Free OpenClaw Skill for Dermatology Practices: Recall and Biopsy Follow-up Agent (Download)

What this skill does for your dermatology practices

• Compiles the daily pathology follow-up roster from ModMed / EMA, flagging benign, atypical, and malignant results with the called-by-EOD priority queue.
• Runs Mohs scheduling outreach for confirmed BCC and SCC patients, with pre-op instruction templates and same-week slot offers from the surgical schedule.
• Owns the iPLEDGE 30-day pregnancy test, lab, and counseling cadence for isotretinoin patients with the REMS clock visible to the MA.
• Compiles annual skin check recall for full-body exam patients on the 12-month, 18-month, and 24-month windows based on AAD risk stratification.
• Chases prior authorizations on biologics (Dupixent, Skyrizi, Tremfya, Cosentyx, Rinvoq) with payer-specific submission templates and appeal language.

What's inside this OpenClaw skill

The full file you download, indexed below for search engines and for operators who want to read before they install.

---
name: dermatology-recall-and-biopsy
description: Pathology follow-up, Mohs scheduling, iPLEDGE adherence, annual skin check recall, and biologic prior auth chase for dermatology practices. Integrates with ModMed EMA, Nextech, eClinicalWorks.
version: 1.0.0
author: OpenClaw Consult (Adhiraj Hangal)
license: MIT
url: https://openclawconsult.com/skills/dermatology-practices
---

# OpenClaw Skill: Dermatology Recall and Biopsy Follow-up

## Overview

This skill turns the OpenClaw agent into a recall and biopsy follow-up coordinator
for your dermatology practice. It owns the daily pathology callback workload, the
Mohs scheduling chase, the iPLEDGE 30-day clock for isotretinoin patients, and the
annual full-body skin check recall on AAD-aligned windows.

It is designed for 1 to 6 provider general dermatology practices, Mohs surgical
practices, and mixed medical / cosmetic groups running ModMed EMA, Nextech, or
eClinicalWorks. Single-location and small DSO-style multi-location practices
both work.

The skill does not replace the MA or the path tech: it amplifies them. A 2-derm
practice typically posts 30 to 50 biopsy results per day and the MA spends
2 to 3 hours per day on callback work that the agent can pre-draft and triage
in minutes.

## What this skill does

1. Daily pathology follow-up roster (benign, atypical, malignant) with severity-keyed routing
2. Mohs scheduling outreach for confirmed BCC and SCC patients with same-week slot offers
3. iPLEDGE 30-day clock tracking for isotretinoin patients with REMS attestation prompts for the prescriber
4. Annual full-body skin check recall on AAD risk-stratified windows (high-risk 6 months, standard 12 months)
5. Biologic prior auth chase (Dupixent, Skyrizi, Tremfya, Cosentyx, Rinvoq) with payer-specific clinical justification drafts
6. No-show recovery for surgical and cosmetic appointments with same-week rebook logic

## Triggers

```yaml
triggers:
  - type: heartbeat
    schedule: "0 7 * * 1-5"          # Weekdays 7am
    action: compile_pathology_roster
    lookback_hours: 18

  - type: heartbeat
    schedule: "0 8 * * 1-5"          # Weekdays 8am
    action: run_ipledge_clock_check

  - type: heartbeat
    schedule: "0 7 * * 1"            # Mondays 7am
    action: compile_annual_skin_check_recall

  - type: heartbeat
    schedule: "0 14 * * 1-5"         # Weekdays 2pm
    action: prior_auth_followup_roster

  - type: on_event
    event: ehr.pathology_result_posted
    action: enter_pathology_callback_queue

  - type: on_event
    event: ehr.biopsy_confirmed_malignant
    action: enter_mohs_scheduling_queue
```

## Workflow: pathology follow-up

When the lab posts pathology to the EHR, the agent:

