Healthcare Eval Harness

affaan-m/ECC/docs/zh-CN/skills/healthcare-eval-harness

by affaan-mef648e01899ba3e8dc6371642deaaf64b4477775No license275K starsListed Oct 9, 2026Updated Oct 9, 2026Repository updated 4 days ago

用于医疗应用部署的患者安全评估工具。针对CDSS准确性、PHI暴露、临床工作流完整性和集成合规性的自动化测试套件。在安全故障时阻止部署。

Instructions onlySoftware Development DevOps & Cloud

AI-generated overview

Defines a five-category patient-safety test harness that gates deployment of healthcare applications on test pass rates.

What it does: This skill provides instructions for running a five-category evaluation suite for healthcare applications: CDSS accuracy, PHI exposure, data integrity, clinical workflows, and integration compliance. It specifies pass thresholds, with the first three categories requiring 100% and blocking deployment on any failure, and the remaining two requiring at least 95%. It also supplies example commands, a CI/CD workflow configuration, an anti-pattern list, and a sample evaluation report format.
When to use it: Use it before deploying an EMR/EHR application, after changing CDSS logic, patient-data schemas, or authentication and access control, and when configuring a healthcare CI/CD pipeline. It is also intended for resolving merge conflicts in clinical modules.
Requirements: An agent following the instructions; a JavaScript test runner such as Jest (the examples note other frameworks can be substituted), plus jq and bc for the pass-rate calculations in the shell examples. No scripts ship with the skill; the test suites themselves are not included.

医疗评估框架 — 患者安全验证

医疗应用部署的自动化验证系统。单个严重故障将阻止部署。患者安全不容妥协。

注意：示例使用 Jest 作为参考测试运行器。请根据您的框架（Vitest、pytest、PHPUnit 等）调整命令——测试类别和通过阈值与框架无关。

使用场景

部署任何 EMR/EHR 应用之前
修改 CDSS 逻辑（药物相互作用、剂量验证、评分）之后
更改涉及患者数据的数据库模式之后
修改身份验证或访问控制之后
配置医疗应用 CI/CD 流水线期间
解决临床模块合并冲突之后

工作原理

评估框架按顺序运行五个测试类别。前三个（CDSS 准确性、PHI 暴露、数据完整性）是严重关卡，要求 100% 通过率——单个故障即阻止部署。其余两个（临床工作流、集成）是高优先级关卡，要求 95% 以上通过率。

每个类别对应一个 Jest 测试路径模式。CI 流水线使用 --bail（首次失败即停止）运行严重关卡，并使用 --coverage --coverageThreshold 强制执行覆盖率阈值。

评估类别

1. CDSS 准确性（严重 — 要求 100%）

测试所有临床决策支持逻辑：药物相互作用对（双向）、剂量验证规则、临床评分与发布规范的对比、无假阴性、无静默故障。

2. PHI 暴露（严重 — 要求 100%）

测试受保护健康信息泄露：API 错误响应、控制台输出、URL 参数、浏览器存储、跨机构隔离、未认证访问、服务角色密钥缺失。

3. 数据完整性（严重 — 要求 100%）

测试临床数据安全：锁定就诊记录、审计追踪条目、级联删除保护、并发编辑处理、无孤立记录。

4. 临床工作流（高优先级 — 要求 95% 以上）

测试端到端流程：就诊生命周期、模板渲染、用药集、药物/诊断搜索、处方 PDF、红色警报。

bash

tmp_json=$(mktemp)npx jest --testPathPattern='tests/clinical' --ci --json --outputFile="$tmp_json" || truetotal=$(jq '.numTotalTests // 0' "$tmp_json")passed=$(jq '.numPassedTests // 0' "$tmp_json")if [ "$total" -eq 0 ]; then  echo "No clinical tests found" >&2  exit 1firate=$(echo "scale=2; $passed * 100 / $total" | bc)echo "Clinical pass rate: ${rate}% ($passed/$total)"

tmp_json=$(mktemp)npx jest --testPathPattern='tests/clinical' --ci --json --outputFile="$tmp_json" || truetotal=$(jq '.numTotalTests // 0' "$tmp_json")passed=$(jq '.numPassedTests // 0' "$tmp_json")if [ "$total" -eq 0 ]; then  echo "No clinical tests found" >&2  exit 1firate=$(echo "scale=2; $passed * 100 / $total" | bc)echo "Clinical pass rate: ${rate}% ($passed/$total)"

