mcp-ratchet-clinical-charting

MCP server for clinical charting with Claude (codename: Ratchet) - Enables Claude to document patient visits directly into Electronic Medical Records, reducing administrative burden for home health nurses.

Note: Currently runs in Mock Mode for development/testing. Production EMR integration coming soon.

# Status

| Component | Status |
|- -- -- -- -- --|- -- -- -- -|
| MCP Server | ✅ Working (Mock Mode) |
| Unit Tests | ✅ 20/20 Passing |
| Claude Desktop | ✅ Ready for Testing |
| PointCare API | ⏳ Pending API Documentation |

Current Mode: Mock Mode - Uses realistic test data for development and testing.

# Quick Start

# # From npm (Recommended)

npx mcp-ratchet-clinical-charting

# # From Source

git clone https://github.com/m2ai-mcp-servers/mcp-ratchet-clinical-charting.git
cd mcp-ratchet-clinical-charting
npm install
npm run build
npm run dev  #  Development mode
npm test     #  Run tests

# Mock Mode

Ratchet runs in mock mode by default when POINTCARE_API_URL is not configured. Mock mode:

• Uses 5 fictional test patients
• Stores visit notes in memory
• Returns realistic responses
• Perfect for development and Claude Desktop testing

# Available Tools

| Tool | Description | Mock Mode |
|- -- -- -|- -- -- -- -- -- --|- -- -- -- -- --|
| search_patient | Find patient by name, ID, or phone | ✅ Working |
| create_visit_note | Document a patient visit with vitals | ✅ Working |
| get_patient_history | Retrieve patient visit history | ✅ Working |

# # Example Usage (in Claude)

"Search for patient Eleanor Thompson"
→ Returns patient PT-10001 with demographics and status

"Create a visit note for PT-10001 with blood pressure 120/80"
→ Creates and stores visit note with vitals

"Get visit history for PT-10001"
→ Returns list of previous visits

# Claude Desktop Integration

# # Configure Claude Desktop

Add to your Claude Desktop config file:

macOS: ~/Library/Application Support/Claude/claude_desktop_config.json
Windows: %APPDATA%\Claude\claude_desktop_config.json

{
  "mcpServers": {
    "ratchet": {
      "command": "npx",
      "args": ["-y", "mcp-ratchet-clinical-charting"]
    }
  }
}

For production mode with EMR integration:

{
  "mcpServers": {
    "ratchet": {
      "command": "npx",
      "args": ["-y", "mcp-ratchet-clinical-charting"],
      "env": {
        "POINTCARE_API_URL": "https://api.pointcare.com",
        "POINTCARE_API_KEY": "your-api-key"
      }
    }
  }
}

# # Step 3: Restart Claude Desktop

Restart Claude Desktop to load the new MCP server.

# # Step 4: Verify

In Claude Desktop, you should see:

• search_patient tool available
• create_visit_note tool available
• get_patient_history tool available

Try: "Search for patient Eleanor"

# Test Patients (Mock Mode)

| ID | Name | Status | Primary Diagnosis |
|- -- -|- -- -- -|- -- -- -- -|- -- -- -- -- -- -- -- -- --|
| PT-10001 | Eleanor Thompson | Active | Type 2 Diabetes, CHF |
| PT-10002 | Robert Martinez | Active | COPD, Post-surgical |
| PT-10003 | Margaret Wilson | Active | Parkinson's Disease |
| PT-10004 | James Thompson | Active | Post-stroke rehab |
| PT-10005 | Dorothy Anderson | Discharged | Hip replacement |

# Origin Story

Ratchet evolved from the M2AI NurseCall n8n workflow, built to help home health nurses with visit documentation:

Current Flow (M2AI NurseCall):
┌─────────┐    ┌─────────┐    ┌─────────┐    ┌─────────┐
│ Twilio  │───>│  n8n    │───>│  VAPI   │───>│  Email  │
│  SMS    │    │ Workflow│    │  Call   │    │ Summary │
└─────────┘    └─────────┘    └─────────┘    └─────────┘

The Problem: Visit notes go to email but still need manual entry into PointCare EMR.

Ratchet's Solution:

Future Flow (with Ratchet):
┌─────────┐    ┌─────────┐    ┌──────────┐    ┌───────────┐
│ Twilio  │───>│  n8n    │───>│ Ratchet  │───>│ PointCare │
│  SMS    │    │ Workflow│    │   MCP    │    │    EMR    │
└─────────┘    └─────────┘    └──────────┘    └───────────┘

# Configuration

| Variable | Required | Description |
|- -- -- -- -- -|- -- -- -- -- -|- -- -- -- -- -- --|
| POINTCARE_API_URL | No* | PointCare API base URL |
| POINTCARE_API_KEY | No* | API key or token |
| RATCHET_MOCK_MODE | No | Force mock mode (true/false) |
| LOG_LEVEL | No | Logging level (debug/info/warn/error) |

*Required for production use. Mock mode activates when not set.

# Project Structure

ratchet/
├── src/
│   ├── index.ts              #  MCP server entry point
│   ├── config.ts             #  Configuration management
│   ├── tools/                #  Tool implementations
│   │   ├── search-patient.ts
│   │   ├── create-visit-note.ts
│   │   └── get-patient-history.ts
│   ├── services/             #  Business logic
│   │   ├── patient-service.ts
│   │   └── mock-data.ts
│   ├── types/                #  TypeScript types
│   └── utils/                #  Logger, errors
├── tests/
│   └── patient-service.test.ts
├── dist/                     #  Compiled output
├── prds/
│   └── RATCHET-PRD.yaml
├── docs/
│   └── API_REQUIREMENTS.md
├── package.json
├── tsconfig.json
└── jest.config.js

# Development

#  Run in watch mode
npm run dev

#  Run tests
npm test

#  Run tests with coverage
npm test - - - -coverage

#  Lint
npm run lint

# Next Steps

1. Acquire PointCare API documentation - See docs/API_REQUIREMENTS.md
2. Complete PRD - Fill in tool specifications with real API details
3. Implement real API calls - Replace mock responses
4. Integration testing - Test with PointCare sandbox

# Related Projects

• GRIMLOCK - Autonomous MCP Server Factory
• ratchet-demo-emr - Demo EMR React app for testing

# License

MIT

Built with GRIMLOCK - Autonomous MCP Server Factory