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Large Language Models for Semantic Interoperability in Value-Based Perioperative Care
Seshadri C Mudumbai1,2, Vikas N O'Reilly-Shah3, Lichy Han4
1Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, US. mudumbai@stanford.edu.
Journal of Medical Systems
|May 14, 2026
Summary
Large language models can bridge data gaps between electronic health record systems, enhancing clinical protocol portability. This approach enables semantic interoperability without requiring universal data standards across institutions.
Area of Science:
- Health Informatics
- Artificial Intelligence in Medicine
- Clinical Data Management
Background:
- Electronic Health Record (EHR) systems lack semantic interoperability, isolating valuable clinical protocols within institutions.
- Existing data models improve interoperability but do not fully address cross-institutional protocol portability challenges.
- The need for seamless data exchange is critical for advancing evidence-based medicine and patient care.
Purpose of the Study:
- To explore the potential of large language models (LLMs) in achieving semantic interoperability for clinical protocols.
- To propose a novel approach for cross-institutional protocol portability using LLMs.
- To overcome the limitations of current data models in facilitating data exchange between disparate EHR systems.
Main Methods:
- Utilizing large language models (LLMs) as a translation layer between different EHR systems.
- Leveraging existing data model frameworks as foundational structures, termed "clinical constitutions."
- Developing LLM-based translation protocols to interpret and map data semantically across institutional boundaries.
Main Results:
- LLMs demonstrate the capability to translate clinical data semantically across heterogeneous EHR systems.
- The proposed method facilitates protocol portability without necessitating the adoption of universal data standards.
- Proof-of-concept suggests significant potential for LLMs in enhancing healthcare data interoperability.
Conclusions:
- Large language models offer a viable solution to the long-standing problem of EHR semantic interoperability.
- This approach can unlock the potential of isolated clinical protocols by enabling their portability across institutions.
- Future research should focus on validating LLM-based interoperability in real-world clinical settings.
