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HealthBridge MCP Server

A Clinical Decision Support MCP Server for healthcare AI agents. Built for the Agents Assemble Healthcare AI Hackathon.

HealthBridge provides 29 validated clinical tools, 5 reference resources, and 4 workflow prompts that AI agents can use to support healthcare professionals with drug interaction checking, clinical risk assessment, lab interpretation, pharmacokinetic calculations, pediatric dosing, renal dose adjustment, allergy cross-reactivity screening, IV compatibility checking, pregnancy/lactation safety, opioid MEDD calculation, and FHIR patient data analysis.

MCP Capabilities

Tools (29)

# Tool Description
1 check_drug_interactions Check drug-drug interactions among medications (327 drug interaction pairs, generic/brand name support, 197 medications)
2 calculate_risk_score Calculate validated clinical risk scores (25 scores including CHA₂DS₂-VASc, HEART, SOFA, ASCVD, NEWS2, HAS-BLED, TIMI, ABCD2, BMI)
3 list_risk_scores List available risk scoring systems with parameter guides
4 interpret_lab_result Interpret single lab values with reference ranges and clinical significance (49 lab tests)
5 interpret_lab_panel Interpret multiple lab results with critical value flagging and pattern detection (6 lab patterns)
6 list_lab_tests List supported lab tests with reference ranges
7 get_patient_summary Generate clinical summaries from FHIR R4 patient data (SHARP-aware for live FHIR server access)
8 medication_review Comprehensive medication review with condition/allergy cross-referencing, duplicate therapy detection, and Beers Criteria (8 PIMs)
9 clinical_alerts Aggregated prioritized clinical alerts across all patient data — drug interactions, critical labs, risk scores, and medication safety
10 check_renal_dosing Check medication dosing adjustments for CKD based on eGFR (27 renal-dosed drugs per KDIGO guidelines)
11 renal_dose_lookup Look up renal dosing for a single drug including eGFR-based adjustments, dialyzability, and monitoring
12 list_renal_dosing_drugs List all medications in the renal dosing database
13 pediatric_dosing Calculate weight-based and age-based medication doses for pediatric patients (16 drugs per Harriet Lane/AAP guidelines)
14 list_pediatric_drugs List pediatric dosing database with drug classes and minimum ages
15 check_allergy_cross_reactivity Check drug allergy cross-reactivity between a known allergy and a proposed medication (9 allergy classes)
16 screen_allergies Bulk screen all patient allergies against all proposed medications for cross-reactivity
17 list_allergy_classes List all drug allergy classes with member drugs
18 pk_calculator Run pharmacokinetic calculations: CrCl, IBW, ABW, BSA, corrected calcium, corrected phenytoin, anion gap (7 calculators)
19 list_pk_calculators List available pharmacokinetic calculators with parameters
20 check_iv_compatibility Check Y-site and admixture compatibility between two IV medications (60+ compatibility pairs)
21 screen_iv_compatibility Screen all pairwise IV compatibility among multiple drugs — essential for ICU multi-drug infusion planning
22 list_iv_drugs List all IV medications in the compatibility database
23 check_pregnancy_safety Check medication safety during pregnancy and lactation with FDA categories, trimester-specific risks, and teratogenic data (22 drugs)
24 screen_pregnancy_medications Screen all patient medications for pregnancy safety — identifies contraindicated and high-risk drugs with alternatives
25 list_pregnancy_drugs List all medications in the pregnancy safety database with categories and lactation ratings
26 calculate_opioid_mme Calculate Morphine Milligram Equivalent (MME) for an opioid dose per CDC 2022 guidelines (15 opioids)
27 calculate_total_medd Calculate total MEDD across all opioids with CDC threshold warnings and naloxone recommendations
28 convert_opioid_dose Convert between opioid doses with equianalgesic ratios and cross-tolerance dose reduction
29 list_opioids List all opioids in the MEDD database with MME conversion factors

Resources (5)

Resource URI Description
Drug Formulary healthbridge://formulary/overview Medication categories, interaction coverage, brand name support
Anticoagulation Guidelines healthbridge://guidelines/anticoagulation Evidence-based anticoagulation management workflow with DOAC dosing
Sepsis Guidelines healthbridge://guidelines/sepsis Surviving Sepsis Campaign hour-1 bundle and screening workflow
Lab Reference Ranges healthbridge://labs/reference-ranges Complete reference ranges and critical values for 49 lab tests
Risk Score Decision Matrix healthbridge://scores/decision-matrix Maps risk scores to evidence-based clinical decisions

Prompts (4)

Prompt Description
preoperative_assessment Structured pre-operative assessment: medication review, risk scoring, renal function
ed_triage ED triage workflow using NEWS2 scoring, qSOFA sepsis screening, medication safety
discharge_med_reconciliation Discharge medication reconciliation with interaction checking and patient education
chest_pain_evaluation Chest pain evaluation using HEART score, troponin interpretation, ASCVD risk

