Set up an OpenMed de-identification policy

Use this skill before a de-identification pipeline when the privacy decisions are not already recorded. It creates a small policy document; it does not inspect, transform, upload, or retain clinical data. The setup is local-first, deterministic, and has no mandatory network call.

The output is a draft configuration contract, not a compliance certification, legal opinion, or guarantee of de-identification. A human must review and approve the draft before it controls a run.

When to use this skill

Use it when a project needs to turn implicit privacy choices into a reviewable DEID-POLICY.md file. Use the focused de-identification skills afterward to apply or audit the selected policy.

Do not use this skill to collect a note, dataset row, identifier, model output, secret, credential, or any other source payload. The setup questions accept policy choices only. Keep logs, exceptions, reports, and fixtures free of raw sensitive values.

Bounded decision contract

Collect these five decisions, one at a time. Do not invent a sixth field or silently choose a value. The value written to the artifact must be the lowercase canonical value in the right-hand column.

The jurisdiction choices are context labels, not findings that a law applies. For example, us may be used for a US/HIPAA-context workflow and eu for an EU/GDPR-context workflow, but the generated document must not claim that the workflow is compliant. research and organization-defined require the project's own governance review.

The recall floor is a release target, not an observed score. Do not write a metric, benchmark result, dataset name, or model claim into this artifact. replace must use deterministic, synthetic surrogates when it is later implemented; any re-identification mapping remains a separately protected secret. hash is one-way for this policy document, but hashes can still be sensitive linkage material.

Setup workflow

Follow this order exactly:

1. Explain that the result is a draft configuration and that human approval is required. Ask only for the five decisions in the table.

2. Normalize each answer for comparison by trimming surrounding whitespace, folding case, and treating spaces or underscores as hyphens. Match the normalized answer against the bounded choices exactly. Do not accept a free-form value, and do not infer a jurisdiction from prose.

3. If an answer is missing or invalid, stop before writing the artifact. Report only the field name and the allowed canonical choices; never echo the answer, a source value, or exception text.

4. Read the local DEID-POLICY.template.md and replace only its five decision placeholders:

   • {{ jurisdiction }}
   • {{ recall_floor }}
   • {{ surrogate_strategy }}
   • {{ model_policy }}
   • {{ audit_location }}

   Before substitution, require Template version: 1.0, Policy schema: 1, and exactly one occurrence of each listed placeholder with no other placeholder. If that contract differs, stop before writing and report only that the template contract is invalid. Preserve the template version, section order, checkboxes, and line endings. Do not add a timestamp, random identifier, machine path, user identity, source text, detected span, model output, or free-form rationale.

5. Resolve the user-requested project directory and require it to be an existing local directory. The output target is exactly its direct child DEID-POLICY.md; do not accept a different filename or derive one from an answer. Refuse a symlink or any existing non-regular target. If a regular file already exists, ask for explicit permission before replacing it; never overwrite it implicitly or write through a symlink. Render to a uniquely created sibling temporary file, flush and sync its bytes, recheck the resolved parent and target immediately before replacement, and atomically replace the target. If the target appeared after the first check and no replacement was approved, stop. Clean up the temporary file on every failure.

6. Report only that DEID-POLICY.md was written in the requested project directory and that review is pending. Never print the absolute or parent directory path, the collected answers, a source payload, or exception text.

The same five canonical choices and the same template version must produce byte-for-byte identical output. Do not use the current time, environment variables, network responses, or machine-specific paths in the artifact.

Local-only model rule

This setup does not download a model or call a hosted service. With local-preinstalled, stop and ask the project owner to install or provide the approved local model if it is absent. With local-user-supplied, record no secret or personal path in DEID-POLICY.md; the caller supplies the model outside the artifact. rules-only must remain deterministic and local. A later pipeline may have its own explicitly approved setup step, but it is not part of this skill and must never be mandatory here.

Human approval gate

The template always writes DRAFT — HUMAN APPROVAL REQUIRED. Stop after the draft is written. A human reviewer must inspect the five choices, verify that the intended local model and audit handling exist, and explicitly change the status to approved through the project's review process. The setup workflow must not self-approve, sign, certify, or claim a regulatory outcome.

Handoff

• Apply the selected profile with configuring-privacy-policies.
• Transform text with deidentifying-clinical-text.
• Check coverage with auditing-deidentification-runs.

Those skills inherit this artifact's guardrails. Keep any audit report limited to offsets, hashes, provenance, counts, and risk summaries; never put raw identifiers into logs, exceptions, reports, fixtures, or the policy file.