Monitoring and Evaluating LLMs in Clinical Contexts with Azure AI Foundry
👀 Missed Session 02? Don’t worry—you can still catch up. But first, here’s what AI HLS Ignited is all about: What is AI HLS Ignited? AI HLS Ignited is a Microsoft-led technical series for healthcare innovators, solution architects, and AI engineers. Each session brings to life real-world AI solutions that are reshaping the Healthcare and Life Sciences (HLS) industry. Through live demos, architectural deep dives, and GitHub-hosted code, we equip you with the tools and knowledge to build with confidence. Session 02 Recap: In this session, we introduced MedEvals, an end-to-end evaluation framework for medical AI applications built on Azure AI Foundry. Inspired by Stanford’s MedHELM benchmark, MedEvals enables providers and payers to systematically validate performance, safety, and compliance of AI solutions across clinical decision support, documentation, patient communication, and more. 🧠Why Scalable Evaluation Is Critical for Medical AI "Large language models (LLMs) hold promise for tasks ranging from clinical decision support to patient education. However, evaluating the performance of LLMs in medical contexts presents unique challenges due to the complex and critical nature of medical information." — Evaluating large language models in medical applications: a survey As AI systems become deeply embedded in healthcare workflows, the need for rigorous evaluation frameworks intensifies. Although large language models (LLMs) can augment tasks ranging from clinical documentation to decision support, their deployment in patient-facing settings demands systematic validation to guarantee safety, fidelity, and robustness. Benchmarks such as MedHELM address this requirement by subjecting models to a comprehensive battery of clinically derived tasks built on dataset (ground truth), enabling fine-grained, multi-metric performance assessment across the full spectrum of clinical use cases.​ However, shipping a medical LLM is only step one. Without a repeatable, metrics-driven evaluation loop, quality erodes, regulatory gaps widen, and patient safety is put at risk. This project accelerates your ability to operationalize trustworthy LLMs by delivering plug-and-play medical benchmarks, configurable evaluators, and CI/CD templates—so every model update triggers an automated, domain-specific “health check” that flags drift, surfaces bias, and validates clinical accuracy before it ever reaches production. 🚀 How to Get Started with MedEvals Kick off your MedEvals journey by following our curated labs. Newcomers to Azure AI Foundry can start with the foundational workflow; seasoned practitioners can dive into advanced evaluation pipelines and CI/CD integration. 🧪 Labs 🧪 Foundry Basics & Custom Evaluations: 🧾 Notebook Authenticate, initialize a Foundry project, run built-in metrics, and build custom evaluators with EvalAI and PromptEval. 🧪 Search & Retrieval Evaluations: 🧾 Notebook Prepare datasets, execute search metrics (precision, recall, NDCG), visualize results, and register evaluators in Foundry. 🧪 Repeatable Evaluations & CI/CD: 🧾 Notebook Define evaluation schemas, build deterministic pipelines with PyTest, and automate drift detection using GitHub Actions. 🏥 Use Cases 📝 Creating Your Clinical Evaluation with RevCycle Determinations Select a model and metric that best supports the determination behind the rationale made on AI-assisted prior authorizations based on real payor policy. This notebook use case includes: Selecting multiple candidate LLMs (e.g., gpt-4o, o1) Breaking down determinations both in deterministic results (approved vs rejected) and the supporting rationale and logic. Running evaluations across multiple dimensions Combining deterministic evaluators and LLM-as-a-Judge methods Evaluating the differential impacts of evaluators on the rationale across scenarios 🧾Get Started with the Notebook Why it matters: Enables data-driven metric selection for clinical workflows, ensures transparent benchmarking, and accelerates safe AI adoption in healthcare. 📝 Evaluating AI Medical Notes Summarization Applications Systematically assess how different foundation models and prompting strategies perform on clinical summarization tasks, following the MedHELM framework. This notebook use case includes: Preparing real-world datasets of clinical notes and summaries Benchmarking summarization quality using relevance, coherence, factuality, and harmfulness metrics Testing prompting techniques (zero-shot, few-shot, chain-of-thought prompting) Evaluating outputs using both automated metrics and human-in-the-loop scoring 🧾Get Started with the Notebook Why it matters: Ensures responsible deployment of AI applications for clinical summarization, guaranteeing high standards of quality, trustworthiness, and usability. 📣 Join Us for the Next Session Help shape the future of healthcare by sharing AI HLS Ignited with your network—and don’t miss what’s coming next! 📅 Register for the upcoming session → AI HLS Ignited Event Page 💻 Explore the code, demos, and architecture → AI HLS Ignited GitHub Repository
