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Mcp Ratchet Clinical Charting

m2ai-mcp-servers/mcp-ratchet-clinical-charting
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Summary

Bridges Claude to Electronic Medical Records for home health nursing documentation, currently running in mock mode while awaiting PointCare EMR API integration. Exposes three tools: search_patient finds patients by name, ID, or phone; create_visit_note documents visits with vitals and observations; get_patient_history retrieves past visit records. Ships with five fictional test patients and in-memory storage so you can prototype clinical charting workflows in Claude Desktop before connecting to production systems. Born from an existing n8n workflow that sends nurse visit summaries to email, this closes the loop by writing structured notes directly into the EMR instead of requiring manual data entry.

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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

ComponentStatus
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

ToolDescriptionMock Mode
search_patientFind patient by name, ID, or phone✅ Working
create_visit_noteDocument a patient visit with vitals✅ Working
get_patient_historyRetrieve 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)

IDNameStatusPrimary Diagnosis
PT-10001Eleanor ThompsonActiveType 2 Diabetes, CHF
PT-10002Robert MartinezActiveCOPD, Post-surgical
PT-10003Margaret WilsonActiveParkinson's Disease
PT-10004James ThompsonActivePost-stroke rehab
PT-10005Dorothy AndersonDischargedHip 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

VariableRequiredDescription
POINTCARE_API_URLNo*PointCare API base URL
POINTCARE_API_KEYNo*API key or token
RATCHET_MOCK_MODENoForce mock mode (true/false)
LOG_LEVELNoLogging 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

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Configuration

POINTCARE_API_URL

EMR API base URL (optional - runs in mock mode if not set)

POINTCARE_API_KEYsecret

EMR API key (required for production mode)

Categories
Documents & Knowledge
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Packagemcp-ratchet-clinical-charting
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UpdatedJan 19, 2026
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