Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

Annotations already declare readOnlyHint=true, destructiveHint=false and openWorldHint=true, so safety is covered. The description still adds real behavior beyond them: default ordering ('newest first as Akute returns them'), the 10-record page cap, and the default exclusion of entered-in-error notes. No auth or rate-limit detail, so not a 5.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Is the description appropriately sized, front-loaded, and free of redundancy?

Two tight sentences with the resource, scope and returned fields front-loaded; nothing is padded. 'as Akute returns them' is slightly vague and the trailing 'GET /notes' adds little, but overall it is efficiently sized.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

There is no output schema, so the description carries the return-value burden and does so by enumerating the fields returned plus ordering and page size. Given a read-only list tool with 5 parameters this is close to complete; only error/edge behavior is unaddressed.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema coverage is 60%, so the schema already documents limit and offset well. The description compensates where it matters by stating patient_id is required, that pages are capped at 10, and that the status enum's 'entered-in-error' value is opt-in only. It says nothing extra about service_date_start.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Does the description clearly state what the tool does and how it differs from similar tools?

Names the exact resource ('Clinical notes (encounters)'), the scope ('of ONE patient'), the ordering, and the fields returned (type, service date, status, authors, section text). This is enough for an agent to distinguish it from akutehealth_get_note and from the other list_* siblings without opening a schema.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Does the description explain when to use this tool, when not to, or what alternatives exist?

States the prerequisite (patient_id required) and a meaningful inclusion rule ('entered-in-error' notes appear only when asked for), plus the pagination ceiling. It stops short of naming alternatives or saying when to prefer this over get_note / other list tools, so it is clear context without explicit exclusions.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.