FedEHR-Agents: Federated Agentic Optimization for Automated EHR Modeling

[2608.27856] FedEHR-Agents: Federated Agentic Optimization for Automated EHR Modeling Skip to main content Search Submit Donate Log in Computer Science > Machine Learning arXiv:2608.27856 (cs) [Submitted on 28 Aug 2026] Title: FedEHR-Agents: Federated Agentic Optimization for Automated EHR Modeling Authors: Jun Bai , Ruilin Wang , Yue Li View PDF HTML (experimental) Abstract: Recent advances in large language models are enabling autonomous clinical agents to perform increasingly complex electronic health record (EHR) modeling workflows. However, agents deployed at individual hospitals remain constrained by institution-specific data and modeling environments, while direct cross-hospital collaboration is restricted by the sensitivity of patient-level EHR data. Although federated learning (FL) provides a natural foundation for privacy-preserving collaboration, existing approaches remain predominantly model-centric, limiting federation to prediction models or their updates while overlooking the richer modeling experience accumulated by autonomous agents. To address this limitation, we propose FedEHR-Agents, an experience-centric federated agentic optimization framework for automated EHR modeling. Each hospital deploys an autonomous clinical EHR agent that performs data preprocessing and model development while refining local clinical modeling experience through historical memory, task-specific evaluation, and TextGrad-based prompt refinement. The federated server performs evidence-guided experience aggregation to integrate reliable and complementary modeling experience across heterogeneous hospitals and distills the aggregated experience into global meta-prompts for subsequent local refinement. Extensive experiments on real-world multi-hospital EHR benchmarks demonstrate that FedEHR-Agents consistently outperforms local and federated baselines across diverse clinical prediction tasks and remains robust across different federation scales and LLM backbones. These results establish clinical modeling experience as a promising collaborative object beyond conventional parameter-centric FL and point toward federated autonomous clinical intelligence. Comments: 25 pages, 6 figures Subjects: Machine Learning (cs.LG) ; Artificial Intelligence (cs.AI); Multiagent Systems (cs.MA) Cite as: arXiv:2608.27856 [cs.LG] (or arXiv:2608.27856v1 [cs.LG] for this version) https://doi.org/10.48550/arXiv.2608.27856 Focus to learn more arXiv-issued DOI via DataCite Submission history From: Jun Bai [ view email ] [v1] Fri, 28 Aug 2026 03:02:10 UTC (3,513 KB) Full-text links: Access Paper: View PDF HTML (experimental) TeX Source view license Additional Features Audio Summary Current browse context: cs.LG < prev | next > new | recent | 2026-08 Change to browse by: cs cs.AI cs.MA References & Citations SciX Google Scholar Semantic Scholar export BibTeX citation Bookmark Bibliographic Tools Bibliographic and Citation Tools Bibliographic Explorer Toggle Bibliographic Explorer ( What is the Explorer? ) Connected Papers Toggle Connected Papers ( What is Connected Papers? ) Litmaps Toggle Litmaps ( What is Litmaps? ) scite.ai Toggle scite Smart Citations ( What are Smart Citations? ) Code, Data, Media Code, Data and Media Associated with this Article alphaXiv Toggle alphaXiv ( What is alphaXiv? ) Links to Code Toggle CatalyzeX Code Finder for Papers ( What is CatalyzeX? ) DagsHub Toggle DagsHub ( What is DagsHub? ) GotitPub Toggle Gotit.pub ( What is GotitPub? ) Huggingface Toggle Hugging Face ( What is Huggingface? ) ScienceCast Toggle ScienceCast ( What is ScienceCast? ) Demos Demos Replicate Toggle Replicate ( What is Replicate? ) Spaces Toggle Hugging Face Spaces ( What is Spaces? ) Spaces Toggle TXYZ.AI ( What is TXYZ.AI? ) Related Papers Recommenders and Search Tools Link to Influence Flower Influence Flower ( What are Influence Flowers? ) Core recommender toggle CORE Recommender ( What is CORE? ) IArxiv recommender toggle IArxiv Recommender ( What is IArxiv? ) Author Venue Institution Topic About arXivLabs arXivLabs: experimental projects with community collaborators arXivLabs is a framework that allows collaborators to develop and share new arXiv features directly on our website. Both individuals and organizations that work with arXivLabs have embraced and accepted our values of openness, community, excellence, and user data privacy. arXiv is committed to these values and only works with partners that adhere to them. Have an idea for a project that will add value for arXiv's community? Learn more about arXivLabs . Which authors of this paper are endorsers? | Disable MathJax ( What is MathJax? ) We gratefully acknowledge support from our major funders , member institutions , and all contributors. About · Help · Contact · Subscribe · Copyright · Privacy · Accessibility · Operational Status (opens in new tab)

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