Cardiovascular disease (CVD) continues to be the major cause of death globally, calling for predictive models that not only handle diverse and high-dimensional biomedical signals but also maintain interpretability and privacy. We create a single multimodal learning framework that integrates cross modal transformers with graph neural networks and causal representation learning to measure personalized CVD risk. The model combines genomic variation, cardiac MRI, ECG waveforms, wearable streams, and structured EHR data to predict risk while also implementing causal invariance constraints across different clinical subpopulations. To maintain transparency, we employ SHAP based feature attribution, counterfactual explanations and causal latent alignment for understandable risk factors. Besides, we position the design in a federated, privacy, preserving optimization protocol and establish rules for convergence, calibration and uncertainty quantification under distributional shift. Experimental studies based on large-scale biobank and multi institutional datasets reveal state discrimination and robustness, exhibiting fair performance across demographic strata and clinically distinct cohorts. This study paves the way for a principled approach to clinically trustworthy, interpretable and privacy respecting CVD prediction at the population level.

COVID-19 pandemic has caused unprecedented negative impacts on our society, including further exposing inequity and disparity in public health. To study the impact of socioeconomic factors on COVID transmission, we first propose a spatial-temporal model to examine the socioeconomic heterogeneity and spatial correlation of COVID-19 transmission at the community level. Second, to assess the individual risk of severe COVID-19 outcomes after a positive diagnosis, we propose a dynamic, varying-coefficient model that integrates individual-level risk factors from electronic health records (EHRs) with community-level risk factors. The underlying neighborhood prevalence of infections (both symptomatic and pre-symptomatic) predicted from the previous spatial-temporal model is included in the individual risk assessment so as to better capture the background risk of virus exposure for each individual. We design a weighting scheme to mitigate multiple selection biases inherited in EHRs of COVID patients. We analyze COVID transmission data in New York City (NYC, the epicenter of the first surge in the United States) and EHRs from NYC hospitals, where time-varying effects of community risk factors and significant interactions between individual-and community-level risk factors are detected. By examining the socioeconomic disparity of infection risks and interaction among the risk factors, our methods can assist public health decision-making and facilitate better clinical management of COVID patients.

Large Language Models (LLMs) have become a key topic in AI and NLP, transforming sectors like healthcare, finance, education, and marketing by improving customer service, automating tasks, providing insights, improving diagnostics, and personalizing learning experiences. Information extraction from clinical records is a crucial task in digital healthcare. Although traditional NLP techniques have been used for this in the past, they often fall short due to the complexity, variability of clinical language, and high inner semantics in the free clinical text. Recently, Large Language Models (LLMs) have become a powerful tool for better understanding and generating human-like text, making them highly effective in this area. In this paper, we explore the ability of open-source multilingual LLMs to understand EHRs (Electronic Health Records) in Italian and help extract information from them in real-time. Our detailed experimental campaign on comorbidity extraction from EHR reveals that some LLMs struggle in zero-shot, on-premises settings, and others show significant variation in performance, struggling to generalize across various diseases when compared to native pattern matching and manual annotations.

Electronic Health Records (EHRs) have been increasingly used as real-world evidence (RWE) to support the discovery and validation of new drug indications. This paper surveys current approaches to EHR-based drug repurposing, covering data sources, processing methodologies, and representation techniques. It discusses study designs and statistical frameworks for evaluating drug efficacy. Key challenges in validation are discussed, with emphasis on the role of large language models (LLMs) and target trial emulation. By synthesizing recent developments and methodological advances, this work provides a foundational resource for researchers aiming to translate real-world data into actionable drug-repurposing evidence.

Drug-drug interactions (DDIs) remain a major source of preventable harm, and many clinically important mechanisms are still unknown. Existing models either rely on pharmacologic knowledge graphs (KGs), which fail on unseen drugs, or on electronic health records (EHRs), which are noisy, temporal, and site-dependent. We introduce, to our knowledge, the first system that conditions KG relation scoring on patient-level EHR context and distills that reasoning into an EHR-only model for zero-shot inference. A fusion "Teacher" learns mechanism-specific relations for drug pairs represented in both sources, while a distilled "Student" generalizes to new or rarely used drugs without KG access at inference. Both operate under a shared ontology (set) of pharmacologic mechanisms (drug relations) to produce interpretable, auditable alerts rather than opaque risk scores. Trained on a multi-institution EHR corpus paired with a curated DrugBank DDI graph, and evaluated using a a clinically aligned, decision-focused protocol with leakage-safe negatives that avoid artificially easy pairs, the system maintains precision across multi-institutuion test data, produces mechanism-specific, clinically consistent predictions, reduces false alerts (higher precision) at comparable overall detection performance (F1), and misses fewer true interactions compared to prior methods. Case studies further show zero-shot identification of clinically recognized CYP-mediated and pharmacodynamic mechanisms for drugs absent from the KG, supporting real-world use in clinical decision support and pharmacovigilance.

