Exploring Scaling Laws for EHR Foundation Models
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Abstract (arXiv)
The emergence of scaling laws has profoundly shaped the development of large language models (LLMs), enabling predictable performance gains through systematic increases in model size, dataset volume, and compute. Yet, these principles remain largely unexplored in the context of electronic health records (EHRs) -- a rich, sequential, and globally abundant data source that differs structurally from natural language. In this work, we present the first empirical investigation of scaling laws for EHR foundation models. By training transformer architectures on patient timeline data from the MIMIC-IV database across varying model sizes and compute budgets, we identify consistent scaling patterns, including parabolic IsoFLOPs curves and power-law relationships between compute, model parameters, data size, and clinical utility. These findings demonstrate that EHR models exhibit scaling behavior analogous to LLMs, offering predictive insights into resource-efficient training strategies. Our results lay the groundwork for developing powerful EHR foundation models capable of transforming clinical prediction tasks and advancing personalized healthcare.
Key facts. Cited by 12 papers in the map (data through 14 Oct 2026). Builds on 10 of its 22 references that are in the map. First posted on arXiv 29 May 2025.
Builds on
10 of 22 references.
References · 10
- 2018BERT: Pre-training of Deep Bidirectional Transformers for Language Understandingcited by 40,399
- 2020Scaling Laws for Neural Language Modelscited by 6,586
- 2021RoFormer: Enhanced Transformer with Rotary Position Embeddingcited by 4,703
- 2020GLU Variants Improve Transformercited by 1,804
- 2023GQA: Training Generalized Multi-Query Transformer Models from Multi-Head Checkpointscited by 1,346
- 2020Scaling Laws for Autoregressive Generative Modelingcited by 522
- 2020Med-BERT: pre-trained contextualized embeddings on large-scale structured electronic health records for disease predictioncited by 373
- 2019BEHRT: Transformer for Electronic Health Recordscited by 263
- 2024Zero Shot Health Trajectory Prediction Using Transformercited by 77
- 2023Event Stream GPT: A Data Pre-processing and Modeling Library for Generative, Pre-trained Transformers over Continuous-time Sequences of Complex Eventscited by 46
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Citing papers per year: 2025: 1; 2026: 11.
12 papers.
- 2026Scaling Recurrence-aware Foundation Models for Clinical Records via Next-Visit Predictioncited by 3
- 2026From Statistical Fidelity to Clinical Consistency: Scalable Generation and Auditing of Synthetic Patient Trajectoriescited by 1
- 2026TrajOnco: a multi-agent framework for temporal reasoning over longitudinal EHR for multi-cancer early detectioncited by 1
- 2026Foundation Models to Unlock Real-World Evidence from Nationwide Medical Claimscited by 1
- 2025Scaling Electronic Health Record Foundation Models for Population Health Managementcited by 0
- 2026Problems with Chinchilla Approach 2: Systematic Biases in IsoFLOP Parabola Fitscited by 0
- 2026On the Invariance and Generality of Neural Scaling Lawscited by 0
- 2026Federated generative event models for tokenized electronic health recordscited by 0
- 2026Foresight-England: Development of a National-Scale Generative AI Model of Electronic Health Records for Medical Event Prediction across the COVID-19 Pandemiccited by 0
- 2026Reinforcement Learning over Patient Trajectories for Clinical Reasoning in EHR Foundation Modelscited by 0
- 2026Training and Scaling Compute-Optimal Physiological Waveform Foundation Modelscited by 0
- 2026Sequence Composition in EHR Foundation Model Pretrainingcited by 0
- 2026Sequence Composition in EHR Foundation Model Pretraining12 Oct 2026
- 2026Training and Scaling Compute-Optimal Physiological Waveform Foundation Models5 Oct 2026
- 2026Reinforcement Learning over Patient Trajectories for Clinical Reasoning in EHR Foundation Models10 Sep 2026
- 2026Foresight-England: Development of a National-Scale Generative AI Model of Electronic Health Records for Medical Event Prediction across the COVID-19 Pandemic17 Aug 2026
- 2026Federated generative event models for tokenized electronic health records3 Aug 2026
- 2026On the Invariance and Generality of Neural Scaling Laws8 May 2026
- 2026Foundation Models to Unlock Real-World Evidence from Nationwide Medical Claims4 May 2026
- 2026TrajOnco: a multi-agent framework for temporal reasoning over longitudinal EHR for multi-cancer early detection12 Apr 2026
- 2026Scaling Recurrence-aware Foundation Models for Clinical Records via Next-Visit Prediction25 Mar 2026
- 2026Problems with Chinchilla Approach 2: Systematic Biases in IsoFLOP Parabola Fits21 Mar 2026
- 2026From Statistical Fidelity to Clinical Consistency: Scalable Generation and Auditing of Synthetic Patient Trajectories6 Mar 2026
- 2025Scaling Electronic Health Record Foundation Models for Population Health Management30 May 2025