5. 集成合规性（高优先级 — 要求 95% 以上）

测试外部系统：HL7 消息解析（v2.x）、FHIR 验证、实验室结果映射、格式错误消息处理。

bash

tmp_json=$(mktemp)npx jest --testPathPattern='tests/integration' --ci --json --outputFile="$tmp_json" || truetotal=$(jq '.numTotalTests // 0' "$tmp_json")passed=$(jq '.numPassedTests // 0' "$tmp_json")if [ "$total" -eq 0 ]; then  echo "No integration tests found" >&2  exit 1firate=$(echo "scale=2; $passed * 100 / $total" | bc)echo "Integration pass rate: ${rate}% ($passed/$total)"

tmp_json=$(mktemp)npx jest --testPathPattern='tests/integration' --ci --json --outputFile="$tmp_json" || truetotal=$(jq '.numTotalTests // 0' "$tmp_json")passed=$(jq '.numPassedTests // 0' "$tmp_json")if [ "$total" -eq 0 ]; then  echo "No integration tests found" >&2  exit 1firate=$(echo "scale=2; $passed * 100 / $total" | bc)echo "Integration pass rate: ${rate}% ($passed/$total)"

通过/失败矩阵

类别	阈值	失败时操作
CDSS 准确性	100%	阻止部署
PHI 暴露	100%	阻止部署
数据完整性	100%	阻止部署
临床工作流	95% 以上	警告，允许经审查后部署
集成	95% 以上	警告，允许经审查后部署

CI/CD 集成

yaml

name: Healthcare Safety Gateon: [push, pull_request]
jobs:  safety-gate:    runs-on: ubuntu-latest    steps:      - uses: actions/checkout@v4      - uses: actions/setup-node@v4        with:          node-version: '20'      - run: npm ci
      # CRITICAL gates — 100% required, bail on first failure      - name: CDSS Accuracy        run: npx jest --testPathPattern='tests/cdss' --bail --ci --coverage --coverageThreshold='{"global":{"branches":80,"functions":80,"lines":80}}'
      - name: PHI Exposure Check        run: npx jest --testPathPattern='tests/security/phi' --bail --ci
      - name: Data Integrity        run: npx jest --testPathPattern='tests/data-integrity' --bail --ci
      # HIGH gates — 95%+ required, custom threshold check      # HIGH gates — 95%+ required      - name: Clinical Workflows        run: |          TMP_JSON=$(mktemp)          npx jest --testPathPattern='tests/clinical' --ci --json --outputFile="$TMP_JSON" || true          TOTAL=$(jq '.numTotalTests // 0' "$TMP_JSON")          PASSED=$(jq '.numPassedTests // 0' "$TMP_JSON")          if [ "$TOTAL" -eq 0 ]; then            echo "::error::No clinical tests found"; exit 1          fi          RATE=$(echo "scale=2; $PASSED * 100 / $TOTAL" | bc)          echo "Pass rate: ${RATE}% ($PASSED/$TOTAL)"          if (( $(echo "$RATE < 95" | bc -l) )); then            echo "::warning::Clinical pass rate ${RATE}% below 95%"          fi
      - name: Integration Compliance        run: |          TMP_JSON=$(mktemp)          npx jest --testPathPattern='tests/integration' --ci --json --outputFile="$TMP_JSON" || true          TOTAL=$(jq '.numTotalTests // 0' "$TMP_JSON")          PASSED=$(jq '.numPassedTests // 0' "$TMP_JSON")          if [ "$TOTAL" -eq 0 ]; then            echo "::error::No integration tests found"; exit 1          fi          RATE=$(echo "scale=2; $PASSED * 100 / $TOTAL" | bc)          echo "Pass rate: ${RATE}% ($PASSED/$TOTAL)"          if (( $(echo "$RATE < 95" | bc -l) )); then            echo "::warning::Integration pass rate ${RATE}% below 95%"          fi

