start-dhti — community start-dhti, community, ide skills, Claude Code, Cursor, Windsurf

v1.0.0
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About this Skill

Ideal for Gen AI Healthcare Agents requiring rapid prototyping and development of backend and frontend components with Node.js and Docker DHTI: a reference architecture for Gen AI in healthcare and a skill platform for vibe coding!

dermatologist dermatologist
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Updated: 3/5/2026

Agent Capability Analysis

The start-dhti skill by dermatologist is an open-source community AI agent skill for Claude Code and other IDE workflows, helping agents execute tasks with better context, repeatability, and domain-specific guidance.

Ideal Agent Persona

Ideal for Gen AI Healthcare Agents requiring rapid prototyping and development of backend and frontend components with Node.js and Docker

Core Value

Empowers agents to install elixirs and conches, set up fully functional DHTI development servers, and rapidly prototype GenAI healthcare applications using Node.js, Docker, and Docker Compose, facilitating efficient testing and deployment

Capabilities Granted for start-dhti

Installing custom elixirs and conches for GenAI healthcare applications
Setting up DHTI development servers for rapid prototyping
Developing and testing backend and frontend components for healthcare applications

! Prerequisites & Limits

  • Requires Node.js version 18.0.0 or higher
  • Docker and Docker Compose must be installed and running
  • Sufficient disk space required for Docker images
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start-dhti

Install start-dhti, an AI agent skill for AI agent workflows and automation. Works with Claude Code, Cursor, and Windsurf with one-command setup.

SKILL.md
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When to Use This Skill

Use this skill when you need to:

  • Install elixirs and conches created by other skills
  • Set up a fully functional DHTI development server for testing and prototyping
  • Rapidly prototype GenAI healthcare applications with both backend and frontend components

Prerequisites

Before using this skill, ensure you have:

  • Node.js (>= 18.0.0) installed
  • Docker and Docker Compose installed and running
  • Sufficient disk space for Docker images

Instructions

You are a DHTI orchestration agent working to create a complete GenAI healthcare application. Follow these instructions sequentially. The user conversation may provide context on the work you have done in the past. Always internalize that and reuse it where possible.

Phase 1: Environment Setup

  1. Verify Prerequisites:

    • Check that Node.js and Docker are installed
    • Verify Docker is running: docker ps
  2. Directory Structure

workspace/
└── dhti-elixir/
    └── packages/
        └── <name>/                # Your generated elixir package
            ├── notes/todo.md          # Your detailed TODO list and plan
            ├── src/dhti_elixir_<name>/   # Main code for the elixir
            │   ├── chain.py              # Main chain implementation
            │   ├── bootstrap.py          # Bootstrap/configuration file
            │   ├── README.md             # Documentation for your elixir
            │   └── (other files, e.g., __init__.py, utils.py)
            ├── pyproject.toml            # Add new dependencies here
            └── tests/
                └── test_chain.py         # Example test file for chain.py
└── openmrs-esm-dhti/
    └── packages/
        └── esm-dhti-<name>/           # Your generated elixir package
            ├── notes/todo.md          # Your detailed TODO list and plan
            ├── src/   # Main code for the conch with multiple subdirectories.
            ├── package.json          # Update dependencies and metadata here
            └── README.md             # Documentation for your conch

Phase 2: Set Up DHTI Infrastructure

  1. Create Docker Compose Configuration:

    bash
    1npx dhti-cli compose add -m langserve

    This creates a Docker Compose configuration with:

    • LangServe (GenAI backend)
    • Other necessary infrastructure

    Optionally add additional modules as needed:

    • -m ollama for local LLM hosting
    • -m langfuse for monitoring
    • -m redis for vector store
    • -m neo4j for graph utilities
    • -m cqlFhir for CQL support
    • -m mcpFhir for MCP server
  2. Verify Compose Configuration:

    bash
    1npx dhti-cli compose read

Phase 3: Install Elixir from Local Directory (If Applicable)

