# Learning Continuous Patient Trajectories from Electronic Health Records

arXiv: https://arxiv.org/abs/2609.36144 · HTML: https://mlsanity.com/paper/2609.36144/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Flow matching, time series and science, one of 14 directions in Diffusion models.
- Builds on 38 of its 59 references that are in the map.
- First posted on arXiv 28 Sep 2026.

## Placed in

- Diffusion models / [Flow matching, time series and science](https://mlsanity.com/diffusion/flow-matching-time-series-and-science/)

## Builds on (most cited first, 30 of 38)

- [Classifier-Free Diffusion Guidance](https://mlsanity.com/paper/2207.12598/) (2022)
- [Flow Matching for Generative Modeling](https://mlsanity.com/paper/2210.02747/) (2022)
- [Neural Ordinary Differential Equations](https://mlsanity.com/paper/1806.07366/) (2018)
- [Empirical Evaluation of Gated Recurrent Neural Networks on Sequence Modeling](https://mlsanity.com/paper/1412.3555/) (2014)
- [Building Normalizing Flows with Stochastic Interpolants](https://mlsanity.com/paper/2209.15571/) (2022)
- [FFJORD: Free-form Continuous Dynamics for Scalable Reversible Generative Models](https://mlsanity.com/paper/1810.01367/) (2018)
- [CSDI: Conditional Score-based Diffusion Models for Probabilistic Time Series Imputation](https://mlsanity.com/paper/2107.03502/) (2021)
- [Neural Controlled Differential Equations for Irregular Time Series](https://mlsanity.com/paper/2005.08926/) (2020)
- [RETAIN: An Interpretable Predictive Model for Healthcare using Reverse Time Attention Mechanism](https://mlsanity.com/paper/1608.05745/) (2016)
- [Autoregressive Denoising Diffusion Models for Multivariate Probabilistic Time Series Forecasting](https://mlsanity.com/paper/2101.12072/) (2021)
- [Real-valued (Medical) Time Series Generation with Recurrent Conditional GANs](https://mlsanity.com/paper/1706.02633/) (2017)
- [BEHRT: Transformer for Electronic Health Records](https://mlsanity.com/paper/1907.09538/) (2019)
- [GRU-ODE-Bayes: Continuous modeling of sporadically-observed time series](https://mlsanity.com/paper/1905.12374/) (2019)
- [Doctor AI: Predicting Clinical Events via Recurrent Neural Networks](https://mlsanity.com/paper/1511.05942/) (2015)
- [Generating Multi-label Discrete Patient Records using Generative Adversarial Networks](https://mlsanity.com/paper/1703.06490/) (2017)
- [Structured Inference Networks for Nonlinear State Space Models](https://mlsanity.com/paper/1609.09869/) (2016)
- [Deep Kalman Filters](https://mlsanity.com/paper/1511.05121/) (2015)
- [TrajectoryNet: A Dynamic Optimal Transport Network for Modeling Cellular Dynamics](https://mlsanity.com/paper/2002.04461/) (2020)
- [Estimating Counterfactual Treatment Outcomes over Time Through Adversarially Balanced Representations](https://mlsanity.com/paper/2002.04083/) (2020)
- [Causal Transformer for Estimating Counterfactual Outcomes](https://mlsanity.com/paper/2204.07258/) (2022)
- [MOTOR: A Time-To-Event Foundation Model For Structured Medical Records](https://mlsanity.com/paper/2301.03150/) (2023)
- [Non-autoregressive Conditional Diffusion Models for Time Series Prediction](https://mlsanity.com/paper/2306.05043/) (2023)
- [Metric Flow Matching for Smooth Interpolations on the Data Manifold](https://mlsanity.com/paper/2405.14780/) (2024)
- [Zero Shot Health Trajectory Prediction Using Transformer](https://mlsanity.com/paper/2407.21124/) (2024)
- [CEHR-BERT: Incorporating temporal information from structured EHR data to improve prediction tasks](https://mlsanity.com/paper/2111.08585/) (2021)
- [Manifold Interpolating Optimal-Transport Flows for Trajectory Inference](https://mlsanity.com/paper/2206.14928/) (2022)
- [ContiFormer: Continuous-Time Transformer for Irregular Time Series Modeling](https://mlsanity.com/paper/2402.10635/) (2024)
- [Generating Synthetic Mixed-type Longitudinal Electronic Health Records for Artificial Intelligent Applications](https://mlsanity.com/paper/2112.12047/) (2021)
- [Meta Flow Matching: Integrating Vector Fields on the Wasserstein Manifold](https://mlsanity.com/paper/2408.14608/) (2024)
- [Flow Matching with Gaussian Process Priors for Probabilistic Time Series Forecasting](https://mlsanity.com/paper/2410.03024/) (2024)

## Abstract (arXiv)

Electronic health records provide irregular observations of latent patient states that evolve continuously over time. Recent autoregressive models condition on clinical histories to forecast future events as sequences of discrete observations. Conversely, multi-marginal flow matching provides a continuous-time formulation, but using multiple observations to supervise training paths does not itself give the learned dynamics access to preceding patient history. We introduce EHRFlow, a multi-marginal flow-matching framework that conditions on encoded patient history, thereby allowing future dynamics to depend on the patient's prior clinical trajectory. Our proposed framework accommodates irregular observation times and supports forecasting at arbitrary horizons. Across controlled synthetic benchmarks, EHRFlow improves clinical-code forecasting and latent-state recovery. On real-world clinical datasets comprising more than one million patients, including an independent external validation cohort, EHRFlow improves horizon-averaged top-5 clinical-code accuracy over autoregressive and history-independent flow-matching baselines. Finally, in a controlled counterfactual simulation, conditional guidance approximates the known effect of an antihypertensive intervention without training a task-specific outcome model.