1. Reads the pathology category: benign, atypical (mild / moderate / severe dysplastic), or malignant (BCC, SCC, melanoma, melanoma in situ, other)
2. Tags the patient with the urgency tier: standard (benign, 5 business days), priority (atypical, 48 hours), urgent (malignant, same day)
3. For benign results, drafts the reassurance message including the patient's original concern from the visit note
4. For atypical results, holds outbound contact and routes to the dermatologist for the conservative excision vs observation decision
5. For malignant results, generates an MA call script, a same-day callback flag, and an open Mohs surgical slot offer (if BCC or SCC on a high-risk site)
6. Logs every outbound and outcome to memory so the daily standup digest reflects what closed and what is still open

The skill defaults to MA-approves-every-benign-message and prescriber-approves-every-atypical-or-malignant. After two weeks of validation, the benign callbacks move to autonomous.

## Workflow: Mohs scheduling

After a malignant pathology result is logged for BCC or SCC, the agent enters the patient into the Mohs scheduling queue:

1. Pulls the next 14 days of Mohs surgical slots from the practice scheduling system
2. Drafts a same-day callback script for the MA that explains the diagnosis at a 6th-grade reading level, the Mohs procedure, and the pre-op instructions
3. Offers three same-week slots prioritized by tumor location (nasal, periocular, ear, lip ranked higher than trunk and extremities)
4. Schedules the pre-op call 48 hours before the surgical date with anticoagulation, antibiotic, and ride-home reminders
5. Schedules the post-op wound care call 24 hours after the surgical date
6. Schedules the suture removal reminder at day 7 to 14 depending on body site

The skill does not place the patient in the surgical schedule. The Mohs coordinator confirms the slot manually. The agent is the upstream chase.

## Workflow: iPLEDGE compliance

For every isotretinoin patient, the agent maintains a REMS clock visible to the MA:

1. Tracks the 30-day pregnancy test window for patients of childbearing potential
2. Tracks the monthly counseling visit
3. Tracks the lab requirements (CBC, LFTs, lipid panel)
4. Surfaces patients at day 23 of their clock (one week before lockout) with a scheduling nudge
5. Surfaces patients at day 28 with no test logged as a red flag to the prescriber
6. Generates the MA script for missed-window patients with the rescheduling path

The skill never confirms anything in the iPLEDGE REMS portal. The prescriber and the MA still attest manually. This is decision support, not REMS submission.

## Workflow: annual skin check recall

Every Monday at 7am the agent:

1. Pulls the patient panel from the EHR
2. Filters for patients with full-body skin exam (FBSE) annotations in the chart
3. Stratifies by AAD risk: high-risk (personal history of melanoma, family history, transplant, immunosuppression) gets 6-month recall; standard gets 12-month; elevated gets 9-month
4. Flags patients hitting their next recall window this week
5. Drafts a recall message that references their last visit reason (mole check, atypical nevus surveillance, post-Mohs surveillance) for personalization
6. Routes to the MA for approval

A representative 2-derm practice with 6,000 active patients has 200 to 400 FBSE patients due in any 4-week window. The skill picks the right ones and ignores the rest.

## Workflow: biologic prior authorization

For new prescriptions of Dupixent, Skyrizi, Tremfya, Cosentyx, Rinvoq, Otezla, Olumiant, or Adbry, the agent:

1. Reads the payer from the patient's insurance
2. Loads the payer-specific clinical criteria (step therapy, severity thresholds, body surface area requirements, prior failed conservative therapies)
3. Drafts the clinical justification letter referencing the patient's documented history
4. Pre-fills the CoverMyMeds form or the payer portal questionnaire
5. Submits to the MA or prior auth coordinator for review
6. Tracks the submission, the payer's stated response window, and the appeal path if denied

The first denial is the most common. The skill includes appeal templates for the top 20 payers with citation-level references to the policy bulletins.

