In the realm of big data and digital healthcare, Electronic Health Records (EHR) have become a rich source of information with the potential to improve patient care and medical research. In recent years, machine learning models have proliferated for analyzing EHR data to predict patients' future health conditions. Among them, some studies advocate for multi-task learning (MTL) to jointly predict multiple target diseases for improving the prediction performance over single task learning. Nevertheless, current MTL frameworks for EHR data have significant limitations due to their heavy reliance on human experts to identify task groups for joint training and design model architectures. To reduce human intervention and improve the framework design, we propose an automated approach named AutoDP, which can search for the optimal configuration of task grouping and architectures simultaneously. To tackle the vast joint search space encompassing task combinations and architectures, we employ surrogate model-based optimization, enabling us to efficiently discover the optimal solution. Experimental results on real-world EHR data demonstrate the efficacy of the proposed AutoDP framework. It achieves significant performance improvements over both hand-crafted and automated state-of-the-art methods, also maintains a feasible search cost at the same time.

Large language models (LLMs) have shown impressive capabilities in solving a wide range of tasks based on human instructions. However, developing a conversational AI assistant for electronic health record (EHR) data remains challenging due to (1) the lack of large-scale instruction-following datasets and (2) the limitations of existing model architectures in handling complex and heterogeneous EHR data.In this paper, we introduce MIMIC-Instr, a dataset comprising over 400K open-ended instruction-following examples derived from the MIMIC-IV EHR database. This dataset covers various topics and is suitable for instruction-tuning general-purpose LLMs for diverse clinical use cases. Additionally, we propose Llemr, a general framework that enables LLMs to process and interpret EHRs with complex data structures. Llemr demonstrates competitive performance in answering a wide range of patient-related questions based on EHR data.Furthermore, our evaluations on clinical predictive modeling benchmarks reveal that the fine-tuned Llemr achieves performance comparable to state-of-the-art (SOTA) baselines using curated features.

Deep learning models exhibit state-of-the-art performance for many predictive healthcare tasks using electronic health records (EHR) data, but these models typically require training data volume that exceeds the capacity of most healthcare systems. External resources such as medical ontologies are used to bridge the data volume constraint, but this approach is often not directly applicable or useful because of inconsistencies with terminology. To solve the data insufficiency challenge, we leverage the inherent multilevel structure of EHR data and, in particular, the encoded relationships among medical codes. We propose Multilevel Medical Embedding (MiME) which learns the multilevel embedding of EHR data while jointly performing auxiliary prediction tasks that rely on this inherent EHR structure without the need for external labels. We conducted two prediction tasks, heart failure prediction and sequential disease prediction, where MiME outperformed baseline methods in diverse evaluation settings. In particular, MiME consistently outperformed all baselines when predicting heart failure on datasets of different volumes, especially demonstrating the greatest performance improvement (15% relative gain in PR-AUC over the best baseline) on the smallest dataset, demonstrating its ability to effectively model the multilevel structure of EHR data.

We help address these challenges through three contributions. First, we publish a new dataset, EHRSHOT, which contains de-identified structured data from the electronic health records (EHRs) of 6,739 patients from Stanford Medicine.

Electronic health record (EHR) data has emerged as a valuable resource for analyzing patient health status.

This dataset covers various topics and is suitable for instruction-tuning general-purpose LLMs for diverse clinical use cases.

Integrating multi-modal clinical data, such as electronic health records (EHR) and chest X-ray images (CXR), is particularly beneficial for clinical prediction tasks. However, in a temporal setting, multi-modal data are often inherently asynchronous.