在本地设备上实现急诊病历快速摘要,保护隐私且响应快
Dual-stage and Lightweight Patient Chart Summarization for Emergency Physicians
- 分两阶段运行:先检索相关病历片段,再生成结构化摘要
- 30秒内完成摘要,支持关键发现列表与问答式叙述
- 全程离线运行,适合急诊场景下的隐私敏感应用
电子健康记录(EHR)包含大量非结构化临床数据,常使急诊医生难以快速定位关键信息。本文提出一种双阶段摘要系统,可在嵌入式设备上完全离线运行,保障患者隐私。系统采用双设备架构:使用Jetson Nano-R进行检索,从本地存储的EHR中将长篇记录切分为语义连贯段落,并基于查询筛选最相关部分;随后由另一台Jetson Nano-S上的小型语言模型(SLM)生成摘要。摘要输出包括两部分:固定格式的关键发现列表,以及针对临床问题的上下文相关叙述。我们对六款参数小于7B的开源SLM进行了基准测试,并引入大模型作为评判者评估摘要的事实准确性、完整性与清晰度。在MIMIC-IV及去标识化真实EHR数据集上的初步结果表明,该系统可在30秒内生成有效摘要。
原文摘要 · Abstract (English)
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.
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