  1. Install the Generated Elixir:

    • Install the elixir from workspace directory in the current path.
    • If workspace directory does not exist, use the path provided in the original user prompt.
    • Use the -l flag to specify the directory.
    • Use -n flag with the elixir's project name (starting with dhti-elixir-)
    bash
    1npx dhti-cli elixir install -l <elixir-path> -n <elixir-name>

    Example:

    bash
    1npx dhti-cli elixir install -l workspace/dhti-elixir/packages/glycemic_advisor -n glycemic_advisor
  2. Build Elixir Docker Image:

    bash
    1npx dhti-cli docker -n dhti/genai-test:1.0 -t elixir

    Replace dhti with your Docker Hub username or registry name if available from the original user prompt.

Phase 4: Install Conch from Local Directory (If Applicable)

  1. Install the Generated Conch:

    • Install the conch from workspace directory in the current path.
    • If workspace directory does not exist, use the path provided in the original user prompt.
    • Use the -l flag to install the conch from the directory.
    • Use -n flag with the conch's project name (starting with openmrs-esm-dhti-)
    bash
    1npx dhti-cli conch install -l <conch-path> -n <conch-name>

    Example:

    bash
    1npx dhti-cli conch install -l workspace/openmrs-esm-dhti/packages/esm-glycemic-advisor -n esm-glycemic-advisor

Hot Reload / Dev Sync (If Applicable)

Use these commands to sync work-in-progress code/assets into running containers. This is ideal for UI tweaks and elixir logic changes that don't alter dependencies.

  • Elixir dev sync
bash
1npx dhti-cli elixir dev -d <<workspace>>/dhti-elixir/packages/<<elixir-name>> -n <<elixir-name>> -c dhti-langserve-1

Note: If dependencies change (e.g., requirements.txt or pyproject.toml), rebuild the image instead of using dev sync.

  • Conch dev sync
bash
1npx dhti-cli conch dev -d <<workspace>>/openmrs-esm-dhti/packages/<<conch-name>> -n <<conch-name>> -c dhti-frontend-1

Tip: Clear your browser cache if assets look stale after syncing.

  • Update runtime bootstrap
bash
1npx dhti-cli docker bootstrap -f <<workspace>>/bootstrap.py -c dhti-langserve-1

When run for the first time, this command will copy the bootstrap file into the langserve container to workspace. Subsequent runs will sync changes from the local bootstrap file to the container, allowing you to update runtime configurations without rebuilding the image. This is especially useful for tweaking model settings, tool configurations, or other parameters defined in the bootstrap file during development.

Phase 5: Start DHTI Server

  1. Start All Services:
    bash
    1npx dhti-cli docker -u

Phase 6: Decide whether to use OpenMRS or CDS-Hooks container.

If a conch is installed, then you should use OpenMRS container to see the conch in action. If no conch is installed, you can choose to use CDS-Hooks container to test the elixir functionality.

If using OpenMRS container:

npx dhti-cli conch install # if you have not performed this step before.
npx dhti-cli conch start -s packages/<<conch-name>>

Example:

npx dhti-cli conch install # if you have not performed this step before.
npx dhti-cli conch start -s packages/esm-chatbot-agent
  • Login to OpenMRS with at http://localhost:8080/openmrs/spa/home
    • Username: admin
    • Password: Admin123

You may include multiple conches with multiple -s flags to start them at the same time.

  1. Wait for Services to Initialize:

    • Wait 2-3 minutes for all services to fully start
    • Monitor logs: docker compose logs -f
  2. Hand off with the following instructions:

    • Navigate to http://localhost:8080/openmrs/spa/home
    • Login credentials:
      • Username: admin
      • Password: Admin123

If using CDS-Hooks container:

  • First kill any running processes on port 8080 to free it up for CDS-Hooks container. Then start the CDS-Hooks container with the elixir.
npx dhti-cli elixir start -n <<elixir-name>> &

Example:

npx dhti-cli elixir start -n glycemic_advisor &

NOTE the Application link in the output rather than the final display link.

