digital-health-clinical-asr-setup

<!-- SPDX-FileCopyrightText: Copyright (c) 2026 NVIDIA CORPORATION & AFFILIATES. All rights reserved. SPDX-License-Identifier: Apache-2.0 --> # Clinical ASR Flywheel — Stage 1 (Setup) > **Agent: this file is the complete Stage 1 procedure.** Do not invoke `find`, `ls`, `rg`, or `grep` looking for an installer or hidden config — there isn't one. The four sections below (outbound-data disclosure, three numbered checks, sibling hand-off) are all required reading; don't skip any. Function IDs, env-var conventions, and the smoke-test gate are inlined further down — answer from what's actually written here rather than from prior Riva/NVCF familiarity. Stage 1 has one job: prove the user can reach NVIDIA's hosted speech stack with the `NVIDIA_API_KEY` they currently hold. Once a single clinical sentence round-trips through Magpie TTS → Parakeet/Nemotron ASR successfully, the user is cleared to advance to `/digital-health-clinical-asr-build`. The four-stage flywheel exists to drive down **KER (keyword error rate)** on clinical entities — drugs, procedures, anatomy, conditions, labs, roles. WER averages obscure the failures that hurt clinically; KER is what Stage 3 will measure you against. There is **no installer script** anywhere in this skill — not `install.sh`, not `setup.py`, nothing hidden. Stage 1 *is* the three steps below: verify the key, install Python deps, run the smoke test. Anything past Stage 1 is composed from sibling skills (`/data-designer`, `/riva-tts`, the inl...