## Memory keys

```yaml
memory:
  - key: derm.pathology_queue[{patient_id}]
    description: Active pathology callback status
    schema: { result: benign|atypical|malignant, urgency: standard|priority|urgent, callback_drafted: bool, callback_sent: datetime, outcome: string }

  - key: derm.mohs_queue[{patient_id}]
    description: Mohs scheduling chase status
    values: [pending_first_contact, slot_offered, scheduled, pre_op_call_sent, post_op_call_sent, suture_removal_scheduled, complete]

  - key: derm.ipledge_clock[{patient_id}]
    description: Current iPLEDGE REMS clock state
    schema: { current_day: int, pregnancy_test_due: date, counseling_due: date, lab_due: date, flagged: bool }

  - key: derm.skin_check_recall[{patient_id}]
    description: Next FBSE recall date based on AAD risk
    schema: { risk_tier: high|elevated|standard, last_fbse: date, next_due: date, last_outreach: date }

  - key: derm.prior_auth_queue[{patient_id}][{drug}]
    description: Active biologic prior auth status
    values: [drafted, submitted, approved, denied_first, appeal_drafted, appeal_submitted, approved_on_appeal, abandoned]
```

## Message templates

```yaml
templates:
  pathology_benign_callback:
    body: |
      Hi {patient_first_name},

      Good news from {practice_name}. The biopsy we took on {biopsy_date} came
      back benign, which means no further treatment is needed.

      We do want to keep an eye on it long-term, so {provider_last_name} will
      see you back at your next routine skin check.

      Any questions, just reach back.

      {ma_first_name}

  pathology_malignant_callback_script:
    channel: ma_phone_script
    body: |
      Hi {patient_first_name}, this is {ma_first_name} from {practice_name}.
      I am calling about the biopsy results from {biopsy_date}. {provider_last_name}
      reviewed them with me and we want to walk you through next steps.

      The biopsy showed {layperson_diagnosis}. It is treatable and we have a clear
      next step: Mohs surgery, which is the gold standard for this kind of skin
      cancer in this location. We have an open slot {open_slot_1} or {open_slot_2}
      this coming week. Which one works for you?

      Before I let you go, I want you to know this is a very common diagnosis and
      we treat hundreds of cases like this every year. You are in good hands.

  ipledge_day_23_nudge:
    body: |
      Hi {patient_first_name},

      Quick reminder from {practice_name}. Your next iPLEDGE pregnancy test and
      check-in is due by {test_due_date}. The pharmacy will not refill your
      isotretinoin without it.

      Open slots:
      {open_slots}

      Reply with the one that works.

      {ma_first_name}

  skin_check_recall_annual:
    subject: "Time for your annual skin check"
    body: |
      Hi {patient_first_name},

      It has been about a year since {provider_last_name} last saw you for your
      skin exam. We want to keep on top of {last_visit_concern}, so we are
      reaching out to get the next one on the calendar.

      Open slots over the next 3 weeks:
      {open_slots}

      Whichever works, let me know.

      {ma_first_name}

  biologic_prior_auth_clinical_justification:
    channel: drafted_letter
    body: |
      Re: Prior Authorization for {drug_name} for {patient_full_name}

      {patient_full_name} is a {patient_age}-year-old with {diagnosis_with_icd10}
      who has failed an adequate trial of {prior_failed_therapies_list}. Severity
      at last visit on {last_visit_date}: {bsa_percent}% body surface area
      affected, {dlqi_score} DLQI, {pga_score} PGA.

      Per {payer_name} policy {payer_policy_number}, {drug_name} is indicated
      for patients meeting the above criteria.

      Requesting authorization for {drug_dose} {drug_frequency} for 12 months.

      Respectfully,
      {provider_full_name}, {provider_credentials}
      {provider_npi}
```

