Representation Augmentation for Electronic Health Records via Knowledge Graphs, Large Language Models, and Contrastive Learning

Electronic Health Records (EHRs) provide rich longitudinal patient information, but their high dimensionality, sparsity, heterogeneity, and temporal complexity make robust representation learning difficult. This dissertation studies how to improve patient and medical concept representation learning in EHRs and consequently enhance healthcare predictive tasks by integrating domain knowledge, knowledge graphs, large language models (LLMs), and contrastive learning. First, it introduces an ontology-aware temporal contrastive framework for survival analysis that learns discriminative patient representations from censored and observed trajectories by modeling temporal distinctiveness in longitudinal EHR data. Second, it proposes a multi-ontology representation learning framework that jointly propagates knowledge within and across diagnosis, medication, and procedure ontologies, enabling richer medical concept embeddings, especially under limited data and for rare conditions. Third, it develops an LLM-enriched, text-attributed medical knowledge graph framework that combines EHR-derived statistical evidence with type-constrained LLM reasoning to infer semantic relations, generate contextual node and edge descriptions, and co-learn concept embeddings through joint language-model and graph-neural-network training. Together, these studies advance a unified view of EHR representation learning in which structured medical knowledge, textual semantics, and temporal patient trajectories are jointly leveraged to build more accurate, interpretable, and robust healthcare prediction models.