arXiv Machine Learning

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.

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
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 Machine Learning
Aug 21

Explainable Transformer Models for Clinical Prediction Tasks on Structured Electronic Health Records

arXiv:2608. 20315v1 Announce Type: new Abstract: Predictive models over structured electronic health records (EHRs) remain central to machine learning for healthcare, but few have jointly emphasized quantitative laboratory information and interpretability with respect to input medical events.

By Jun Ni Du, Lukas Adamek, Maxim Kryukov, Flavio Dormont, Ziv Bar-Joseph, Sven Jager, Brandon Rufino
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 AI
Sep 1

INTERVenE: Temporal-Abstraction-Interval Based Transformers for Short-Horizon Medical Event Prediction

INTERVenE introduces Transformer models that use a knowledge‑based temporal abstraction (KBTA) token stream of named clinical concepts instead of raw measurements, enabling per‑token attributions to resolve directly to clinical concepts. Two variants are offered: an auto‑regressive decoder that generates future abstraction trajectories with step‑wise risk readouts, and a bidirectional encoder that jointly predicts risk and time‑to‑event in a single pass. On 57,078 MIMIC‑IV admissions, the encoder variant outperforms neural baselines with a support‑weighted AUPRC of 0.672 and AUROC of 0.901, while the decoder provides complementary token‑level risk trajectories.

By Shahar Oded, Yuval Shahar
arXiv Machine Learning
Sep 14

Representation Before Training: A Practical Benchmark for Generative Medical Event Model Tokenization

The study benchmarks tokenization choices for generative medical event models, evaluating quantization granularity, reference-range anchoring, code–value fusion, numeric and temporal encodings, and native versus harmonized event representations. Using Llama and Qwen architectures, 156 models were trained and assessed on early hospitalization data, showing that fusing codes with value deciles and using event-order or admission-relative RoPE embeddings improved predictive performance. The Common Longitudinal Intensive Care Unit Data Format (CLIF) reduced token count by 30.8% while enhancing outcomes in most families.

By Inhyeok Lee, Luke Solo, Michael C. Burkhart, Bashar Ramadan, Sahil Sethi, Sarah Jabbour, William F. Parker, Brett K. Beaulieu-Jones
arXiv AI
Aug 18

Foresight-England: Development of a National-Scale Generative AI Model of Electronic Health Records for Medical Event Prediction across the COVID-19 Pandemic

arXiv:2608. 16273v1 Announce Type: cross Abstract: Foresight-England (Foresight-E) is the first national-scale generative foundation model of electronic health records (EHRs), developed as a research pilot strictly for COVID-19 research.

By Simon Ellershaw, Christopher Tomlinson, Zeljko Kraljevic, Spiros Denaxas, Harry Hemingway, Cathie Sudlow, Angela M. Wood, Anoop D. Shah, Richard Dobson
arXiv AI
Aug 28

Structured Evidence Routing for Incident Risk Prediction from Multimodal Longitudinal EHRs

The paper introduces structured evidence routing for incident risk prediction using multimodal longitudinal electronic health records (EHRs). It proposes a router‑predictor‑reviewer workflow that condenses full patient records into compact summaries and targeted evidence slices, enabling a predictor to generate evidence‑linked risk assessments that a reviewer can critique. Experiments on five one‑year incident diagnosis tasks show that the method matches the AUROC of established supervised EHRSHOT baselines and remains competitive on AUPRC, while providing a patient‑specific evidence trail.

By Animesh Agarwal, Meysam Ghaffari, Nina Fatehi, Carlos Morato
arXiv Machine Learning
Jul 27

Autoregressive EHR Foundation Models with Multimodal Inputs

arXiv:2607. 22264v1 Announce Type: new Abstract: Autoregressive foundation models trained on tokenized electronic health records (EHRs) can support zero-shot clinical prediction, yet most operate on structured event codes alone, and do not incorporate multiple modalities in a principled way.

By Yuxuan Liu, Joshua Placidi, Jinpei Han, Alfred John Balston, Marek Rei, A. Aldo Faisal
arXiv AI
3d ago

EHR2Trace: Auditable EHR Data Infrastructure for Patient World Models and Clinical Agents

EHR2Trace is a system that transforms electronic health records from multiple sources into a standardized, traceable event format suitable for training and evaluating patient world models and clinical agents. It links each event to its original record, separates the event time from the time the information became available, and distinguishes between medication orders, dispensing, and administration. The tool supports both OMOP and MEDS data models, includes automated validation, and was tested on three clinical datasets, converting 846.4 million events and detecting all injected faults.

By Xinye Yang, Yuli Wang, Cheng Ting Lin, Harrison Bai
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