Jong Ha Lee

Gyubok Lee, Elea Bach, Eric Yang et al.

The recent shift toward the Health Level Seven Fast Healthcare Interoperability Resources (HL7 FHIR) standard opens a new frontier for clinical AI, demanding LLM agents to navigate complex, resource-based data models instead of conventional structured health data. However, existing benchmarks have lagged behind this transition, lacking the realism needed to evaluate recent LLMs on interoperable clinical data. To bridge this gap, we introduce FHIR-AgentBench, a benchmark that grounds 2,931 real-world clinical questions in the HL7 FHIR standard. Using this benchmark, we systematically evaluate agentic frameworks, comparing different data retrieval strategies (direct FHIR API calls vs. specialized tools), interaction patterns (single-turn vs. multi-turn), and reasoning strategies (natural language vs. code generation). Our experiments highlight the practical challenges of retrieving data from intricate FHIR resources and the difficulty of reasoning over them, both of which critically affect question answering performance. We publicly release the FHIR-AgentBench dataset and evaluation suite (https://github.com/glee4810/FHIR-AgentBench) to promote reproducible research and the development of robust, reliable LLM agents for clinical applications.

Sina Rashidian, Nan Li, Jonathan Amar et al.

Background: We present a Patient Simulator that leverages real world patient encounters which cover a broad range of conditions and symptoms to provide synthetic test subjects for development and testing of healthcare agentic models. The simulator provides a realistic approach to patient presentation and multi-turn conversation with a symptom-checking agent. Objectives: (1) To construct and instantiate a Patient Simulator to train and test an AI health agent, based on patient vignettes derived from real EHR data. (2) To test the validity and alignment of the simulated encounters provided by the Patient Simulator to expert human clinical providers. (3) To illustrate the evaluation framework of such an LLM system on the generated realistic, data-driven simulations -- yielding a preliminary assessment of our proposed system. Methods: We first constructed realistic clinical scenarios by deriving patient vignettes from real-world EHR encounters. These vignettes cover a variety of presenting symptoms and underlying conditions. We then evaluate the performance of the Patient Simulator as a simulacrum of a real patient encounter across over 500 different patient vignettes. We leveraged a separate AI agent to provide multi-turn questions to obtain a history of present illness. The resulting multiturn conversations were evaluated by two expert clinicians. Results: Clinicians scored the Patient Simulator as consistent with the patient vignettes in those same 97.7% of cases. The extracted case summary based on the conversation history was 99% relevant. Conclusions: We developed a methodology to incorporate vignettes derived from real healthcare patient data to build a simulation of patient responses to symptom checking agents. The performance and alignment of this Patient Simulator could be used to train and test a multi-turn conversational AI agent at scale.