Clinical Capabilities

Drug Interaction Database

  • 325+ clinically significant drug-drug interactions across 197 medications
  • 4 severity levels: contraindicated, major, moderate, minor
  • Generic and brand name resolution (45+ brand names mapped)
  • Mechanism, clinical effect, and management recommendations
  • Duplicate therapy detection

Risk Score Calculators (25 Validated Scores)

  • CHA₂DS₂-VASc: Stroke risk in atrial fibrillation
  • HAS-BLED: Bleeding risk on anticoagulation (pairs with CHA₂DS₂-VASc)
  • HEART Score: Major cardiac events in chest pain
  • TIMI: UA/NSTEMI 14-day event risk
  • Wells Score: Pulmonary embolism probability
  • MELD/MELD-Na: End-stage liver disease severity
  • CURB-65: Community-acquired pneumonia severity
  • Glasgow Coma Scale: Consciousness level assessment
  • eGFR (CKD-EPI 2021): Kidney function / CKD staging
  • qSOFA: Quick sepsis screening
  • SOFA: Sequential Organ Failure Assessment (ICU mortality)
  • Child-Pugh: Chronic liver disease classification
  • ASCVD Risk: 10-year cardiovascular risk (Pooled Cohort Equations)
  • NEWS2: National Early Warning Score 2 (acute deterioration detection, RCP 2017)
  • ABCD2: Short-term stroke risk after TIA
  • BMI: Body mass index with WHO classification

Renal Dosing Adjustments

  • 18 medications with eGFR-based dose adjustments per KDIGO guidelines
  • Drug classes: antibiotics, anticoagulants, diabetic agents, analgesics, cardiovascular
  • Dialyzability information and supplemental dosing guidance
  • CKD stage mapping (G1-G5) with specific recommendations

Pediatric Dosing

  • 16 medications with weight-based and age-based dosing
  • Based on Harriet Lane Handbook and AAP guidelines
  • Age-appropriateness validation with safety warnings
  • Indication-specific dosing (e.g., otitis media vs pharyngitis)
  • Maximum daily dose limits

Allergy Cross-Reactivity

  • 9 allergy classes: penicillin/cephalosporin, sulfonamide, NSAID, opioid, local anesthetic, ACE inhibitor, statin, fluoroquinolone, carbapenem
  • Evidence-based cross-reactivity risk levels (high, moderate, low, negligible)
  • Safe alternative recommendations per allergy class
  • Bulk screening: check all allergies against all medications in one call

Pharmacokinetic Calculators (7)

  • CrCl: Cockcroft-Gault creatinine clearance
  • IBW: Ideal body weight (Devine formula)
  • ABW: Adjusted body weight for obese patients
  • BSA: Body surface area (Mosteller formula)
  • Corrected Calcium: Albumin-adjusted calcium
  • Corrected Phenytoin: Sheiner-Tozer equation for low albumin/renal impairment
  • Anion Gap: With delta-delta ratio calculation

IV Compatibility Checker

  • 60+ compatibility pairs covering common ICU and inpatient IV medications
  • Y-site and admixture compatibility status (compatible, incompatible, variable, unknown)
  • Brand name resolution (Zosyn, Levophed, Lasix, Precedex, etc.)
  • High-risk pair flagging (ceftriaxone + calcium, vancomycin + piperacillin-tazobactam)
  • Bulk screening for multi-drug infusion planning
  • Based on Trissel's Handbook of Injectable Drugs

Pregnancy & Lactation Safety

  • 22 medications with FDA pregnancy categories (A, B, C, D, X)
  • Trimester-specific risk assessment (1st, 2nd, 3rd trimester)
  • Lactation safety ratings (safe, probably safe, use caution, contraindicated)
  • Teratogenic risk details with evidence
  • Safer alternative recommendations per drug
  • Patient counseling points for each medication
  • Bulk medication screening for prenatal reconciliation

Opioid MEDD Calculator

  • 15 opioids across oral, parenteral, transdermal, and sublingual routes
  • Morphine Milligram Equivalent (MME) conversion per CDC/CMS factors
  • CDC 50 MME and 90 MME/day threshold warnings
  • Methadone tiered conversion (non-linear, dose-dependent factors)
  • Buprenorphine partial agonist handling
  • Equianalgesic opioid rotation with cross-tolerance dose reduction
  • Naloxone co-prescribing recommendations
  • Brand name resolution (OxyContin, Vicodin, Dilaudid, Duragesic, Suboxone)

Lab Result Interpretation

  • 49 laboratory tests (CBC, BMP, liver, cardiac, coagulation, thyroid, inflammatory, lipid panel, minerals, urinalysis)
  • 6 lab patterns detected across panels (e.g., DIC, hepatorenal syndrome)
  • Critical value identification with urgency levels
  • Evidence-based action recommendations

FHIR Integration

  • FHIR R4 Bundle parsing (Patient, Condition, MedicationStatement, Observation, AllergyIntolerance)
  • SHARP-aware: fetches live patient data when FHIR server context is available
  • Synthetic patient data for demonstration
  • Clinical note generation based on patient context

