Abstract:Clinicians routinely navigate fragmented electronic health record (EHR) interfaces to assemble a coherent picture of a patient's problems, medications, recent encounters, and longitudinal trends. This work describes EHRSummarizer, a privacy-aware, FHIR-native reference architecture that retrieves a targeted set of high-yield FHIR R4 resources, normalizes them into a consistent clinical context package, and produces structured summaries intended to support structured chart review. The system can be configured for data minimization, stateless processing, and flexible deployment, including local inference within an organization's trust boundary. To mitigate the risk of unsupported or unsafe behavior, the summarization stage is constrained to evidence present in the retrieved context package, is intended to indicate missing or unavailable domains where feasible, and avoids diagnostic or treatment recommendations. Prototype demonstrations on synthetic and test FHIR environments illustrate end-to-end behavior and output formats; however, this manuscript does not report clinical outcomes or controlled workflow studies. We outline an evaluation plan centered on faithfulness, omission risk, temporal correctness, usability, and operational monitoring to guide future institutional assessments.




Abstract:Objectives: To evaluate large language model (LLM) performance on pharmacy licensure-style question-answering (QA) tasks and develop an external knowledge integration method to improve their accuracy. Methods: We benchmarked eleven existing LLMs with varying parameter sizes (8 billion to 70+ billion) using a 141-question pharmacy dataset. We measured baseline accuracy for each model without modification. We then developed a three-step retrieval-augmented generation (RAG) pipeline, DrugRAG, that retrieves structured drug knowledge from validated sources and augments model prompts with evidence-based context. This pipeline operates externally to the models, requiring no changes to model architecture or parameters. Results: Baseline accuracy ranged from 46% to 92%, with GPT-5 (92%) and o3 (89%) achieving the highest scores. Models with fewer than 8 billion parameters scored below 50%. DrugRAG improved accuracy across all tested models, with gains ranging from 7 to 21 percentage points (e.g., Gemma 3 27B: 61% to 71%, Llama 3.1 8B: 46% to 67%) on the 141-item benchmark. Conclusion: We demonstrate that external structured drug knowledge integration through DrugRAG measurably improves LLM accuracy on pharmacy tasks without modifying the underlying models. This approach provides a practical pipeline for enhancing pharmacy-focused AI applications with evidence-based information.