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

Annotations only supply destructiveHint=true; the description adds substantive context beyond that by disclosing that the call writes PHI and triggers health-information-exchange queries, plus the concrete endpoint. It stops short of covering auth requirements, idempotency, or error behavior, but the key side effects are surfaced.

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?

A single tight sentence with the primary purpose front-loaded, followed by the endpoint and required-param note. Every clause carries information; nothing is padded.

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?

For a 9-parameter mutation with no output schema, the description covers the operation, its side effects, and the endpoint, and the schema fully documents the inputs. The one notable gap is that, with no output schema present, it does not hint at what the call returns (e.g., a patient ID), leaving that to inference.

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 description coverage is 100%, so all 9 parameters (including the 6 required ones) are already documented in the schema. The description only restates that facilityId is required, adding no meaning beyond what the schema provides; baseline 3 applies.

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?

States a specific verb and resource ('Creates a Patient in Metriport') and immediately distinguishes itself from the sibling get_/list_ tools by noting it writes PHI and initiates HIE queries. An agent can identify its role without opening the 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?

There is no explicit when-to-use/when-not guidance and no reference to alternatives (e.g., get_patient or any update path). The implied usage is registration of a new patient, but the agent must infer that from the verb alone.

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