# Three Generations of Healthcare IT: From the Digital Record to the Computable Care Process

arXiv: https://arxiv.org/abs/2608.08806 · HTML: https://mlsanity.com/paper/2608.08806/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 8 of its 53 references that are in the map.
- First posted on arXiv 9 Aug 2026.

## Builds on (most cited first, 8 of 8)

- [Survey of Hallucination in Natural Language Generation](https://mlsanity.com/paper/2202.03629/) (2022)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [Neurosymbolic AI: The 3rd Wave](https://mlsanity.com/paper/2012.05876/) (2020)
- [TimeBench: A Comprehensive Evaluation of Temporal Reasoning Abilities in Large Language Models](https://mlsanity.com/paper/2311.17667/) (2023)
- [CLIP: A Dataset for Extracting Action Items for Physicians from Hospital Discharge Notes](https://mlsanity.com/paper/2106.02524/) (2021)
- [MedDec: A Dataset for Extracting Medical Decisions from Discharge Summaries](https://mlsanity.com/paper/2408.12980/) (2024)
- [Overview of the MEDIQA-OE 2025 Shared Task on Medical Order Extraction from Doctor-Patient Consultations](https://mlsanity.com/paper/2510.26974/) (2025)
- [Reliable Extraction of Clinical Follow-Up Instructions: A Hybrid Neural-Symbolic Pipeline](https://mlsanity.com/paper/2605.26560/) (2026)

## Built on by (most cited first, 1 of 1)

- [Clinical Intent Extraction: A FHIR-Aligned Representation and the CIRCA Benchmark](https://mlsanity.com/paper/2609.29479/) (2026)

## Abstract (arXiv)

Objective. Healthcare IT is usually organized by the technologies it adopts. We instead organize it by the unit of information a system makes computable, and describe a computational layer whose object is patient-specific clinical intent. Approach. We give criteria for a computational layer, derive three (record, clinical state, and a proposed layer of intent), and formalize the Actionable Clinical Record (ACR) as the atomic object of the third layer. Discussion. The framework distinguishes prescribed, observed, and intended process; existing standards represent intent once it is structured but do not recover it from natural communication, the capability we localize. The ACR is complementary to FHIR workflow resources, guidelines, and process mining; a companion feasibility study illustrates tractability for one narrow subproblem. Conclusion. Computable clinical intent is a coherent research direction; the ACR, its readiness ladder, and an executable-correctness evaluation framework are reusable constructs for subsequent work to extend, evaluate, or falsify.