Large Language Models for Clinical Narrative Processing: Methods, Applications, and Challenges

Large language models (LLMs) have rapidly advanced natural language processing and are increasingly used to analyze clinical narratives. Their ability to extract information, summarize records, and support clinical workflows makes them potential tools for enhancing documentation efficiency and the secondary application in the analysis of electronic health record (EHR) data. The aim of this work is to synthesize recent evidence on methodological approaches and applications of LLMs for clinical narrative processing, and to assess their performance, benefits, limitations, and implications for clinical practice. Across 2022-2026 studies, LLMs demonstrated strong performance in information extraction, summarization, triage prediction, section classification, and synthetic text generation, often surpassing traditional machine-learning models. Overall, LLMs improved the conversion of unstructured notes into actionable clinical insights, reduced documentation burden, and supported decision-making tasks. Key challenges included hallucinations, variable reproducibility, sensitivity to prompting, domain adaptation gaps, and limited transparency. Our findings indicate that LLMs show substantial promise for transforming clinical narrative processing, but safe adoption requires rigorous evaluation and continuous model auditing. This work provides a structured, non-systematic synthesis of representative studies and is intended as a high-level overview of emerging applications rather than a comprehensive systematic review.