Authoritative Source Ledger

Research and access date: 2026-07-23

Method: targeted parallel-cli search restricted to official domains, followed by parallel-cli extract for canonical pages and documents. No research output files were retained in the repository.

This ledger supports the skill's documentation and governance design. It is not a clinical evidence review and must not be used to select treatment.

Privacy and data governance

HHS OCR — HIPAA de-identification guidance

• URL: https://www.hhs.gov/hipaa/for-professionals/special-topics/de-identification/index.html
• Page date observed: 2026-03-20
• Used for: the distinction between Expert Determination and Safe Harbor; required documentation for Expert Determination; Safe Harbor's actual-knowledge condition; risks in free text and clinical narratives.
• Boundary: the bundled checklist performs neither method and never claims de-identification or HIPAA compliance.

HHS OCR — Minimum Necessary Requirement

• URL: https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/minimum-necessary-requirement/index.html
• Page date observed: 2026-03-18
• Used for: reasonable limitation of uses, disclosures, and requests; role-based policies; routine/non-routine procedures; listed exceptions including treatment-purpose disclosures and requests.
• Boundary: the skill does not decide whether an exception applies and adopts data minimization as a conservative process safeguard.

HHS OCR — Breach Notification

• URL: https://www.hhs.gov/hipaa/for-professionals/breach-notification/index.html
• Portal: https://ocrportal.hhs.gov/ocr/breach/breach_report.jsf
• Accessed: 2026-07-23
• Used for: identifying the official privacy-incident reporting authority and preserving a local reporting route.
• Boundary: the skill does not determine breach status, legal duty, deadline, or report content and does not submit reports.

FDA labeling and medication-risk programs

FDA — Human prescription-drug labeling resources

• URL: https://www.fda.gov/drugs/laws-acts-and-rules/fdas-labeling-resources-human-prescription-drugs
• Content-current date observed: 2026-03-15
• Used for: distinguishing FDA-approved labeling in Drugs@FDA from other current/in-use labeling; identifying official labeling and safety-change databases.
• Boundary: an authorized clinician or pharmacist verifies exact product applicability. The skill never interprets labeling or derives a patient-specific action.

FDA — Patient labeling resources

• URL: https://www.fda.gov/drugs/fdas-labeling-resources-human-prescription-drugs/patient-labeling-resources
• Content-current date observed: 2024-08-19
• Used for: distinctions among Medication Guides, Patient Package Inserts, Instructions for Use, and non-FDA-reviewed consumer medication information.
• Boundary: the skill does not create or paraphrase product instructions.

FDA — What's in a REMS?

• URL: https://www.fda.gov/drugs/risk-evaluation-and-mitigation-strategies-rems/whats-rems
• Content-current date shown by FDA: 2018-01-26
• Used for: product-specific participant roles, communications, required activities, certifications, enrollment, monitoring, and safe-use conditions.
• Currency control: current programs and materials must be checked in REMS@FDA.
• Boundary: the skill does not decide applicability or whether prescribing, dispensing, or administration may proceed.

FDA — REMS@FDA

• URL: https://www.accessdata.fda.gov/scripts/cder/rems/index.cfm
• Accessed: 2026-07-23
• Used for: authoritative current REMS program and material locators.
• Boundary: no automated lookup occurs while processing patient data.

Medication safety and care transitions

WHO — Transitions of Care

• URL: https://www.who.int/docs/default-source/patient-safety/9789241511599-eng.pdf?sfvrsn=a577528_2
• Publication date observed: 2016-09-19
• Used for: process-level structure for accurate information transfer, medication reconciliation, patient/carer engagement, ownership, checklists, tracking, and local systems.
• Boundary: older global process guidance is not a current specialty treatment guideline; local institution policy and authorized clinicians control.

Joint Commission — Right Patient, Right Care / handoff process

• URL: https://digitalassets.jointcommission.org/api/public/content/2361b813982a420cb9590bd363d9c3f1?v=994360b5
• Material reviewed: 2025 National Performance Goal content
• Used for: high-level identification, handoff communication, critical-result communication, and continuity concepts.
• Boundary: no proprietary standard text is reproduced; the skill does not claim accreditation compliance.

Shared decision-making and person-centered planning

AHRQ — The SHARE Approach

• URL: https://www.ahrq.gov/health-literacy/professional-training/shared-decision/index.html
• Page review date observed: 2026
• Used for: clinician-led dialogue about options, benefits, harms, risks, and what matters to the person.
• Boundary: the skill records a completed process; it does not conduct the conversation or generate options and risk estimates.

AHRQ — Shared Decisionmaking strategy

• URL: https://www.ahrq.gov/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/communication/strategy6i-shared-decisionmaking.html
• Accessed: 2026-07-23
• Used for: balanced decision-aid principles and avoiding tools that steer toward one treatment.
• Boundary: no decision aid or patient-specific choice is generated.

NICE NG197 — Shared decision making

• URL: https://www.nice.org.uk/guidance/ng197
• Published and last reviewed: 2021-06-17
• Used for: documenting collaboration, risks, benefits, consequences, uncertainty, and organizational support.
• Boundary: NICE states the guideline excludes unexpected emergencies and does not replace professional judgment; local jurisdiction and policy control.

CMS — Person-Centered Care

• URL: https://www.cms.gov/priorities/innovation/key-concepts/person-centered-care
• Page date observed: 2023-08-14
• Used for: high-level goals, values, preferences, communication, coordination, and patient-reported outcomes concepts.
• Boundary: this is not treated as a universal documentation mandate. Program-specific CMS requirements are used only after applicability review.

Reporting and safety governance

FDA — Reporting Serious Problems to FDA / MedWatch

• URL: https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program/reporting-serious-problems-fda
• Page date observed: 2026-06-05
• Used for: identifying MedWatch as an official route for specified medical-product problems and distinguishing voluntary and mandatory reporting contexts.
• Boundary: local qualified personnel determine applicability and reporting obligations. The skill does not file a report.

AHRQ PSO — Common Formats and NPSD

• URL: https://pso.ahrq.gov/common-formats
• Page last reviewed: 2026-01
• Used for: identifying standardized patient-safety event formats and non-identifiable NPSD data within authorized PSO workflows.
• Boundary: the skill does not create a PSO submission or confer Patient Safety and Quality Improvement Act privilege/confidentiality.

Deliberate exclusions

• No disease-specific, specialty-specific, dosing, treatment-sequencing, interaction, contraindication, tapering, prognosis, triage, or emergency-treatment source was embedded.
• No commercial point-of-care reference was treated as authoritative regulatory guidance.
• No CMS billing or care-plan rule was generalized beyond its exact program.
• No source in this ledger replaces current local institution policy or case-specific review by authorized licensed professionals.