Jonathan Carlson

Ruican Zhong, Jiachen Li, Gary Hsieh et al. · uw

Electronic health records (EHRs) have improved data accessibility but have also introduced cognitive burden for physicians, given the sheer volume and complexity of the data involved. Advances in large language models (LLMs) create new opportunities to rethink how clinicians interact with medical data through dynamic, adaptive interfaces. In this position paper, we explore how generative AI can support physicians' information needs by enabling more dynamic interactions with patient data. Through semi-structured interviews with internal physicians at Microsoft, we identify key challenges in data navigation and synthesis, and characterize clinicians' information needs during diagnostic workflows. We further examine how physicians conceptualize AI can help their work process and how these mental models shape expectations for interaction and trust. Based on these insights, we discuss design considerations for generative user interfaces that support clinician-centered workflows.

Harsha Nori, Mayank Daswani, Christopher Kelly et al.

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.