Assessment and Integration of Large Language Models for Automated Electronic Health Record Documentation in Emergency Medical Services.

Automating Electronic Health Records (EHR) documentation can significantly reduce the burden on care providers, particularly in emergency care settings where rapid and accurate record-keeping is crucial. A critical aspect of this automation involves using natural language processing (NLP) techniques...

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Publicado en:Journal of Medical Systems Vol. 49; no. 1; pp. 1 - 20
Autores principales: Bai, Enze, Luo, Xiao, Zhang, Zhan, Adelgais, Kathleen, Ali, Humaira, Finkelstein, Jack, Kutzin, Jared
Formato: pictorial research tables/charts Journal Article
Publicado: Springer Nature 5/17/2025
Acceso en línea:Ver este registro en EBSCOhost
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          Bai, Enze
          Luo, Xiao
          Zhang, Zhan
          Adelgais, Kathleen
          Ali, Humaira
          Finkelstein, Jack
          Kutzin, Jared
        affil: https://ror.org/047p7y759 School of Computer Science and Information Systems, Pace University, New York City, NY, USA
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        subj:
          Natural Language Processing Evaluation
          Electronic Health Records
          Documentation
          Automation
          Emergency Medical Services
          Human
          Emergency Service Information Systems
          Program Implementation
          Program Development
          Descriptive Statistics
          Comparative Studies
          Funding Source
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        Automating Electronic Health Records (EHR) documentation can significantly reduce the burden on care providers, particularly in emergency care settings where rapid and accurate record-keeping is crucial. A critical aspect of this automation involves using natural language processing (NLP) techniques to convert transcribed conversations into structured EHR fields. For instance, extracting temperature values like "102.4 Fahrenheit" from the transcribed text "His temperature is 39.1, which is 102.4 Fahrenheit." However, traditional rule-based and single-model NLP approaches often struggle with domain-specific medical terminology, contextual ambiguity, and numerical extraction errors. This study investigates the potential of integrating multiple Large Language Models (LLMs) to enhance EMS documentation accuracy. We developed an LLM integration framework and evaluated four state-of-the-art LLMs—Claude 3.5, GPT-4, Gemini, and Mistral—on a dataset comprising transcribed conversations from 40 EMS training simulations. The evaluation focused on precision, recall, and F1 score across zero-shot and few-shot learning scenarios. Results showed that the integrated LLM framework outperformed individual models, achieving overall F1 scores of 0.78 (zero-shot) and 0.81 (few-shot). In addition to quantitative evaluation, a preliminary user study was conducted with domain experts to assess the perceived usefulness and challenges of the integrated framework. The findings suggest that this approach has the potential to reduce documentation effort compared to traditional manual documentation. However, challenges such as misinterpretation of medical context and occasional omissions were noted, highlighting areas for further refinement and future work. This research is the first to systematically explore and evaluate the use of LLMs for real-time EMS EHR documentation. By addressing key challenges in automated transcription and structured data extraction, our work lays a foundation for real-world implementation, improving efficiency and accuracy in emergency medical documentation.
        Clinical trial number: Not applicable.
      pubtype: Academic Journal
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        research
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      ougenre: Article
    language: English
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