CliniCIRCA: A Modular LLM Framework for Constructing Longitudinal Mental Health Patient Journeys from Raw EHR Narratives

Aiwei Ivy Zhang; Nimra Ishfaq; Mohit Chandra; Santiago Alvarez Lesmes; Adam Coscia; Khatiya Chelidze Moon; Xiaohan Ding; Munmun De Choudhury

arXiv · 2609.19585

CliniCIRCA: A Modular LLM Framework for Constructing Longitudinal Mental Health Patient Journeys from Raw EHR Narratives

Aiwei Ivy Zhang·Nimra Ishfaq·Mohit Chandra·Santiago Alvarez Lesmes·Adam Coscia·Khatiya Chelidze Moon·Xiaohan Ding·Munmun De Choudhury

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Abstract

In mental health care, reasoning over patient journeys is a key task for clinicians. Yet these journeys, encompassing a longitudinal progression of biological, psychological, and social events, are often spread across disparate unstructured text narratives, making temporal recovery challenging. We present CliniCIRCA, a multi-stage LLM framework for Calendar-anchored, Imprecision-aware Reconstruction of Clinical Annals. To our knowledge, CliniCIRCA is the first to temporally classify clinical events across unstructured discharge summaries without event-level timestamps. From 14,882 MIMIC-III mental health admissions, we first construct a benchmark of 52 discharge summaries on which CliniCIRCA produces 15,891 temporally tagged events. After correcting 629 errors based on a clinician-in-the-loop evaluation, we produce verified gold-standard labels. Finally, the corrected timelines drive a temporally grounded summarization stage that compresses each source 1.52 times into a date-grouped chronological record. We then scale the framework to generate 1,000 silver-standard timelines and evaluate them as training data. Compared with zero- and few-shot prompting, instruction tuning generally improves five open-weight models on event extraction, temporal tagging, and summarization across silver and clinician-verified evaluations.

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Aiwei Ivy Zhang, Nimra Ishfaq, Mohit Chandra, Santiago Alvarez Lesmes, Adam Coscia, Khatiya Chelidze Moon, Xiaohan Ding, Munmun De Choudhury. 2026-09-17. CliniCIRCA: A Modular LLM Framework for Constructing Longitudinal Mental Health Patient Journeys from Raw EHR Narratives. https://arxiv.org/abs/2609.19585

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