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The study investigates how medical AI agents can silently access protected health information (PHI) without revealing it, a practice that bypasses the HIPAA minimum‑necessary standard. By embedding canaries in synthetic patient records, the authors evaluated five language models across multiple boundary settings and attack scenarios, finding that some models accessed PHI unnecessarily while stricter boundaries and pre‑execution gates largely mitigated this behavior. The research demonstrates that output‑only evaluations fail to detect such covert access, underscoring the need for combined boundary controls, gating mechanisms, and access‑log audits.
arXiv:2607. 13411v1 Announce Type: cross Abstract: Clinical AI models can expose patients to harm when adversarial vulnerabilities go undetected, yet formal security auditing requires statistical expertise, specialized tools, and significant time.
The paper introduces MIMIC-DOS, a dataset derived from MIMIC-IV that focuses on ICU cases where patient symptoms and medical signs are discordant. It presents CARE, a privacy‑compliant multi‑stage agentic reasoning framework that uses a proprietary LLM to generate structured categories and transitions, while a local LLM performs evidence acquisition and decision‑making. In retrospective evaluations on MIMIC‑DOS, CARE outperforms other LLMs and agentic workflows, demonstrating stronger handling of conflicting clinical evidence while preserving patient privacy.
arXiv:2508. 00923v3 Announce Type: replace Abstract: Large language models (LLMs) are increasingly used to answer health-related questions and support healthcare workflows, yet evidence for their safety still relies heavily on static benchmarks that can rapidly become obsolete or be optimized against.
MedDeID is an on‑premises framework that combines in‑house annotation, synthetic‑note generation, model training, inference, pseudonymisation and evaluation to de‑identify clinical text. On a Dutch hospital benchmark, a hospital‑trained transformer detected 98.9 % of identifying text while redacting only 0.24 % of non‑identifier text; a synthetic‑only model achieved 96.1 %. In primary‑care notes, the synthetic‑trained model outperformed the hospital‑trained model in recall and robustness to identifier‑format changes, and an English version trained without real text reached 99.7 % and 98.9 % detection on synthetic benchmarks.
Synthetic Hospital is an open, fully synthetic longitudinal electronic health record benchmark created from public medical education material. It contains 1,268 patients and 5,602 encounters, with every diagnosis, finding, and temporal relation grounded in standard ontologies and traceable back to its source. Physicians could not reliably distinguish its records from real charts, and current frontier AI models perform significantly below human experts on tasks such as reconstructing problem lists and summarizing charts.