The Complex Discharge Summary
Hospital notes are written for clinicians, not patients.
- 11–15: Avg. discharge FK grade (college reading level)
- 7–8: Avg. US adult reading level (grade equivalent)
- ~40%: Patients misunderstanding instructions (after discharge)
- high: 30-day readmission link (to low comprehension)
Why discharge notes are so dense
Clinicians write for other clinicians, not patients.
Jargon hides in plain sight
Terms like "afebrile" feel routine to staff, foreign to patients.
The cost of confusion
Misunderstood instructions drive missed doses and readmissions.
The AI Simplification Model
A language model rewrites sentences while preserving medical meaning.
- LLM: Model type (fine-tuned for clinical text)
- sentence: Rewrite unit (preserves clinical intent)
- 0–100%: Simplification strength (user-tunable)
- >95%: Meaning preservation target (semantic fidelity)
Sentence-level rewriting
The model shortens sentences and swaps register, not just words.
Strength as a dial
Higher strength pushes further toward everyday phrasing.
Guardrails on meaning
Clinical facts must survive the rewrite unchanged.
Jargon Substitution
Medical terms map one-to-one onto everyday equivalents.
- 24: Jargon terms tracked (per sample note)
- 1,000+: Substitution dictionary size (clinical-to-plain pairs)
- ~8%: Ambiguous term rate (need context-aware choice)
- 2.1: Avg. syllables saved/term (plain vs. clinical word)
One term, one meaning
"Myocardial infarction" becomes "heart attack" everywhere.
Context matters
Some terms need surrounding words to pick the right swap.
Fewer syllables, same fact
Shorter plain words cut both grade level and reading time.
Readability Scoring
The Flesch-Kincaid grade level formula rescores the simplified text.
- 2: FK formula inputs (words/sentence, syllables/word)
- ~4–7: Grade drop per pass (grade levels typical)
- live: Rescoring frequency (after every edit)
- 5th–8th: Target band (recommended for patients)
The Flesch-Kincaid formula
0.39×(words/sentence) + 11.8×(syllables/word) − 15.59.
Two levers, one score
Shorter sentences and simpler words both cut the grade level.
Scoring against a target
The gauge tracks distance from the chosen reading grade.
The Patient-Ready Summary
The final text lands at the reader's chosen grade level.
- 6–8: Final FK grade (typical) (matches target slider)
- 0: Jargon terms remaining (fully substituted)
- +30%: Comprehension gain (in patient studies)
- preserved: Clinical fidelity (facts unchanged)
A readable handoff
Patients leave with instructions they can actually follow.
Same facts, plainer words
Doses, dates, and diagnoses carry over exactly.
A tunable target
Care teams can raise or lower the target grade per patient.