2.0.0-beta.1 (candidate)

• Release preparation fixes beta publication to npm next and GitHub prerelease semantics, verifies exact approved commit/repository/package metadata, installs locked dependencies before CI checks, and detects any latest-channel change. Existing publishing permissions and environment are retained; no publication is performed by preparation. Native/model evidence remains tied to its recorded source commits.

The local contract repair makes free-text routing discovery-only, adds validated explicit/host selection with retained multi-workflow drafts, and enforces complete MCP/callback output envelopes with typed size errors. Existing specialists, workup artifacts and calculation contracts remain available through explicit IDs; old auto-selection integrations require migration.

Adds routing abstention, CHNA fallback, six deep workflow skills, compact role briefs, aggregate outcome contracts, custom workflow generation and five-target payload exports. The successor adds official-SDK stdio/loopback MCP tools, portable plugin packaging and local Claude/Azure/Databricks callback contracts. Independent routing defects are repaired; builder validation wording now reflects shape-only prose checks. A pinned native Codex synthetic MCP campaign is recorded separately from unqualified customer hosts and publication.

Changelog

All notable changes to this project will be documented in this file.

Unreleased

• Preserve the parent's declared selector and custom rationale in each multi-workflow child draft, including async and packaged CLI paths.

Added

• Added a machine-readable seven-role USHSO Review Protocol Registry with content-addressed compact index and strict v1 JSON contracts.
• Added a deterministic strategic-review evaluator and advisory-only conflict mapper that preserve frozen inputs, six separate postures, dissent, and the human professional-judgment boundary.
• Added CLI, adversarial fixtures, validation, packaging, and release-readiness coverage for the reusable review contracts.

[1.6.0] - 2026-07-09

Added

• Added generated compact workflow-first and agent-fallback router indexes with freshness and context-size validation.
• Added GPT-5.6 model-role, prompting, reasoning-effort, and migration guidance grounded in current OpenAI documentation.
• Added three synthetic HealthAdminBench-derived reliability canaries for prior authorization, denial appeals, and closed-loop DME processing.

Changed

• Updated the plugin router, generated platform instructions, workflow skills, per-agent skill wrappers, and CLI starter prompts with a compact state-ledger and terminal-completion contract.
• Updated the eval workflow and exam-architect playbook to test long-horizon state, document transitions, and full-task completion separately from subtask quality.
• Replaced the 500-line prompt incentive with a prompt-economy review band and tightened eval growth caps for future compaction passes.
• Bumped npm, installer, Codex plugin, README, changelog, and release metadata to v1.6.0.

[1.5.0] - 2026-05-31

Operator OS catalog hardening for all 16 healthcare administration workflows.

Added

• Added the Healthcare Admin Workup Engine with workflow listing, workflow detail, workup routing, and Microsoft/Copilot export commands.
• Added 16 canonical healthcare administration workflows, workflow/platform schemas, centralized safety snippets, platform renderers, routing canaries, platform export validation, snapshot checks, and workflow docs validation.
• Added Claude and Codex workflow skill installation, stronger Codex AGENTS.md generation, GitHub Copilot repository instructions, path instructions, custom agents, prompt files, and issue templates.
• Added Microsoft 365 Copilot declarative agent, Copilot Studio, and Azure AI Foundry export templates for governed enterprise review.
• Added workflow gallery pages, 35 example workup prompts, platform compatibility guides, demo setup folders, and workflow contribution guidance.
• Added a governed npm publication workflow and release publishing runbook for maintainer-authenticated public distribution.
• Added Operator OS coverage metadata and offline-first standard evidence packs for all 16 workflows, including citation-card source families, human owners, verification status, red flags, and PHI/compliance notes.
• Added scaffold generation for workflow-specific Operator OS evidence packs.

Changed

• Expanded README and INSTALL around workflow-first routing, multi-runtime workflow installs, Copilot compatibility, and enterprise export paths.
• Expanded Operator OS docs with catalog coverage and evidence-pack authoring guidance.
• Bumped package, installer, README badge, and version metadata to v1.5.0.

Fixed

• Accepted hyphenated --data-mode aliases such as public-evidence and documented valid data modes in CLI help.

Validation

• Ran npm test / npm run release:check successfully on merged main before release edits.
• Dogfooded all 16 workflows through operator-os coverage --json, evidence-pack show <workflow> --json, evidence-pack scaffold <workflow>, and routed workup ... --target codex --data-mode public-evidence --json.

See docs/release-notes/2026-05-31-operator-os-catalog-hardening.md for full details.

[1.4.0] - 2026-05-30

Release-grade eval coverage for the full Healthcare Agents catalog.

Added

• Added latest tracked eval rows for all 51 registry agents in eval/results.tsv.
• Added strict full-coverage validation to the release-readiness gate via REQUIRE_FULL_EVAL_COVERAGE=1 npm run validate:eval-coverage.
• Added release notes for the 2026-05-30 eval coverage campaign.

Changed

• Updated all 51 agent prompts with narrow, role-specific improvements retained from canonical eval loops.
• Regenerated docs/eval/scorecard.md and docs/eval/scorecard.json to show 51/51 evaluated agents, 51/51 tracked improved agents, and a 94.18 average latest tracked score.
• Updated README and docs/release-manifest.json claims to match generated scorecard evidence and preserve internal-eval scope limits.
• Bumped package, installer, and version metadata to v1.4.0.

See docs/release-notes/2026-05-30-release-grade-eval-coverage.md for full details.