name: Healthcare Safety Gateon: [push, pull_request]
jobs:  safety-gate:    runs-on: ubuntu-latest    steps:      - uses: actions/checkout@v4      - uses: actions/setup-node@v4        with:          node-version: '20'      - run: npm ci
      # CRITICAL gates — 100% required, bail on first failure      - name: CDSS Accuracy        run: npx jest --testPathPattern='tests/cdss' --bail --ci --coverage --coverageThreshold='{"global":{"branches":80,"functions":80,"lines":80}}'
      - name: PHI Exposure Check        run: npx jest --testPathPattern='tests/security/phi' --bail --ci
      - name: Data Integrity        run: npx jest --testPathPattern='tests/data-integrity' --bail --ci
      # HIGH gates — 95%+ required, custom threshold check      # HIGH gates — 95%+ required      - name: Clinical Workflows        run: |          TMP_JSON=$(mktemp)          npx jest --testPathPattern='tests/clinical' --ci --json --outputFile="$TMP_JSON" || true          TOTAL=$(jq '.numTotalTests // 0' "$TMP_JSON")          PASSED=$(jq '.numPassedTests // 0' "$TMP_JSON")          if [ "$TOTAL" -eq 0 ]; then            echo "::error::No clinical tests found"; exit 1          fi          RATE=$(echo "scale=2; $PASSED * 100 / $TOTAL" | bc)          echo "Pass rate: ${RATE}% ($PASSED/$TOTAL)"          if (( $(echo "$RATE < 95" | bc -l) )); then            echo "::warning::Clinical pass rate ${RATE}% below 95%"          fi
      - name: Integration Compliance        run: |          TMP_JSON=$(mktemp)          npx jest --testPathPattern='tests/integration' --ci --json --outputFile="$TMP_JSON" || true          TOTAL=$(jq '.numTotalTests // 0' "$TMP_JSON")          PASSED=$(jq '.numPassedTests // 0' "$TMP_JSON")          if [ "$TOTAL" -eq 0 ]; then            echo "::error::No integration tests found"; exit 1          fi          RATE=$(echo "scale=2; $PASSED * 100 / $TOTAL" | bc)          echo "Pass rate: ${RATE}% ($PASSED/$TOTAL)"          if (( $(echo "$RATE < 95" | bc -l) )); then            echo "::warning::Integration pass rate ${RATE}% below 95%"          fi

反模式

跳过 CDSS 测试，因为"上次通过了"
将严重关卡阈值设为低于 100%
在严重测试套件中使用 --no-bail
在集成测试中模拟 CDSS 引擎（必须测试真实逻辑）
安全关卡为红色时仍允许部署
在 CDSS 套件中运行测试时不使用 --coverage

示例

示例 1：本地运行所有严重关卡

bash

npx jest --testPathPattern='tests/cdss' --bail --ci --coverage && \npx jest --testPathPattern='tests/security/phi' --bail --ci && \npx jest --testPathPattern='tests/data-integrity' --bail --ci

npx jest --testPathPattern='tests/cdss' --bail --ci --coverage && \npx jest --testPathPattern='tests/security/phi' --bail --ci && \npx jest --testPathPattern='tests/data-integrity' --bail --ci

示例 2：检查高优先级关卡通过率

bash

tmp_json=$(mktemp)npx jest --testPathPattern='tests/clinical' --ci --json --outputFile="$tmp_json" || truejq '{  passed: (.numPassedTests // 0),  total: (.numTotalTests // 0),  rate: (if (.numTotalTests // 0) == 0 then 0 else ((.numPassedTests // 0) / (.numTotalTests // 1) * 100) end)}' "$tmp_json"# Expected: { "passed": 21, "total": 22, "rate": 95.45 }

tmp_json=$(mktemp)npx jest --testPathPattern='tests/clinical' --ci --json --outputFile="$tmp_json" || truejq '{  passed: (.numPassedTests // 0),  total: (.numTotalTests // 0),  rate: (if (.numTotalTests // 0) == 0 then 0 else ((.numPassedTests // 0) / (.numTotalTests // 1) * 100) end)}' "$tmp_json"# Expected: { "passed": 21, "total": 22, "rate": 95.45 }

示例 3：评估报告

## 医疗评估：2026-03-27 [commit abc1234]
### 患者安全：通过
| 类别 | 测试数 | 通过 | 失败 | 状态 ||----------|-------|------|------|--------|| CDSS 准确性 | 39 | 39 | 0 | 通过 || PHI 暴露 | 8 | 8 | 0 | 通过 || 数据完整性 | 12 | 12 | 0 | 通过 || 临床工作流 | 22 | 21 | 1 | 95.5% 通过 || 集成 | 6 | 6 | 0 | 通过 |
### 覆盖率：84%（目标：80%以上）### 结论：可安全部署

## 医疗评估：2026-03-27 [commit abc1234]
### 患者安全：通过
| 类别 | 测试数 | 通过 | 失败 | 状态 ||----------|-------|------|------|--------|| CDSS 准确性 | 39 | 39 | 0 | 通过 || PHI 暴露 | 8 | 8 | 0 | 通过 || 数据完整性 | 12 | 12 | 0 | 通过 || 临床工作流 | 22 | 21 | 1 | 95.5% 通过 || 集成 | 6 | 6 | 0 | 通过 |
### 覆盖率：84%（目标：80%以上）### 结论：可安全部署

Source and attribution

Source:affaan-m/ECCindocs/zh-CN/skills/healthcare-eval-harnessat commitef648e0

License: No license

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Healthcare Eval Harness

医疗评估框架 — 患者安全验证

使用场景

工作原理

评估类别

通过/失败矩阵

CI/CD 集成

反模式

示例

示例 1：本地运行所有严重关卡

示例 2：检查高优先级关卡通过率

示例 3：评估报告

Source and attribution

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