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ED-Copilot: Reduce Emergency Department Wait Time with Language Model Diagnostic Assistance

Liwen Sun, Abhineet Agarwal, Aaron Kornblith, Bin Yu, Chenyan Xiong

arXiv, 2024

Abstract

In the emergency department (ED), patients undergo triage and multiple laboratory tests before diagnosis. This time-consuming process causes ED crowding which impacts patient mortality, medical errors, staff burnout, etc. This work proposes (time) cost-effective diagnostic assistance that leverages artificial intelligence systems to help ED clinicians make efficient and accurate diagnoses. In collaboration with ED clinicians, we use public patient data to curate MIMIC-ED-Assist, a benchmark for AI systems to suggest laboratory tests that minimize wait time while accurately predicting critical outcomes such as death. With MIMIC-ED-Assist, we develop ED-Copilot which sequentially suggests patient-specific laboratory tests and makes diagnostic predictions. ED-Copilot employs a pre-trained bio-medical language model to encode patient information and uses reinforcement learning to minimize ED wait time and maximize prediction accuracy. On MIMIC-ED-Assist, ED-Copilot improves prediction accuracy over baselines while halving average wait time from four hours to two hours. ED-Copilot can also effectively personalize treatment recommendations based on patient severity, further highlighting its potential as a diagnostic assistant. Since MIMIC-ED-Assist is a retrospective benchmark, ED-Copilot is restricted to recommend only observed tests. We show ED-Copilot achieves competitive performance without this restriction as the maximum allowed time increases. Our code is available at…

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