divyanshkul/claude_code_for_health

class MedAction(Action):
    command: str  # e.g. "chart.labs CBC", "submit 25.2", "note.correct 5 Fixed text"

class MedObservation(Observation):
    output: str                    # Command output text
    error: str                     # Error message if command invalid
    available_commands: list[str]  # Tools available for current task
    task_type: str                 # diagnosis | calculation | note_review
    step_number: int
    max_steps: int                 # 50

class MedState(State):
    task_type: str
    difficulty: str        # easy | medium | hard
    total_score: float     # Cumulative reward
    commands_issued: int
    is_submitted: bool

chart.history              View past medical history, medications, allergies
chart.vitals               View vital signs
chart.labs [panel]         View lab results (list panels or view specific)
chart.imaging [type]       View imaging findings
chart.exam [system]        View physical exam findings
chart.medications          View current medications
chart.allergies            View known allergies
ddx.add <diagnosis>        Add to differential
ddx.remove <diagnosis>     Remove from differential
ddx.list                   Show current differential
ddx.confirm <diagnosis>    Submit final diagnosis (ends episode)

case.read                  Read the full patient note + question
calculate <name>           Declare which calculator you're using
submit <number>            Submit numeric answer (ends episode)

note.read                  Read the clinical note with numbered sentences
note.correct <id> <text>   Correct a sentence by ID
note.approve               Approve note / submit corrections (ends episode)

reference.ranges <test>           Normal range lookup (e.g. sodium, troponin)
reference.criteria <condition>    Diagnostic criteria (e.g. DKA, sepsis, PE)
reference.drug_info <drug>        Drug mechanism, indications, contraindications
interpret <test> <value>          Interpret a lab value against normal range

> reset(options={"task": "hard"})
Patient: 45M, presenting with fever, rash, and joint pain
Type 'help' for available tools.

> chart.history                                        reward: +0.02
PMH: None significant
Medications: None
Social: Non-smoker, occasional alcohol

> chart.vitals                                         reward: +0.02
BP: 130/85 | HR: 102 | Temp: 39.2C | RR: 18 | SpO2: 98%

> chart.labs                                           reward: 0.00
Available lab panels: CBC, BMP, inflammatory_markers, LFTs

> chart.labs inflammatory_markers                      reward: +0.02
inflammatory_markers:
  ESR: 85 mm/hr
  CRP: 12.4 mg/dL
  Ferritin: 26,250 ng/mL

> reference.ranges ferritin                            reward: 0.00
FERRITIN: Normal range 12-300 ng/mL
  Female 12-150, Male 12-300. Very high in HLH, Still disease

> interpret ferritin 26250                             reward: 0.00
FERRITIN 26250.0 ng/mL: HIGH - critically elevated (normal 12-300)
  Female 12-150, Male 12-300. Very high in HLH, Still disease

> reference.criteria hlh                               reward: 0.00
HLH (HScore): Fever, organomegaly, cytopenias (2-3 lineages),
hypertriglyceridemia (>=265) or hypofibrinogenemia (<=150),
ferritin >=500 (often >10,000), elevated soluble CD25...

> ddx.add HLH                                         reward: 0.00
Added 'HLH'. Differential has 1 entry(ies).

> ddx.add Adult-onset Still disease                    reward: 0.00
Added 'Adult-onset Still disease'. Differential has 2 entry(ies).

> ddx.confirm Adult-onset Still disease                reward: +0.34
Diagnosis submitted: 'Adult-onset Still disease'. Score: 0.34

[STATUS] DDX: [HLH, Adult-onset Still disease] | Step: 10/50
Total episode score: 0.40

# Install
uv sync

# Run server
uv run uvicorn server.app:app --port 8000

# Run inference (set HF_TOKEN first)
export HF_TOKEN="your_token"
uv run python inference.py

docker build -t claude_code_for_health .
docker run -p 8000:8000 claude_code_for_health

claude_code_for_health/
├── Dockerfile              # Container image definition
├── openenv.yaml            # OpenEnv manifest
├── pyproject.toml          # Dependencies
├── inference.py            # Baseline inference script
├── models.py               # MedAction, MedObservation, MedState
├── client.py               # EnvClient wrapper
├── __init__.py             # Module exports
├── data/
│   ├── MedCaseReasoning/   # Diagnosis cases (JSONL)
│   ├── MedCalcBench/       # Calculation cases (CSV)
│   ├── MEDEC/              # Note review cases (CSV)
│   └── reference/          # Lab ranges, criteria, drug info (JSON)
└── server/
    ├── app.py              # FastAPI application
    ├── claude_code_for_health_environment.py  # Core environment
    ├── command_parser.py   # CLI command parsing
    ├── data_loader.py      # Dataset loading
    ├── task_configs.py     # Difficulty tiers + case selection
    ├── graders.py          # Dense reward functions
    ├── constants.py        # Reference data loader
    └── ui.py               # Custom Gradio dashboard