Electronic health records (EHRs) contain extensive unstructured clinical data that can overwhelm emergency physicians trying to identify critical information. We present a two-stage summarization system that runs entirely on embedded devices, enabling offline clinical summarization while preserving patient privacy. In our approach, a dual-device architecture first retrieves relevant patient record sections using the Jetson Nano-R (Retrieve), then generates a structured summary on another Jetson Nano-S (Summarize), communicating via a lightweight socket link. The summarization output is two-fold: (1) a fixed-format list of critical findings, and (2) a context-specific narrative focused on the clinician's query. The retrieval stage uses locally stored EHRs, splits long notes into semantically coherent sections, and searches for the most relevant sections per query. The generation stage uses a locally hosted small language model (SLM) to produce the summary from the retrieved text, operating within the constraints of two NVIDIA Jetson devices. We first benchmarked six open-source SLMs under 7B parameters to identify viable models. We incorporated an LLM-as-Judge evaluation mechanism to assess summary quality in terms of factual accuracy, completeness, and clarity. Preliminary results on MIMIC-IV and de-identified real EHRs demonstrate that our fully offline system can effectively produce useful summaries in under 30 seconds.

Attention-based models have become the leading approach in modeling medical language for Natural Language Processing (NLP) in clinical notes. These models outperform traditional techniques by effectively capturing contextual representations of language. In this research a comparative analysis is done amongst pre-trained attention based models namely Bert Base, BioBert, two variations of Bio+Clinical Bert, RoBerta, and Clinical Longformer on task related to Electronic Health Record (EHR) information extraction. The tasks from Track 1 of Harvard Medical School's 2022 National Clinical NLP Challenges (n2c2) are considered for this comparison, with the Contextualized Medication Event Dataset (CMED) given for these task. CMED is a dataset of unstructured EHRs and annotated notes that contain task relevant information about the EHRs. The goal of the challenge is to develop effective solutions for extracting contextual information related to patient medication events from EHRs using data driven methods. Each pre-trained model is fine-tuned and applied on CMED to perform medication extraction, medical event detection, and multi-dimensional medication event context classification. Processing methods are also detailed for breaking down EHRs for compatibility with the applied models. Performance analysis has been carried out using a script based on constructing medical terms from the evaluation portion of CMED with metrics including recall, precision, and F1-Score. The results demonstrate that models pre-trained on clinical data are more effective in detecting medication and medication events, but Bert Base, pre-trained on general domain data showed to be the most effective for classifying the context of events related to medications.

Generative Artificial Intelligence (GenAI), particularly Large Language Models (LLMs), offer powerful capabilities for interpreting the complex data landscape in healthcare. In this paper, we present a comprehensive overview of the capabilities, requirements and applications of GenAI for deriving clinical insights and improving clinical efficiency. We first provide some background on the forms and sources of patient data, namely real-time Remote Patient Monitoring (RPM) streams and traditional Electronic Health Records (EHRs). The sheer volume and heterogeneity of this combined data present significant challenges to clinicians and contribute to information overload. In addition, we explore the potential of LLM-powered applications for improving clinical efficiency. These applications can enhance navigation of longitudinal patient data and provide actionable clinical decision support through natural language dialogue. We discuss the opportunities this presents for streamlining clinician workflows and personalizing care, alongside critical challenges such as data integration complexity, ensuring data quality and RPM data reliability, maintaining patient privacy, validating AI outputs for clinical safety, mitigating bias, and ensuring clinical acceptance. We believe this work represents the first summarization of GenAI techniques for managing clinician data overload due to combined RPM / EHR data complexities.

Background Predicting mortality and resource utilization from electronic health records (EHRs) is challenging yet crucial for optimizing patient outcomes and managing costs in intensive care unit (ICU). Existing approaches predominantly focus on structured EHRs, often ignoring the valuable clinical insights in free-text notes. Additionally, the potential of textual information within structured data is not fully leveraged. This study aimed to introduce and assess a deep learning framework using natural language processing techniques that integrates multimodal EHRs to predict mortality and resource utilization in critical care settings. Methods Utilizing two real-world EHR datasets, we developed and evaluated our model on three clinical tasks with leading existing methods. We also performed an ablation study on three key components in our framework: medical prompts, free-texts, and pre-trained sentence encoder. Furthermore, we assessed the model's robustness against the corruption in structured EHRs. Results Our experiments on two real-world datasets across three clinical tasks showed that our proposed model improved performance metrics by 1.6\%/0.8\% on BACC/AUROC for mortality prediction, 0.5%/2.2% on RMSE/MAE for LOS prediction, 10.9%/11.0% on RMSE/MAE for surgical duration estimation compared to the best existing methods. It consistently demonstrated superior performance compared to other baselines across three tasks at different corruption rates. Conclusions The proposed framework is an effective and accurate deep learning approach for predicting mortality and resource utilization in critical care. The study also highlights the success of using prompt learning with a transformer encoder in analyzing multimodal EHRs. Importantly, the model showed strong resilience to data corruption within structured data, especially at high corruption levels.

Electronic health records (EHRs) are long, noisy, and often redundant, posing a major challenge for the clinicians who must navigate them. Large language models (LLMs) offer a promising solution for extracting and reasoning over this unstructured text, but the length of clinical notes often exceeds even state-of-the-art models' extended context windows. Retrieval-augmented generation (RAG) offers an alternative by retrieving task-relevant passages from across the entire EHR, potentially reducing the amount of required input tokens. In this work, we propose three clinical tasks designed to be replicable across health systems with minimal effort: 1) extracting imaging procedures, 2) generating timelines of antibiotic use, and 3) identifying key diagnoses. Using EHRs from actual hospitalized patients, we test three state-of-the-art LLMs with varying amounts of provided context, using either targeted text retrieval or the most recent clinical notes. We find that RAG closely matches or exceeds the performance of using recent notes, and approaches the performance of using the models' full context while requiring drastically fewer input tokens. Our results suggest that RAG remains a competitive and efficient approach even as newer models become capable of handling increasingly longer amounts of text.