Bilal Mawji

Nigam H. Shah, Nerissa Ambers, Abby Pandya et al.

While large language models (LLMs) can support clinical documentation needs, standalone tools struggle with "workflow friction" from manual data entry. We developed ChatEHR, a system that enables the use of LLMs with the entire patient timeline spanning several years. ChatEHR enables automations - which are static combinations of prompts and data that perform a fixed task - and interactive use in the electronic health record (EHR) via a user interface (UI). The resulting ability to sift through patient medical records for diverse use-cases such as pre-visit chart review, screening for transfer eligibility, monitoring for surgical site infections, and chart abstraction, redefines LLM use as an institutional capability. This system, accessible after user-training, enables continuous monitoring and evaluation of LLM use. In 1.5 years, we built 7 automations and 1075 users have trained to become routine users of the UI, engaging in 23,000 sessions in the first 3 months of launch. For automations, being model-agnostic and accessing multiple types of data was essential for matching specific clinical or administrative tasks with the most appropriate LLM. Benchmark-based evaluations proved insufficient for monitoring and evaluation of the UI, requiring new methods to monitor performance. Generation of summaries was the most frequent task in the UI, with an estimated 0.73 hallucinations and 1.60 inaccuracies per generation. The resulting mix of cost savings, time savings, and revenue growth required a value assessment framework to prioritize work as well as quantify the impact of using LLMs. Initial estimates are $6M savings in the first year of use, without quantifying the benefit of the better care offered. Such a "build-from-within" strategy provides an opportunity for health systems to maintain agency via a vendor-agnostic, internally governed LLM platform.

Jiangqin Ma, Bilal Mawji, Franz Williams

The modern saying, "You Are What You Eat" resonates on a profound level, reflecting the intricate connection between our identities and the food we consume. Our project, Deep Image-to-Recipe Translation, is an intersection of computer vision and natural language generation that aims to bridge the gap between cherished food memories and the art of culinary creation. Our primary objective involves predicting ingredients from a given food image. For this task, we first develop a custom convolutional network and then compare its performance to a model that leverages transfer learning. We pursue an additional goal of generating a comprehensive set of recipe steps from a list of ingredients. We frame this process as a sequence-to-sequence task and develop a recurrent neural network that utilizes pre-trained word embeddings. We address several challenges of deep learning including imbalanced datasets, data cleaning, overfitting, and hyperparameter selection. Our approach emphasizes the importance of metrics such as Intersection over Union (IoU) and F1 score in scenarios where accuracy alone might be misleading. For our recipe prediction model, we employ perplexity, a commonly used and important metric for language models. We find that transfer learning via pre-trained ResNet-50 weights and GloVe embeddings provide an exceptional boost to model performance, especially when considering training resource constraints. Although we have made progress on the image-to-recipe translation, there is an opportunity for future exploration with advancements in model architectures, dataset scalability, and enhanced user interaction.