Configurable Clinical Information Extraction with Agentic RAG: What Works, What Breaks, and Why
This study addresses the challenge of extracting clinically relevant information from heterogeneous electronic health records, where patient data are scattered across numerous unstructured documents and structured entries lacking document-level metadata. Conventional retrieval-augmented generation (RAG) approaches struggle to support temporal reasoning and cross-document dependency modeling under such conditions. To overcome these limitations, this work proposes ACIE, a locally deployed agent-based RAG system tailored for real-world clinical information extraction. ACIE explicitly handles missing metadata, enables cross-document reasoning, and provides traceable citations to ensure interpretability and verifiability. Evaluated on 7,326 clinical judgments, the system achieved an overall physician acceptance rate of 96.5%, with per-category acceptance rates ranging from 80% to 99%.