Rethinking healthcare data interoperability in the age of large language models

Electronic health records contain extensive real-world clinical data, but their effective use is hindered by data heterogeneity and interoperability challenges. Traditional post hoc standardization is costly and labor-intensive and reduces data granularity. Large language models enable analysis of unstructured data without full harmonization but lack precision for some tasks. We propose a hybrid strategy that combines large-language-model-based analysis of legacy data with prospectively standardized data, offering a scalable alternative that challenges the need for retrospective data harmonization and improves interoperability.