Papers › Experience Retrieval-Augmentation with Electronic Health Records Enables Accurate Discharge QA
Experience Retrieval-Augmentation with Electronic Health Records Enables Accurate Discharge QA
Justice Ou, Tinglin Huang, Yilun Zhao, Ziyang Yu, Peiqing Lu, Rex Ying
To improve the reliability of Large Language Models (LLMs) in clinical applications, retrieval-augmented generation (RAG) is extensively applied to provide factual medical knowledge. However, beyond general medical knowledge from open-ended datasets, clinical case-based knowledge is also critical for effective medical reasoning, as it provides context grounded in real-world patient experiences. Motivated by this, we propose Experience Retrieval Augmentation - ExpRAG framework based on Electronic Health Record (EHR), aiming to offer the relevant context from other patients' discharge reports. ExpRAG performs retrieval through a coarse-to-fine process, utilizing an EHR-based report ranker to efficiently identify similar patients, followed by an experience retriever to extract task-relevant content for enhanced medical reasoning. To evaluate ExpRAG, we introduce DischargeQA, a clinical QA dataset with 1,280 discharge-related questions across diagnosis, medication, and instruction tasks. Each problem is generated using EHR data to ensure realistic and challenging scenarios. Experimental results demonstrate that ExpRAG consistently outperforms a text-based ranker, achieving an average relative improvement of 5.2%, highlighting the importance of case-based knowledge for medical reasoning.
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