Orchestrate multimodal AI insights within your healthcare data estate (Public Preview)
In today’s healthcare landscape, there is an increasing emphasis on leveraging artificial intelligence (AI) to extract meaningful insights from diverse datasets to improve patient care and drive clinical research. However, incorporating AI into your healthcare data estate often brings significant costs and challenges, especially when dealing with siloed and unstructured data.​ Healthcare organizations produce and consume data that is not only vast but also varied in format—ranging from structured EHR entries to unstructured clinical notes and imaging data. Traditional methods require manual effort to prepare and harmonize this data for AI, specify the AI output format, set up API calls, store the AI outputs, integrate the AI outputs, and analyze the AI outputs for each AI model or service you decide to use. Orchestrate multimodal AI insights is designed to streamline and scale healthcare AI within your data estate by building off of the data transformations in healthcare data solutions in Microsoft Fabric. This capability provides a framework to generate AI insights by connecting your multimodal healthcare data to an ecosystem of AI services and models and integrating structured AI-generated insights back into your data estate. When you combine these AI-generated insights with the existing healthcare data in your data estate, you can power advanced analytics scenarios for your organization and patient population. Key features: Metadata store lakehouse acts as a central repository for the metadata for AI orchestration to effectively capture and manage enrichment definitions, view definitions, and contextual information for traceability purposes. Execution notebooks define the enrichment view and enrichment definition based on the model configuration and input mappings. They also specify the model processor and transformer. The model processor calls the model API, and the transformer produces the standardized output while saving the output in the bronze lakehouse in the Ingest folder. Transformation pipeline to ingest AI-generated insights through the healthcare data solutions medallion lakehouse layers and persist the insights in an enrichment store within the silver layer. Conceptual architecture: The data transformations in healthcare data solutions in Microsoft Fabric allow you ingest, store, and analyze multimodal data. With the orchestrate multimodal AI insights capability, this standardized data serves as the input for healthcare AI models. The model results are stored in a standardized format and provide new insights from your data. The diagram below shows the flow of integrating AI generated insights into the data estate, starting as raw data in the bronze lakehouse and being transformed to delta tables in the silver lakehouse. This capability simplifies AI integration across modalities for data-driven research and care, currently supporting: Text Analytics for health in Azure AI Language to extract medical entities such as conditions and medications from unstructured clinical notes. This utilizes the data in the DocumentReference FHIR resource. MedImageInsight healthcare AI model in Azure AI Foundry to generate medical image embeddings from imaging data. This model leverages the data in the ImagingStudy FHIR resource. MedImageParse healthcare AI model in Azure AI Foundry to enable segmentation, detection, and recognition from imaging data across numerous object types and imaging modalities. This model uses the data in the ImagingStudy FHIR resource. By using orchestrate multimodal AI insights to leverage the data in healthcare data solutions for these models and integrate the results into the data estate, you can analyze your existing data alongside AI enrichments. This allows you to explore use cases such as creating image segmentations and combining with your existing imaging metadata and clinical data to enable quick insights and disease progression trends for clinical research at the patient level. Get started today! This capability is now available in public preview, and you can use the in-product sample data to test this feature with any of the three models listed above. For more information and to learn how to deploy the capability, please refer to the product documentation. We will dive deeper into more detailed aspects of the capability, such as the enrichment store and custom AI use cases, in upcoming blogs. Medical device disclaimer: Microsoft products and services (1) are not designed, intended or made available as a medical device, and (2) are not designed or intended to be a substitute for professional medical advice, diagnosis, treatment, or judgment and should not be used to replace or as a substitute for professional medical advice, diagnosis, treatment, or judgment. Customers/partners are responsible for ensuring solutions comply with applicable laws and regulations. FHIR® is the registered trademark of HL7 and is used with permission of HL7.Reshape Business Processes
