基于大模型的电子病历自动生成系统的设计与应用探讨  

Design and application of EMR auto-generation system based on large language models

作　　者：刘少堃 何仲廉[1] 李彬 李超峰[1] LIU Shaokun;HE Zhonglian;LI Bin;LI Chaofeng(Information Center,Sun Yat-sen University Cancer Center,Guangzhou 510080,Guangdong Province,China)

机构地区：[1]中山大学肿瘤防治中心信息中心,广州510080

出　　处：《中国数字医学》2024年第8期8-13,共6页China Digital Medicine

摘　　要：中山大学肿瘤防治中心引入医疗大模型,经数据采集、模型训练和系统集成,构建电子病历自动生成系统,初步实现出院小结、鉴别诊断和病程记录的自动生成,提高了临床医生的病历书写效率。结合本次系统建设实践,从实际操作角度分析电子病历生成系统的设计与构建,探讨大模型如何在电子病历生成领域更好地落地应用。An electronic medical record(EMR)auto-generation system has been established in Sun Yat-sen University Cancer Center based on medical large language models,via data collection,model training and system integration.It has initially realized the automatic generation of discharge summaries,differential diagnosis and progress records,which improved the efficiency of clinical documentation for physicians.Drawing upon the practical experience of this system development,this paper discusses the design and construction of an EMR auto-generation system from the perspective of practical operation,and delves into how to better apply large language models in the field of EMR generation.

关 键 词：大语言模型 电子病历 人工智能生成内容 

分 类 号：R197.3[医药卫生—卫生事业管理] R319[医药卫生—公共卫生与预防医学]