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Diego Mardian

Publications and source records attributed to Diego Mardian.

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MDwAIstScheduler: Bringing On-Device Voice Documentation into Clinical Practice

Clinical documentation forces physicians to split attention between the patient and their keyboard, and much of it spills into uncom- pensated after-hours work. We present MDwAIstScheduler, a low- cost, belt-worn pipeline that lets a physician speak naturally dur- ing the encounter and have the resulting medications, allergies, labs/orders/referrals, follow-up scheduling, vitals, and problems land in the EHR as review-ready drafts. Building on our earlier prototype, which relied on cloud speech recognition and a cloud language model, the current pipeline runs both transcription and intent extraction entirely on-device. Using a medical-domain auto- matic speech recognition (ASR) model and a 1.7B-parameter lan- guage model we fine-tuned for clinical action extraction, no patient audio or text leaves the device, and the structured drafts are written directly into the Elation EHR for the physician to confirm. The result is a documentation tool that removes keyboard work from the visit without removing the clinician from the record, allowing them to focus on what matters most, patient care, while reducing burden at the same time.

cs.HC

Demographic Injection in Medical Language Models under Diversity, Equity, and Inclusion Prompts

Clinical-AI guidance increasingly recommends prompting language models to reason with attention to diversity, equity, and inclusion (DEI). We measure a side effect that misrepresents patients: a one-sentence DEI prompt appended to a medical question leads models to add patient demographic attributes (race, socioeconomic status, sex) the question never stated, in effect rewriting who the patient is. We call this demographic injection. Across 47 models, four medical benchmarks, and 376,000 responses scored by a validated model-judge pipeline, a single DEI prompt raises the injection rate from 0.7% to 33.1% (47x) in all 47 of 47 models, attributable to the equity content rather than to added length (18x above a length-matched control; p=1.4x10^-14). Most added content is a general population statement that leaves the answer unchanged, but a smaller subset attaches an attribute to the specific patient or changes the selected option (0.25-2.4% of responses, 99.8% toward the incorrect option), where the invented demographic changes the answer the model recommends. Phrasing scales the effect from 14% to 56%. DEI prompts are just one example of a more general mechanism. Any instruction that nudges how a model reasons can make it add unrequested details, including details about the patient. Flagged outputs are treated as model errors under study, not clinical guidance.

cs.AI