HL7 FHIR JSON PII Redaction for Node.js: Clinical AI Data Guard

import Anthropic from '@anthropic-ai/sdk';
import { sanitize, restore } from '@privacyscrubber/sdk';

const anthropic = new Anthropic({ apiKey: process.env.ANTHROPIC_API_KEY });

const fhirPatientResource = {
  resourceType: 'Patient',
  id: 'pat-99412',
  name: [{ use: 'official', family: 'Kowalski', given: ['Stanislaw'] }],
  telecom: [{ system: 'phone', value: '312-555-0199' }],
  birthDate: '1968-11-04',
  diagnosis: 'Type 2 Diabetes Mellitus (ICD-10 E11.9)'
};

// 1. Sanitize in local RAM before LLM ingestion (<1ms)
const rawJson = JSON.stringify(fhirPatientResource);
const { scrubbedText, tokenMap } = sanitize(rawJson, {
  profile: 'Medical'
});

const safeResource = JSON.parse(scrubbedText);
console.log('Sanitized FHIR Resource for AI:');
console.log(safeResource);
// name is [NAME_1], telecom is [PHONE_1], but ICD-10 E11.9 is preserved!

// 2. Pass to AI clinical assistant:
const response = await anthropic.messages.create({
  model: 'claude-3-5-sonnet-20241022',
  max_tokens: 1024,
  messages: [{ role: 'user', content: `Provide care management recommendations for this patient:\n\n${scrubbedText}` }]
});
const summary = response.content[0].type === 'text' ? response.content[0].text : '';

// 3. Restore in local EHR:
const cleartextSummary = restore(summary, tokenMap).restoredText;
console.log('\nRestored EHR Clinical Summary:');
console.log(cleartextSummary);