Frank Tuan

Matthias Blondeel, Noel Codella, Sam Preston et al.

Molecular Tumor Boards (MTBs) are multidisciplinary forums where oncology specialists collaboratively assess complex patient cases to determine optimal treatment strategies. A central element of this process is the patient summary, typically compiled by a medical oncologist, radiation oncologist, or surgeon, or their trained medical assistant, who distills heterogeneous medical records into a concise narrative to facilitate discussion. This manual approach is often labor-intensive, subjective, and prone to omissions of critical information. To address these limitations, we introduce the Healthcare Agent Orchestrator (HAO), a Large Language Model (LLM)-driven AI agent that coordinates a multi-agent clinical workflow to generate accurate and comprehensive patient summaries for MTBs. Evaluating predicted patient summaries against ground truth presents additional challenges due to stylistic variation, ordering, synonym usage, and phrasing differences, which complicate the measurement of both succinctness and completeness. To overcome these evaluation hurdles, we propose TBFact, a ``model-as-a-judge'' framework designed to assess the comprehensiveness and succinctness of generated summaries. Using a benchmark dataset derived from de-identified tumor board discussions, we applied TBFact to evaluate our Patient History agent. Results show that the agent captured 94% of high-importance information (including partial entailments) and achieved a TBFact recall of 0.84 under strict entailment criteria. We further demonstrate that TBFact enables a data-free evaluation framework that institutions can deploy locally without sharing sensitive clinical data. Together, HAO and TBFact establish a robust foundation for delivering reliable and scalable support to MTBs.

Alberto Santamaria-Pang, Frank Tuan, Ross Campbell et al.

The COVID-19 pandemic has accelerated the adoption of telemedicine and patient messaging through electronic medical portals (patient medical advice requests, or PMARs). While these platforms enhance patient access to healthcare, they have also increased the burden on healthcare providers due to the surge in PMARs. This study seeks to develop an efficient tool for message triaging to reduce physician workload and improve patient-provider communication. We developed OPTIC (Optimizing Patient-Provider Triaging & Improving Communications in Clinical Operations), a powerful message triaging tool that utilizes GPT-4 for data labeling and BERT for model distillation. The study used a dataset of 405,487 patient messaging encounters from Johns Hopkins Medicine between January and June 2020. High-quality labeled data was generated through GPT-4-based prompt engineering, which was then used to train a BERT model to classify messages as "Admin" or "Clinical." The BERT model achieved 88.85% accuracy on the test set validated by GPT-4 labeling, with a sensitivity of 88.29%, specificity of 89.38%, and an F1 score of 0.8842. BERTopic analysis identified 81 distinct topics within the test data, with over 80% accuracy in classifying 58 topics. The system was successfully deployed through Epic's Nebula Cloud Platform, demonstrating its practical effectiveness in healthcare settings.