arXiv — cs.AI preprintsInternational21 October 2026
Discrete Neural Interlingua for Ontology-Agnostic EHR Modeling
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arXiv:2610.27047v1 Announce Type: cross Abstract: EHR foundation models promise scalable clinical prediction across health systems, yet their deployment is constrained by a tokenization bottleneck. The same clinical concept can appear as different ontology codes, local identifiers, synonyms, or free-text descriptions, which standard EHR tokenizers treat as unrelated symbols. A model trained on MIMIC-III with a closed-vocabulary tokenizer can use only 13% of eICU events. We introduce MEDIATOR, a discrete ontology-agnostic tokenizer that maps any clinical concept expressed as text into a shared
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