[1.3.0] - 2026-05-21

Product-surface release for registry-backed discovery, safer installs, npm distribution, and public trust/eval artifacts.

Added

• Added agents/registry.json with discovery, routing, handoff, trust, and provenance metadata for all 51 agents.
• Added CLI commands for list, show, choose, prompt, and doctor, plus slug-validated single-agent installs.
• Added CI gates for installer syntax, agent linting/audit, package dry-run, CLI smoke tests, and installer dry-run.
• Added public eval scorecard generation under docs/eval/scorecard.md and docs/eval/scorecard.json.
• Added docs/trust-and-safety.md for scope, PHI, human escalation, source freshness, and eval limitations.
• Published healthcare-agents to npm for direct npx --yes healthcare-agents ... usage.

Changed

• Improved installer dry-run output to show exact planned writes and avoid dry-run directory creation.
• Added npm package scripts and Node engine metadata for distribution readiness.
• Updated install documentation to make npm-backed npx the primary path.

See docs/release-notes/2026-05-21-product-surface-release.md for full details.

[1.2.0] - 2026-05-05

Usability release for task-based agent selection, output modes, and handoffs.

Added

• Added docs/usage/agent-selection-guide.md with task-to-agent routing for common healthcare administration jobs.
• Added docs/usage/starter-prompts.md with copy-ready prompts across all 10 domains.
• Added docs/usage/handoff-map.md for cross-functional workflows and human escalation owners.
• Added release-only usability smoke scenarios in docs/eval/usability-release-check.md.

Changed

• Added role-tailored Best Inputs, Output Modes, and Collaboration & Handoffs sections to all 51 agents.
• Updated README discovery flow, installer-managed Codex guidance, contribution template, lint checks, and audit scoring for the new usability contract.
• Bumped package and installer metadata to v1.2.0 for GitHub-backed installs.

See docs/release-notes/2026-05-05-usability-release.md for full details.

[1.1.2] - 2026-04-23

Documentation correction for npm-backed install commands.

Changed

• Updated README and INSTALL examples to use npx --yes github:ajhcs/healthcare-agents because the package name is not published to npm from this environment yet.
• Bumped installer/package metadata to v1.1.2 so GitHub-backed npx installs report the latest compatibility release.

[1.1.1] - 2026-04-23

Installer and documentation compatibility release.

Changed

• Normalized all agent frontmatter name fields to lowercase hyphen slugs for Claude Code and OpenCode compatibility.
• Added display_name frontmatter to preserve human-readable agent names.
• Expanded the installer with aliases for Codex App, Claude Desktop, Claude Cowork, OpenCode, and portable SKILL.md targets.
• Generated valid per-agent SKILL.md folders for Claude Skills, OpenCode skills, and the open .agents/skills convention.
• Updated Codex install behavior to write a managed ~/.codex/AGENTS.md discovery block.
• Refreshed README.md and INSTALL.md for v1.1.x, current eval status, and cross-tool install paths.
• Updated the self-improvement kit installer to copy all role baselines, not only the medical coding baseline.

[1.1.0] - 2026-04-23

Agent-stack optimization release for the full 51-agent healthcare administration library.

Changed

• Improved all 51 healthcare agent prompts through same-question before/after eval passes.
• Raised the first 15 evaluated agents from an 85.0 average score to 93.9.
• Raised the remaining 36 evaluated agents from an 85.11 average score to 95.50.
• Added more role-specific mechanics, compliance boundaries, source hierarchies, workflow handoffs, and deliverable requirements across clinical, operations, payer, quality, health IT, population health, pharmacy, revenue, and strategy agents.
• Reworked the eval workflow for modern SOTA model routing with parent orchestrator, scorer/judge, editor, and optional adjudicator roles.
• Required reusable full-question artifacts for before/after evals so score deltas can be audited against exact Q001-Q025 prompts.

Added

• Role baselines for all 51 installable healthcare agents.
• Eval scorer guidance in docs/eval/exam-architect-playbook.md.
• Current model-routing guidance in docs/eval/model-tuning.md.
• Meta-eval checks for judge calibration, scorer consistency, and prompt-overfitting risk.
• Local run-log documentation for retained questions, scorer outputs, editor briefs, and summaries.

Removed

• Retired the unused Python/DSPy eval harness and related schema, rubric, test, and runner files.
• Removed the standalone eval exam architect agent prompt in favor of the documented eval skill/playbook workflow.

See docs/release-notes/2026-04-23-agent-stack-optimization.md for full details.

[1.0.0] - 2026-04-09

Initial release of the healthcare-agents repository.

Added

• 51 healthcare administration agent system prompts across 10 categories: Revenue, Clinical, Quality, Payer, Operations, Health IT, Population Health, Pharmacy, Strategy, and Emergency Preparedness.
• Karpathy-style automated eval loop (/eval command) with frozen rubric (Accuracy 0.40, Completeness 0.35, Specificity 0.25).
• Split-role scoring architecture: strong judge model generates exams and critiques, fast editor model patches prompts, parent orchestrator owns git writes.
• Identity-preservation constraints to prevent prompt drift during automated improvement.
• Git-ratcheted commit strategy: improvements commit atomically, regressions revert automatically.
• Append-only results log at eval/results.tsv.
• 10 agents improved to 80+ scores through the eval loop, including Revenue Medical Coding Specialist (82.15), Revenue Finance Manager (81.55), and Revenue 340B Program Manager (81.20).
• Cross-tool self-improvement kit and agent quality review infrastructure.

See docs/release-notes/2026-04-09-eval-loop-milestone.md for full details.