC_KEY)
tool InsuranceAPI  : REST("api.availity.com/v1/coverages", apiKey: Env.AVAILITY_KEY)
tool ClinicSlack   : POST("hooks.slack.com/services/intake-alerts")

// --- Store ---
tool PatientHistory : VectorStore(Env.PINECONE_KEY, namespace: "patient-notes")
tool ProtocolDB     : VectorStore(Env.PINECONE_KEY, namespace: "clinical-protocols")

// --- Struct ---
schema IntakeResult {
  patient_id     : String
  insurance_status : String
  triage_level   : String
  clinical_note  : String
  followup_actions : Array
}

// --- Agents ---
agent IntakeBot [openai/gpt-4o-mini, temp: 0.0]
  equips InsuranceAPI, EHR
  requires HIPAA, PHIProtection, ClinicalSafety, AuditTrail, CostGuard

agent ClinicalScribe [anthropic/claude-sonnet-4, temp: 0.1]
  equips PatientHistory, ProtocolDB
  requires HIPAA, PHIProtection, ClinicalSafety, AuditTrail

// --- The Pipeline ---
@timeout(3m)
@retry(2, 10s)
pipeline ProcessIntake(form: PatientForm) -> IntakeResult:
  form
    // Step 1: Fan-out — verify insurance and pull patient history simultaneously
    |* {
         IntakeBot.verify_insurance(
           tool: InsuranceAPI,
           member_id: context.data.form.insurance_id,
           provider_npi: context.data.form.provider_npi
         ),
         IntakeBot.pull_chart(
           tool: EHR,
           patient_id: context.data.form.patient_id,
           sections: ["allergies", "medications", "conditions"]
         )
       }

    // Step 2: Triage based on chief complaint + history
    |> IntakeBot.triage(
         chief_complaint: context.data.form.chief_complaint,
         vitals: context.data.form.vitals,
         history: context.data.pull_chart
       )

    // Step 3: Gate — immediate escalation for critical triage
    |? (context.data.triage.level == "critical")
    |> ClinicSlack.post(
         message: "🚨 CRITICAL INTAKE — immediate provider needed",
         patient_id: context.data.form.patient_id,
         triage: context.data.triage
       )

    // Step 4: Generate structured clinical note
    |> ClinicalScribe.draft_note(
         intake_form: context.data.form,
         insurance: context.data.verify_insurance,
         chart: context.data.pull_chart,
         triage: context.data.triage
       )

    // Step 5: Human sign-off — clinician must review before it enters the chart
    |! yield(
         ClinicSlack,
         context.data.draft_note,
         [context.data.triage, context.data.verify_insurance],
         30m
       )
    ~> listen(ClinicSlack.Reaction)
MARKET: Healthcare — Patient Intake Processing ​

MARKET: Healthcare — Patient Intake Processing