  1. Wait for Services to Initialize:
  • Wait 2-3 minutes for all services to fully start
  • Monitor logs: docker compose logs -f
  1. Hand off with the following instructions:
  • Request the user to run npx dhti-cli elixir start -n <<elixir-name>> to start the CDS-Hooks container with the elixir.
  • Display the Application link: <<application-link>>
  • Request to open application link in browser to access it.

Phase 9: Clean Up (If Needed)

  1. Cleanup Instructions:
    • Provide commands to stop and remove containers:
      bash
      1npx dhti-cli docker -d
    • Document how to restart the server
    • Explain how to rebuild images after changes

Development Mode (Optional)

Dry-Run Mode

Before making any changes, use the --dry-run flag to preview actions:

bash
1npx dhti-cli compose add -m openmrs -m langserve --dry-run 2npx dhti-cli elixir install -l <path> -n <name> --dry-run 3npx dhti-cli conch install -l <path> -n <name> --dry-run

Troubleshooting

Common issues and solutions:

  1. Docker containers fail to start:

    • Check Docker is running: docker ps
    • Verify port availability (80, 8080, 8000)
    • Check Docker logs: docker compose logs <service-name>
  2. Elixir installation fails:

    • Verify the path exists and is accessible
    • Check that the elixir project structure is correct
    • Ensure pyproject.toml exists in the elixir directory
  3. Conch installation fails:

    • Verify the path exists and is accessible
    • Check that routes.json exists in the conch directory
    • Ensure the conch follows OpenMRS ESM structure
  4. OpenMRS not accessible:

    • Wait longer for initialization (3-5 minutes)
    • Check nginx gateway logs
    • Verify all containers are running: docker ps

Notes

  • Always use dry-run mode first to verify commands
  • Generated projects can be version controlled and shared
  • Docker images can be pushed to registries for deployment
  • The skill creates a complete, production-ready DHTI application
  • The user conversation may provide context on the work you have done in the past. Always internalize that and reuse it where possible.

FAQ & Installation Steps

These questions and steps mirror the structured data on this page for better search understanding.

? Frequently Asked Questions

What is start-dhti?

Ideal for Gen AI Healthcare Agents requiring rapid prototyping and development of backend and frontend components with Node.js and Docker DHTI: a reference architecture for Gen AI in healthcare and a skill platform for vibe coding!

How do I install start-dhti?

Run the command: npx killer-skills add dermatologist/dhti/start-dhti. It works with Cursor, Windsurf, VS Code, Claude Code, and 19+ other IDEs.

What are the use cases for start-dhti?

Key use cases include: Installing custom elixirs and conches for GenAI healthcare applications, Setting up DHTI development servers for rapid prototyping, Developing and testing backend and frontend components for healthcare applications.

Which IDEs are compatible with start-dhti?

This skill is compatible with Cursor, Windsurf, VS Code, Trae, Claude Code, OpenClaw, Aider, Codex, OpenCode, Goose, Cline, Roo Code, Kiro, Augment Code, Continue, GitHub Copilot, Sourcegraph Cody, and Amazon Q Developer. Use the Killer-Skills CLI for universal one-command installation.

Are there any limitations for start-dhti?

Requires Node.js version 18.0.0 or higher. Docker and Docker Compose must be installed and running. Sufficient disk space required for Docker images.

How To Install

  1. 1. Open your terminal

    Open the terminal or command line in your project directory.

  2. 2. Run the install command

    Run: npx killer-skills add dermatologist/dhti/start-dhti. The CLI will automatically detect your IDE or AI agent and configure the skill.

  3. 3. Start using the skill

    The skill is now active. Your AI agent can use start-dhti immediately in the current project.

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