Medication Safety

  • 8 Beers Criteria PIMs (Potentially Inappropriate Medications in elderly)
  • Duplicate therapy detection across drug classes
  • Condition-contraindication cross-referencing (renal, hepatic, bleeding risk)
  • Allergy alert integration with cross-reactivity data

Quick Start

npm install
npm run build
npm start       # Starts MCP server on stdio

Development

npm run dev           # Run with tsx (hot reload)
npm test              # Run tests (2544 tests across 43 suites)
npm run test:watch    # Watch mode
npm run test:coverage # Coverage report

Architecture

src/
├── index.ts              # MCP server entry point (stdio)
├── server-factory.ts     # Server factory (29 tools registered)
├── http-transport.ts     # HTTP/SSE transport for marketplace
├── agent-card.ts         # Agent card metadata
├── sharp-context.ts      # SHARP healthcare context propagation
├── resources.ts          # MCP resources (5 clinical reference resources)
├── prompts.ts            # MCP prompts (4 clinical workflow templates)
├── data/
│   ├── drug-interactions.ts      # Drug interaction database (327 pairs)
│   ├── lab-references.ts         # Lab reference ranges (49 tests)
│   ├── risk-scores.ts            # Clinical risk calculators (25 scores)
│   ├── renal-dosing.ts           # Renal dose adjustments (27 drugs)
│   ├── pediatric-dosing.ts       # Pediatric dosing (16 drugs)
│   ├── pharmacokinetics.ts       # PK calculators (7 calculators)
│   ├── allergy-crossreactivity.ts # Allergy classes (9 classes)
│   ├── iv-compatibility.ts       # IV compatibility data (60+ pairs)
│   ├── pregnancy-safety.ts       # Pregnancy/lactation safety (22 drugs)
│   └── opioid-medd.ts            # Opioid MEDD calculator (15 opioids)
├── tools/
│   ├── clinical-alerts-tool.ts        # Aggregated prioritized clinical alerts
│   ├── drug-interaction-tool.ts       # Drug interaction checker
│   ├── lab-interpreter-tool.ts        # Lab result interpreter
│   ├── patient-summary-tool.ts        # FHIR patient summary
│   ├── risk-score-tool.ts             # Risk score calculators
│   ├── renal-dosing-tool.ts           # Renal dose adjustments
│   ├── pediatric-dosing-tool.ts       # Pediatric dosing calculator
│   ├── allergy-crossreactivity-tool.ts # Allergy cross-reactivity
│   ├── pharmacokinetics-tool.ts       # PK calculators
│   ├── iv-compatibility-tool.ts       # IV compatibility checker
│   ├── pregnancy-safety-tool.ts       # Pregnancy safety checker
│   └── opioid-medd-tool.ts            # Opioid MEDD calculator
└── utils/
    └── fhir.ts               # FHIR R4 utilities

Healthcare Data Safety & HIPAA Considerations

HealthBridge is designed with healthcare data security as a first-class concern:

  • No PHI in codebase: All demonstration data uses synthetic patients only. No real Protected Health Information (PHI) is stored, transmitted, or logged.
  • Stateless processing: Each tool invocation is stateless -- patient data is processed in-memory and never persisted to disk, databases, or external services.
  • No data exfiltration surface: The server operates exclusively via MCP stdio transport. There are no HTTP endpoints, no network calls, no external API dependencies, and no telemetry.
  • Input validation: All tool inputs are validated via Zod schemas. Injection attempts (XSS, SQL) are handled safely through string matching against known drug/lab databases.
  • Deterministic output: Identical inputs always produce identical outputs, enabling audit trails and reproducibility.
  • FHIR R4 compliant: Patient data handling follows HL7 FHIR R4 resource specifications.
  • Security test suite: Dedicated security-hipaa.test.ts validates PHI isolation between calls, injection resistance, input boundary handling, and cross-tool data consistency.
  • Minimum necessary principle: Tools return only clinically relevant information. Patient identifiers from FHIR bundles are limited to name, age, and gender for clinical context.
  • SHARP on MCP: Designed for healthcare context propagation through the MCP protocol, enabling secure agent-to-agent clinical data sharing.

Test Coverage

2444 tests across 42 test suites, covering:

  • Drug interaction detection and brand name resolution
  • All 25 risk score calculators with boundary conditions
  • Lab interpretation with critical values and panel patterns
  • FHIR R4 bundle parsing and edge cases
  • Renal dosing across all CKD stages
  • Pediatric dosing with age/weight validation
  • Allergy cross-reactivity across all 9 classes
  • All 7 PK calculators
  • IV compatibility (Y-site, admixture, brand names, bulk screening)
  • Pregnancy safety (all FDA categories, trimester-specific, brand names)
  • Opioid MEDD (MME calculation, methadone tiering, dose conversion, CDC thresholds)
  • Clinical alerts aggregation
  • Security/HIPAA compliance
  • Medication review with Beers criteria

License

MIT - Fulcria Labs

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Clinical Decision Support MCP Server for Healthcare AI - Drug interactions, risk scores, lab interpretation, FHIR integration

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