Verifiable Summarization of Electronic Health Records Using Large Language Models to Support Chart Review

Information overload in electronic health records (EHRs) hampers clinicians' ability to efficiently extract and synthesize critical information from a patient's longitudinal health record, leading to increased cognitive burden and delays in care. This study explores the potential of large language models (LLMs) to address this challenge by generating problem-based admission summaries for patients admitted with heart failure, a leading cause of hospitalization worldwide. We developed an extract-then-abstract approach guided by disease-specific "summary bundles" to generate summaries of longitudinal clinical notes that prioritize clinically relevant information. Through a mixed-methods evaluation using real-world clinical notes, we compared physicians' ability to answer patient-specific clinical questions with the LLM-generated summaries versus standard chart review. While summary access did not significantly reduce overall questionnaire completion time, frequent summary use significantly contributed to faster questionnaire completion (p = 0.002). Individual physicians varied in how effectively they leveraged the summaries. Importantly, summary use maintained accuracy in answering clinical questions (88.0% with summaries vs. 86.4% without). All physicians indicated they were "likely" or "very likely" to use the summaries in clinical practice, and 87.5% reported that the summaries would save them time. Preferences for summary format varied, highlighting the need for customizable summaries aligned with individual clinician workflows. This study provides one of the first extrinsic evaluations of LLMs for longitudinal summarization, demonstrating their potential to enhance clinician efficiency, alleviate workload, and support informed decision-making in time-sensitive care environments.