Zhenhai Pan

Zhenhai Pan, Yan Liu, Jia You

Most dialogue-based electronic medical record (EMR) systems still behave as passive pipelines: transcribe speech, extract information, and generate the final note after the consultation. That design improves documentation efficiency, but it is insufficient for proactive consultation support because it does not explicitly address streaming speech noise, missing punctuation, unstable diagnostic belief, objectification quality, or measurable next-action gains. We present an end-to-end proactive EMR assistant built around streaming speech recognition, punctuation restoration, stateful extraction, belief stabilization, objectified retrieval, action planning, and replayable report generation. The system is evaluated in a preliminary controlled setting using ten streamed doctor-patient dialogues and a 300-query retrieval benchmark aggregated across dialogues. The full system reaches state-event F1 of 0.84, retrieval Recall@5 of 0.87, and end-to-end pilot scores of 83.3% coverage, 81.4% structural completeness, and 80.0% risk recall. Ablations further suggest that punctuation restoration and belief stabilization may improve downstream extraction, retrieval, and action selection within this pilot. These results were obtained under a controlled simulated pilot setting rather than broad deployment claims, and they should not be read as evidence of clinical deployment readiness, clinical safety, or real-world clinical utility. Instead, they suggest that the proposed online architecture may be technically coherent and directionally supportive under tightly controlled pilot conditions. The present study should be read as a pilot concept demonstration under tightly controlled pilot conditions rather than as evidence of clinical deployment readiness or clinical generalizability.

Zhenhai Pan, Yan Liu, Jia You

Most automated electronic medical record (EMR) pipelines remain output-oriented: they transcribe, extract, and summarize after the consultation, but they do not explicitly model what is already known, what is still missing, which uncertainty matters most, or what question or recommendation should come next. We formulate doctor-patient dialogue as a proactive knowledge-inquiry problem under partial observability. The proposed framework combines stateful extraction, sequential belief updating, gap-aware state modeling, hybrid retrieval over objectified medical knowledge, and a POMDP-lite action planner. Instead of treating the EMR as the only target artifact, the framework treats documentation as the structured projection of an ongoing inquiry loop. To make the formulation concrete, we report a controlled pilot evaluation on ten standardized multi-turn dialogues together with a 300-query retrieval benchmark aggregated across dialogues. On this pilot protocol, the full framework reaches 83.3% coverage, 80.0% risk recall, 81.4% structural completeness, and lower redundancy than the chunk-only and template-heavy interactive baselines. These pilot results do not establish clinical generalization; rather, they suggest that proactive inquiry may be methodologically interesting under tightly controlled conditions and can be viewed as a conceptually appealing formulation worth further investigation for dialogue-based EMR generation. This work should be read as a pilot concept demonstration under a controlled simulated setting rather than as evidence of clinical deployment readiness. No implication of clinical deployment readiness, clinical safety, or real-world clinical utility should be inferred from this pilot protocol.