Imported from jeremylongshore/tons-of-skills-marketplace (skills/.curated/abridge-prod-checklist/SKILL.md). Install upstream with npx skills add jeremylongshore/tons-of-skills-marketplace --skill abridge-prod-checklist. Copyright stays with the author (MIT).

Abridge Production Checklist

Overview

Production readiness checklist for deploying Abridge clinical AI in a healthcare organization. Clinical documentation systems are safety-critical — this checklist covers HIPAA compliance, EHR integration validation, provider onboarding, and rollback procedures.

Prerequisites

• A named clinical, security, privacy, EHR, and operations owner empowered to make the go/no-go decision.
• A BAA-covered production environment, approved change window, and a tested manual-documentation fallback.
• Completed sandbox validation using synthetic data, with no unresolved high-severity privacy, safety, or interoperability findings.

Instructions

Work through the pre-launch checklist with the responsible owner for each control, then run the readiness script in the target environment. Treat every fail result as a launch blocker. Record the decision, evidence locations, and rollback owner before enabling the integration; do not use warning-only results to override a failed security, EHR, or patient-safety control.

Pre-Launch Checklist

Legal & Compliance

• BAA signed — Business Associate Agreement executed with Abridge
• HIPAA risk assessment — Completed and documented
• Data flow diagram — PHI flow mapped: microphone → Abridge → EHR
• Breach notification plan — 60-day notification procedure documented
• Patient consent — State-specific recording consent requirements met
• Medical staff approval — Clinical AI usage approved by medical staff committee

Infrastructure

• TLS 1.3 — Enforced on all Abridge API connections
• Secrets management — Credentials in secret manager (not env files)
• Audit logging — All PHI access logged with 6-year retention
• Monitoring — Health checks, latency alerts, error rate dashboards
• Backup connectivity — Fallback for Abridge outages (manual documentation)

EHR Integration

• FHIR R4 endpoint — Verified DocumentReference POST works
• Epic SmartPhrases — Mapped to Abridge note templates
• Provider enrollment — All go-live providers registered in Abridge
• Specialty configuration — Licensed specialties configured per contract
• Note templates — SOAP/H&P/Progress templates validated with clinical leads

Validation Script

// src/prod/readiness-check.ts
interface ReadinessResult {
  check: string;
  status: 'pass' | 'fail' | 'warn';
  detail: string;
}

async function runReadinessChecks(): Promise<ReadinessResult[]> {
  const results: ReadinessResult[] = [];

  // 1. API connectivity
  try {
    const res = await fetch(`${process.env.ABRIDGE_BASE_URL}/health`, {
      headers: { 'Authorization': `Bearer ${process.env.ABRIDGE_CLIENT_SECRET}` },
    });
    results.push({ check: 'API Health', status: res.ok ? 'pass' : 'fail', detail: `HTTP ${res.status}` });
  } catch (err) {
    results.push({ check: 'API Health', status: 'fail', detail: (err as Error).message });
  }

  // 2. FHIR endpoint
  try {
    const res = await fetch(`${process.env.EPIC_FHIR_BASE_URL}/metadata`);
    results.push({ check: 'FHIR Server', status: res.ok ? 'pass' : 'fail', detail: `HTTP ${res.status}` });
  } catch (err) {
    results.push({ check: 'FHIR Server', status: 'fail', detail: (err as Error).message });
  }

  // 3. TLS version
  results.push({
    check: 'TLS Version',
    status: process.env.NODE_TLS_MIN_VERSION === 'TLSv1.3' ? 'pass' : 'warn',
    detail: `Min TLS: ${process.env.NODE_TLS_MIN_VERSION || 'not set'}`,
  });

  // 4. Secrets not in env file
  const envFiles = ['.env', '.env.local', '.env.production'];
  for (const f of envFiles) {
    try {
      const content = await import('fs').then(fs => fs.readFileSync(f, 'utf8'));
      if (content.includes('ABRIDGE_CLIENT_SECRET')) {
        results.push({ check: `Secrets in ${f}`, status: 'fail', detail: 'Credentials in file — use secret manager' });
      }
    } catch { /* file doesn't exist — good */ }
  }

  // 5. Audit logging
  results.push({
    check: 'Audit Logging',
    status: process.env.AUDIT_LOG_ENABLED === 'true' ? 'pass' : 'fail',
    detail: 'HIPAA requires audit trail for all PHI access',
  });

  return results;
}

// Run and display
runReadinessChecks().then(results => {
  console.log('\n=== Abridge Production Readiness ===\n');
  for (const r of results) {
    const icon = r.status === 'pass' ? 'PASS' : r.status === 'warn' ? 'WARN' : 'FAIL';
    console.log(`[${icon}] ${r.check}: ${r.detail}`);
  }
  const failures = results.filter(r => r.status === 'fail');
  console.log(`\n${failures.length === 0 ? 'READY FOR PRODUCTION' : `${failures.length} BLOCKING ISSUES`}`);
});

Rollback Plan

#!/bin/bash
# scripts/abridge-rollback.sh
# Rollback Abridge integration — revert to manual documentation

echo "=== Abridge Rollback Procedure ==="

# 1. Disable Abridge in EHR
echo "Step 1: Disable Abridge module in Epic App Orchard"
echo "  - Navigate to Epic > Admin > App Orchard > Abridge"
echo "  - Set status: DISABLED"

# 2. Notify providers
echo "Step 2: Send notification to enrolled providers"
echo "  - Subject: Abridge temporarily offline — use manual documentation"

# 3. Verify EHR still accepts manual notes
echo "Step 3: Verify manual note creation in Epic works"
curl -X POST "${EPIC_FHIR_BASE_URL}/DocumentReference" \
  -H "Authorization: Bearer $EPIC_TOKEN" \
  -H "Content-Type: application/fhir+json" \
  -d '{"resourceType":"DocumentReference","status":"current","content":[{"attachment":{"contentType":"text/plain","data":"'"$(echo 'Manual note test' | base64)"'"}}]}'

echo "=== Rollback Complete ==="

Post-Launch Monitoring

Output

• Readiness check script with pass/fail results
• Rollback procedure documented and tested
• Post-launch monitoring thresholds configured
• Go/no-go decision evidence collected

Examples

During a scheduled production rehearsal, have each control owner complete the checklist against the BAA-covered target environment and run the readiness script using its managed identity. A clean result contains no fail entries, an authenticated FHIR metadata response, confirmed audit logging, and a named rollback operator. Capture the redacted results and change approval with the release record. If a control fails, declare a no-go, keep the integration disabled, and use the documented manual workflow until the owner corrects and re-verifies the failure.

Error Handling

Resources

• Abridge Platform
• HIPAA Security Rule Checklist
• Epic Go-Live Best Practices

Next Steps

For version upgrades, see abridge-upgrade-migration.