# JEDA: Query-Free Clinical Order Search from Ambient Dialogues

arXiv: https://arxiv.org/abs/2510.14169 · HTML: https://mlsanity.com/paper/2510.14169/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 41 of its 72 references that are in the map.
- First posted on arXiv 16 Oct 2025.

## Builds on (most cited first, 30 of 41)

- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Sentence-BERT: Sentence Embeddings using Siamese BERT-Networks](https://mlsanity.com/paper/1908.10084/) (2019)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [Robust Speech Recognition via Large-Scale Weak Supervision](https://mlsanity.com/paper/2212.04356/) (2022)
- [Dense Passage Retrieval for Open-Domain Question Answering](https://mlsanity.com/paper/2004.04906/) (2020)
- [UMAP: Uniform Manifold Approximation and Projection for Dimension Reduction](https://mlsanity.com/paper/1802.03426/) (2018)
- [FaceNet: A Unified Embedding for Face Recognition and Clustering](https://mlsanity.com/paper/1503.03832/) (2015)
- [Supervised Contrastive Learning](https://mlsanity.com/paper/2004.11362/) (2020)
- [Billion-scale similarity search with GPUs](https://mlsanity.com/paper/1702.08734/) (2017)
- [SimCSE: Simple Contrastive Learning of Sentence Embeddings](https://mlsanity.com/paper/2104.08821/) (2021)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Conformer: Convolution-augmented Transformer for Speech Recognition](https://mlsanity.com/paper/2005.08100/) (2020)
- [Understanding Contrastive Representation Learning through Alignment and Uniformity on the Hypersphere](https://mlsanity.com/paper/2005.10242/) (2020)
- [Datasheets for Datasets](https://mlsanity.com/paper/1803.09010/) (2018)
- [BEIR: A Heterogenous Benchmark for Zero-shot Evaluation of Information Retrieval Models](https://mlsanity.com/paper/2104.08663/) (2021)
- [Unsupervised Dense Information Retrieval with Contrastive Learning](https://mlsanity.com/paper/2112.09118/) (2021)
- [Model Cards for Model Reporting](https://mlsanity.com/paper/1810.03993/) (2018)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [Efficient and robust approximate nearest neighbor search using Hierarchical Navigable Small World graphs](https://mlsanity.com/paper/1603.09320/) (2016)
- [Approximate Nearest Neighbor Negative Contrastive Learning for Dense Text Retrieval](https://mlsanity.com/paper/2007.00808/) (2020)
- [Contrastive Learning with Hard Negative Samples](https://mlsanity.com/paper/2010.04592/) (2020)
- [ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission](https://mlsanity.com/paper/1904.05342/) (2019)
- [Sentence-T5: Scalable Sentence Encoders from Pre-trained Text-to-Text Models](https://mlsanity.com/paper/2108.08877/) (2021)
- [Hard Negative Mixing for Contrastive Learning](https://mlsanity.com/paper/2010.01028/) (2020)
- [Med-BERT: pre-trained contextualized embeddings on large-scale structured electronic health records for disease prediction](https://mlsanity.com/paper/2005.12833/) (2020)
- [Multi-Similarity Loss with General Pair Weighting for Deep Metric Learning](https://mlsanity.com/paper/1904.06627/) (2019)
- [Debiased Contrastive Learning](https://mlsanity.com/paper/2007.00224/) (2020)
- [A Metric Learning Reality Check](https://mlsanity.com/paper/2003.08505/) (2020)
- [ScispaCy: Fast and Robust Models for Biomedical Natural Language Processing](https://mlsanity.com/paper/1902.07669/) (2019)

## Abstract (arXiv)

Clinical conversations mix explicit directives (order a chest X-ray) with implicit reasoning (the cough worsened overnight, we should check for pneumonia). Many systems rely on LLM rewriting, adding latency, instability, and opacity that hinder real-time ordering. We present JEDA (Joint Embedding for Direct and Ambient clinical orders), a domain-initialized bi-encoder that retrieves canonical orders directly and, in a query-free mode, encodes a short rolling window of ambient dialogue to trigger retrieval. Initialized from PubMedBERT and fine-tuned with a duplicate-safe contrastive objective, JEDA aligns heterogeneous expressions of intent to shared order concepts. Training uses constrained LLM guidance to tie each signed order to complementary formulations (command only, context only, command+context, context+reasoning), producing clearer inter-order separation, tighter query extendash order coupling, and stronger generalization. The query-free mode is noise-resilient, reducing sensitivity to disfluencies and ASR errors by conditioning on a short window rather than a single utterance. Deployed in practice, JEDA yields large gains and substantially outperforms its base encoder and recent open embedders (Linq Embed Mistral, SFR Embedding, GTE Qwen, BGE large, Embedding Gemma). The result is a fast, interpretable, LLM-free retrieval layer that links ambient context to actionable clinical orders in real time.