Epic Note

epic-note

When to Use

✅ Use when:

• The user asks for help drafting a message to their PCP or specialist
• Reporting a new or worsening symptom
• Asking about a recent test or lab result
• Requesting a medication refill
• Following up after a visit, procedure, or referral

When NOT to Use

❌ Don't use when:

• Symptoms suggest an emergency - return the 911 redirect from

[references/triage-rules.md](references/triage-rules.md), don't draft

• Generating a clinician-facing note (SOAP, discharge, dictation)
• Drafting non-clinical letters (insurance, billing)
• The user is asking a medical question for advice - that's answered directly,

not in a portal message

Setup

Profile. Resolve from the precedence in [references/profile-schema.md](references/profile-schema.md#where-the-profile-lives) (skill config -> env var -> ~/.openclaw/workspace/memory/profile.yaml). Use care_team.pcp.display_name as the default greeting recipient when the user doesn't name a clinician. The skill never contains the profile.

Workflow

1. Triage first. Scan input for red-flag symptoms. If present, do NOT

draft - return the 911 redirect text from [references/triage-rules.md](references/triage-rules.md).

1. Identify the single ask. If multiple unrelated topics exist, propose

separate messages and ask the user which to send first.

1. Draft using the canonical format in

[references/portal-message-format.md](references/portal-message-format.md): Subject: line with urgency, greeting, one-sentence ask, 2-4 sentences of context, optional bullet data, sign-off.

1. Word budget. Aim for ≤150 words; hard cap 220. Front-load the ask.

Plain language. No self-diagnosis, no filler praise, no PHI of others.

1. Output is copy-paste ready. No explanations or meta-commentary

wrapped around the message - just the message itself.

Examples

See [references/examples.md](references/examples.md) for worked input/output pairs (medication side effect, lab follow-up, refill request, multi-topic split).

Privacy

Portal messages travel through health-system networks under HIPAA. Tula generates drafts locally - no PHI leaves the workspace.

• Don't include PHI of family members or third parties.
• The draft stays in the conversation. Never auto-send.
• Don't paste clinician/patient identifiers into web search or external

services for "verification."

Troubleshooting

• No clinician name given -> use care_team.pcp.display_name from the

profile, or Hello [Care Team], if none resolves.

• Vague input -> ask one clarifying question (onset, severity, which

clinician), then draft.

• User asks for medical advice -> decline politely; this skill drafts

messages to clinicians, not answers from them.

• Multi-topic input -> propose separate messages, don't bundle.
• Emergency-flavored prompt -> return triage redirect; never wrap a

drafted message around it.

Source & license

This open-source skill is cataloged on AgentStack and links to its original source — we do not rehost the code.

• Author: realactivity
• Source: realactivity/tula
• License: Apache-2.0

Install and usage instructions live in the source repository linked above.