## Required integrations

| Integration            | Purpose                                            | Read | Write |
|------------------------|----------------------------------------------------|------|-------|
| ModMed EMA             | Patient, appointment, pathology, prescription data | yes  | optional |
| Nextech                | Patient, appointment, pathology, prescription data | yes  | optional |
| eClinicalWorks (FHIR)  | Patient and clinical data                          | yes  | no    |
| Path lab portals (Quest, LabCorp, dermpath) | Pathology result feed              | yes  | no    |
| CoverMyMeds            | Prior authorization workflow                       | yes  | optional |
| Twilio (or similar)    | Outbound SMS                                       | no   | yes   |
| Email provider         | Outbound email (SendGrid, Postmark, etc)           | no   | yes   |
| OpenClaw Memory        | Cross-run state                                    | yes  | yes   |
| OpenClaw Heartbeat     | Scheduled cadence triggers                         | yes  | yes   |

Write-back to ModMed or Nextech is optional. Most practices start read-only and have the MA commit any EHR changes manually. Once the agent is trusted, flip write access on for low-risk fields (recall date stamps, note appends, prior auth status flags).

## HIPAA notes

By default this skill operates on patient identifiers and appointment metadata
plus a coarse pathology category (benign / atypical / malignant). We deliberately
avoid putting specific histopathologic detail, biopsy site descriptions, or
medication-level treatment plans into outbound SMS. For stricter PHI handling,
set `phi_mode: identifier_only` in the config block and the agent will tokenize
all patient identifiers, requiring the MA to fill in personalized content from
the secure portal.

Confirm your BAA covers the cloud AI provider you point OpenClaw at. The skill
itself is local; the model inference is not. For iPLEDGE, REMS, and isotretinoin
workflows, the skill is decision support only. The prescriber attests directly
in the REMS portal.

## Configuration

```yaml
config:
  practice_name: "Your Practice Name"
  practice_focus: general_dermatology    # or "mohs_surgery", "cosmetic_only"
  providers:
    - last_name: "Patel"
      specialty: medical_dermatology
    - last_name: "Nguyen"
      specialty: mohs_surgery
  approval_mode: ma_approves_all          # or "autonomous_after_2_weeks"
  phi_mode: standard                      # or "identifier_only"
  pathology_urgency_routing:
    benign: standard_5_business_days
    atypical: priority_48h_to_provider
    malignant: urgent_same_day
  ipledge_red_flag_day: 28
  fbse_recall_windows:
    high_risk: 6_months
    elevated_risk: 9_months
    standard_risk: 12_months
  biologic_prior_auth_drugs:
    - Dupixent
    - Skyrizi
    - Tremfya
    - Cosentyx
    - Rinvoq
    - Otezla
    - Adbry
```

## Quick install

```bash
mkdir -p ~/.claude/skills
mv dermatology-practices.md ~/.claude/skills/dermatology-recall-and-biopsy.md
# Edit the config block to match your practice
```

Launch OpenClaw and the skill is live. Run `compile pathology roster` or
`run ipledge clock check` to invoke on demand, or wait for Heartbeat to fire
it on the configured schedule.

## Want it wired to your stack?

This SKILL.md is the starting point. If you want it plugged into your specific
EHR, your specific Mohs scheduling rules, your specific iPLEDGE workflow, and
your specific biologic prior auth playbook, on a fixed-price two-week clock,
with the founder writing every line of the build, the door is at
https://www.adhirajhangal.com/work

Install in 60 seconds

1. 1

   Drop the file into your OpenClaw skills directory

   Save the downloaded dermatology-practices.md as ~/.claude/skills/dermatology-recall-and-biopsy.md (or your project-level .claude/skills/ if you scope it per location). OpenClaw picks up new skill files on next agent launch, no restart command required.

2. 2

   Connect ModMed EMA (or your EHR) read access

   Edit the integrations block to point at your ModMed EMA, Nextech, or eClinicalWorks export. Read-only is enough to start. The skill ships prompts to translate your daily pathology log and Mohs queue into the agent's working memory.

3. 3

   Start in MA approval mode, then move to autonomous

   Run for two weeks with the MA approving every outbound text. The skill defaults route any malignant pathology result, iPLEDGE clock failure, biologic denial, and Mohs same-week scheduling to a human. After two weeks, flip benign biopsy callbacks and annual skin check recall to autonomous.

Example conversation

Common questions

Related free skills