arXiv AI

ReLMem: Learning Recurrent Memory for Longitudinal EHR Modeling

arXiv Machine Learning
Sep 14

Reinforcement Learning over Patient Trajectories for Clinical Reasoning in EHR Foundation Models

The paper proposes a reinforcement learning (RL) fine‑tuning framework for electronic health record (EHR) foundation models, treating them as generative policies over patient trajectories. By framing clinical prediction tasks such as hospital readmission as event‑conditioned, time‑windowed reasoning problems and designing time‑aware, rollout‑sensitive rewards, the authors show that RL fine‑tuning consistently outperforms pre‑trained backbones and strong baselines. The approach enables smaller models to surpass larger pre‑trained models in data‑limited settings, induces positive transfer across tasks, and produces trajectories with stronger structural and semantic alignment to ground truth, improving downstream utility.

By Yuxin Xiao, Sheng Zhang, Chandan Singh, Tristan Naumann, Hoifung Poon, Jianfeng Gao, Xiaodong Liu
arXiv Machine Learning
Aug 4

EHR2Path: Comprehensive Pathway-Level Modeling of Longitudinal Patient Trajectories from Multimodal Electronic Health Records

arXiv:2506. 04831v3 Announce Type: replace Abstract: Forecasting how a patient's condition is likely to evolve, including possible deterioration, recovery, treatment needs, and care transitions, could support more proactive and personalized care, but requires modeling heterogeneous and longitudinal electronic health record (EHR) data.

By Chantal Pellegrini, Ege \"Ozsoy, David Bani-Harouni, Matthias Keicher, Nassir Navab
arXiv Machine Learning
Jul 20

LLM4EHR: Aligning Clinical Time Series with Medical Event Sequences via Large Language Models

arXiv:2607. 15447v1 Announce Type: new Abstract: Recent research in clinical machine learning, focusing on outcome predictions in intensive care unit (ICU), has shifted from bespoke supervised models to foundation models, utilising modern representation learning methods.

By Jingteng Li, Alexander Capstick, Louise Rigny, Iona Biggart, Neil J Sebire, Payam Barnaghi
arXiv Machine Learning
1d ago

GLoC-EHR: Evidence-Cited Clinical Reasoning over Global Context and Local EHR Events

GLoC-EHR is a multimodal language model that processes electronic health records by combining a fixed-size global memory of the entire patient trajectory with a local memory of selected events. It generates hospital-course summaries and masked concept descriptions, then is fine‑tuned to cite evidence before answering clinical questions, using group relative policy optimization to reward correct, evidence‑supported responses. On MIMIC‑IV outcome tasks, GLoC‑EHR achieves the highest macro AUROC among compared models when answering directly, and maintains strong performance with evidence‑cited reasoning while adding distinct supported findings from the local memory.

By Chaiho Shin, Kwangsoo Kim
arXiv Machine Learning
Jun 24

PORTER: Language-Grounded Event Representations for Portable Structured EHR Foundation Models

arXiv:2606. 24102v1 Announce Type: cross Abstract: Most electronic health record (EHR) foundation models encode clinical events as discrete event tokens from a fixed vocabulary and therefore cannot directly represent events containing unseen concepts or new combinations of concepts and attributes such as numeric values.

By Lin Lawrence Guo, Adam Paul Yan, Emily Vettese, Lillian Sung
arXiv AI
Jun 3

ChatHealthAI: Aligning Electronic Health Record Representations with Large Language Models for Grounded Clinical Reasoning

arXiv:2606. 02802v1 Announce Type: new Abstract: Large language models (LLMs) exhibit strong natural-language reasoning abilities for clinical decision support, but struggle to effectively model structured longitudinal electronic health records (EHRs).

By Bo-Hong Wang, Baicheng Peng, Ruilin Wang, Jun Bai, Ziyang Song, Yue Li
arXiv Machine Learning
Jun 8

One Loss to Rule Them All: Marked Time-to-Event for Structured EHR Foundation Models

arXiv:2602. 00541v2 Announce Type: replace Abstract: Clinical events captured in Electronic Health Records (EHR) are irregularly sampled and may consist of a mixture of discrete events and numerical measurements, such as laboratory values or treatment dosages.

By Zilin Jing, Vincent Jeanselme, Yuta Kobayashi, Simon A. Lee, Chao Pang, Aparajita Kashyap, Yanwei Li, Xinzhuo Jiang, Shalmali Joshi