Lookout

Lookout

Ambient health radar. Lookout reads where the user is right now, fuses environmental + place + neighborhood SDoH data with their FHIR record, and surfaces only the items that matter for them. A weather app says "AQI 142." Lookout says "ozone is high, you have asthma on file, want an indoor option?"

When to Use

✅ Use when:

• The user says "lookout for me" or any natural variant ("how's the air today?", "where can I work out right now?", "anything I should know today?", "what's [ZIP] like for me?")
• The configured daily briefing time fires
• The user asks about open-now resources (gym, pharmacy, urgent care, grocery, park) tied to their health
• The user asks about a neighborhood's SDoH overlay for travel or relocation

When NOT to Use

❌ Don't use when:

• The user wants a clinical interpretation of a PDF → use med-pdf
• The user wants to connect/refresh their patient portal → use health-records
• The user wants a drafted clinician message → use epic-note
• A request would diagnose, recommend treatment, or adjust a medication
• A request would produce billing, payor, prior-auth, EOB, or coding content (CPT/HCPCS/HCC). SDoH Z codes are the only codes used, and only as clinical context.

Setup

1. Init the store. python3 {baseDir}/scripts/init_db.py

• Creates ~/.openclaw/workspace/.lookout-cache/lookout.db from schema.sql.
• Seeds only tenant-neutral preferences (imperial, 07:30 briefing, 22:00–07:00 quiet hours). Re-running is safe.

1. Configure location. Onboarding or the user profile must create one location row with is_default = 1 and latitude/longitude before fetch runs. Location is user data; don't hard-code it in the skill.
2. Install Python dependency. Ensure httpx is available to Python (python3 -m pip install httpx or the distro/package-manager equivalent).
3. Optional keys. Lookout runs end-to-end with no keys. For richer data:

• AIRNOW_API_KEY — US AQI by lat/lon (free key from AirNow).
• GOOGLE_PLACES_API_KEY — open-now resources layer (paid).
• LOOKOUT_NWS_UA — descriptive User-Agent for api.weather.gov.

Workflow

1. Fetch — python3 {baseDir}/scripts/fetch_environment.py

• Reads the default location row, calls NWS (alerts + current weather), Open-Meteo (pressure + trend, temp, humidity), and EPA UV (data.gov). No keys required.
• Inserts rows into environment_reading and alert with raw_source_id for traceability. AirNow + Google Places stay stubbed until keyed.
• Cache dir: ~/.openclaw/workspace/.lookout-cache/.

1. Read the patient's record from the local FHIR store:

• Active Condition (clinical-status active)
• Active MedicationStatement
• Recent Observation (category laboratory) — most recent values

1. Triage. Map record signals to ambient signals (asthma/COPD → ozone, PM2.5, smoke; photosensitizing meds → UV; HF or diuretic → heat index; migraine → pressure drop; recent low vitamin D → moderate UV; depression/SAD → daylight; OA → cold/damp/falling pressure). If nothing matches a signal, stay silent about it. Silence about clean air is a feature.

1. Brief. Lead with what matters for this patient. Plain language first, clinical term in parens where it adds clarity. Every health-relevant item ends in an option or a question, never a directive. Tag as informational, not medical advice. Urgent items (severe-asthma + air quality emergency, HF + extreme heat) go first and prominently, with a pointer to the care team.

1. Persist.

• Durable, health-relevant readings → FHIR Observation (environmental-exposure category, UCUM unit, derivedFrom/note back to source).
• SDoH context → Observation social-history with the relevant ICD-10 Z code where one applies. Feeds Tula's SDoH pipeline.
• Path: ~/.openclaw/workspace/tula/fhir/Observation/environmental/ and the existing social-history location.
• Briefing summary → briefing table with source_reading_ids for traceability.

Scripts

• scripts/init_db.py — apply schema.sql and seed tenant-neutral preferences. Idempotent. It does not seed a location.
• scripts/fetch_environment.py — deterministic fetch. No PHI ever leaves the VM — only lat/lng or ZIP reach the providers. Run on a schedule or before a briefing.

Privacy

Lookout sends only a location (lat/lng or ZIP) to public data providers. Conditions, medications, labs never leave the VM. The personalized triage runs through Tula's configured model path (HIPAA-eligible hosted tier, or local open-weight model for air-gapped operation).

• Cache stays under ~/.openclaw/workspace/.lookout-cache/. Don't copy out.
• No environmental provider ever sees PHI.
• Location is sensitive — stored locally only.

Safety

• Not a medical device. Surfaces data and questions; never names a diagnosis, recommends treatment, or adjusts a medication.
• No hallucinated values. Every value surfaced maps to a row with a raw_source_id. If a fetch failed or a value is stale, say so — don't guess.
• Show the full informational-only notice once at onboarding; carry a short standing tag on health-relevant outputs.
• Escalation: urgent items first and prominently, with a pointer to the care team. Open-core counterpart to Aria's configurable escalation policy.

Notes

• v1 scope: NWS, Open-Meteo, EPA UV, AirNow (keyed), Places (keyed), CDC PLACES + SVI overlay, daily briefing, on-demand queries, FHIR Observation logging.
• Later: pollen species, respiratory-virus surveillance, wildfire smoke, water advisories, radon, polished travel/relocation mode, correlation insight, wearable cross-reference.
• Endpoints and field names reflect provider behavior as of early 2026 — verify against current provider docs before depending on a field name.

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.