# Med Pdf

> 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 rep…

- **Type:** Skill
- **Install:** `agentstack add skill-realactivity-tula-med-pdf`
- **Verified:** Yes — security-reviewed for prompt injection and unsafe behavior
- **Seller:** [realactivity](https://agentstack.voostack.com/s/realactivity)
- **Installs:** 0
- **Category:** [Content & Media](https://agentstack.voostack.com/c/content-and-media)
- **Latest version:** 0.1.0
- **License:** Apache-2.0
- **Upstream author:** [realactivity](https://github.com/realactivity)
- **Source:** https://github.com/realactivity/tula/tree/main/skills/med-pdf

## Install

```sh
agentstack add skill-realactivity-tula-med-pdf
```

Requires the [AgentStack CLI](https://agentstack.voostack.com/docs/cli). Works with Claude Code, Cursor, and any MCP-compatible agent.

## About

# 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`](references/profile-schema.md#where-the-profile-lives)
(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  `
   - `outDir` must be inside `~/.openclaw/workspace/`. Suggested:
     `~/.openclaw/workspace/.med-pdf-cache//`.
   - 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 `
   - Labs -> `node {baseDir}/scripts/parse_labs.mjs `
   - 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`](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`](references/scripts.md) for per-script flags,
output schemas, and dictionary maintenance for `parse_labs.mjs`.

## Examples

See [`references/examples.md`](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`](references/scripts.md#maintaining-the-dictionary).
- `hasText: true` but parsing yields garbage -> PDF has hidden Unicode
  ligatures; force OCR with `--images-only`.

## Source & license

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

- **Author:** [realactivity](https://github.com/realactivity)
- **Source:** [realactivity/tula](https://github.com/realactivity/tula)
- **License:** Apache-2.0

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

## Pricing

- **Free** — Free

## Security capabilities

Automated source analysis of v0.1.0 — what this tool can access:

- **Network access:** no
- **Filesystem access:** no
- **Shell / process execution:** no
- **Environment & secrets:** no
- **Dynamic code execution:** no

*"Yes" means the capability is present in the source — more access means more to trust, not that it is unsafe.*


## Versions

- **0.1.0** — security scan: passed — Imported from the upstream source.

## Links

- Listing page: https://agentstack.voostack.com/l/skill-realactivity-tula-med-pdf
- Seller: https://agentstack.voostack.com/s/realactivity
- Browse the marketplace: https://agentstack.voostack.com/browse

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Listed on AgentStack — the marketplace for AI agent skills and MCP servers. Every listing is security-reviewed. Creators keep 70%.