* To see all 4 pillars and links to the associated blog posts see AI Transformation with Microsoft 365 Copilot | Microsoft Community Hub Below is the list of Healthcare & Lifesciences Blog posts focused on Reshaping Business Processes: AGS Health: Call audits simplified Apollo Hospitals: Transforming clinical documentation audits Azure AI Foundry: Your AI App and agent factory | Microsoft Azure Blog Empower clinicians with trusted content and GenAI: MSD Manuals added to healthcare agent service Enhancing Genomics Annotation with GraphRAG How generative AI is reshaping business applications - Microsoft Dynamics 365 Blog SolutionHealth builds patient-focused workflows with Dragon for two health systems | Microsoft Customer Stories Syneos Health reduces time for clinical trial site activation by about 10% with Azure OpenAI Service | Microsoft Customer StoriesBuilding AI-Powered Clinical Knowledge Stores with Azure AI Search
👀 Missed Session 01? Don’t worry—you can still catch up. But first, here’s what AI HLS Ignited is all about: What is AI HLS Ignited? AI HLS Ignited is a Microsoft-led technical series for healthcare innovators, solution architects, and AI engineers. Each session brings to life real-world AI solutions that are reshaping the Healthcare and Life Sciences (HLS) industry. Through live demos, architectural deep dives, and GitHub-hosted code, we equip you with the tools and knowledge to build with confidence. Session 01 Recap: In our first session, we introduced the accelerator MedIndexer - which is an indexing framework designed for the automated creation of structured knowledge bases from unstructured clinical sources. Whether you're dealing with X-rays, clinical notes, or scanned documents, MedIndexer converts these inputs into a schema-driven format optimized for Azure AI Search. This will allow your applications to leverage state-of-the-art retrieval methodologies, including vector search and re-ranking. Moreover, by applying a well-defined schema and vectorizing the data into high-dimensional representations, MedIndexer empowers AI applications to retrieve more precise and context-aware information... The result? AI systems that surface more relevant, accurate, and context-aware insights—faster. 🔍 Turning Your Unstructured Data into Value "About 80% of medical data remains unstructured and untapped after it is created (e.g., text, image, signal, etc.)" — Healthcare Informatics Research, Chungnam National University In the era of AI, the rise of AI copilots and assistants has led to a shift in how we access knowledge. But retrieving clinical data that lives in disparate formats is no trivial task. Building retrieval systems takes effort—and how you structure your knowledge store matters. It’s a cyclic, iterative, and constantly evolving process. That’s why we believe in leveraging enterprise-ready retrieval platforms like Azure AI Search—designed to power intelligent search experiences across structured and unstructured data. It serves as the foundation for building advanced retrieval systems in healthcare. However, implementing Azure AI Search alone is not enough. Mastering its capabilities and applying well-defined patterns can significantly enhance your ability to address repetitive tasks and complex retrieval scenarios. This project aims to accelerate your ability to transform raw clinical data into high-fidelity, high-value knowledge structures that can power your next-generation AI healthcare applications. 🚀 How to Get Started with MedIndexer New to Azure AI Search? Begin with our guided labs to build a strong foundation and get hands-on with the core capabilities. Already familiar with the tech? Jump ahead to the real-world use cases—learn how to build Coded Policy Knowledge Stores and X-ray Knowledge Stores. 🧪 Labs 🧪 Building Your Azure AI Search Index: 🧾 Notebook - Building your first Index Learn how to create and configure an Azure AI Search index to enable intelligent search capabilities for your applications. 🧪 Indexing Data into Azure AI Search: 🧾 Notebook - Ingest and Index Clinical Data Understand how to ingest, preprocess, and index clinical data into Azure AI Search using schema-first principles. 🧪 Retrieval Methods for Azure AI Search: 🧾 Notebook - Exploring Vector Search and Hybrid Retrieval Dive into retrieval techniques such as vector search, hybrid retrieval, and reranking to enhance the accuracy and relevance of search results. 🧪 Evaluation Methods for Azure AI Search: 🧾 Notebook - Evaluating Search Quality and Relevance Learn how to evaluate the performance of your search index using relevance metrics and ground truth datasets to ensure high-quality search results. 🏥 Use Cases 📝 Creating Coded Policy Knowledge Stores In many healthcare systems, policy documents such as pre-authorization guidelines are still trapped in static, scanned PDFs. These documents are critical—they contain ICD codes, drug name coverage, and payer-specific logic—but are rarely structured or accessible in real-time. To solve this, we built a pipeline that transforms these documents into intelligent, searchable knowledge stores. This diagram shows how pre-auth policy PDFs are ingested via blob storage, passed through an OCR and embedding skillset, and then indexed into Azure AI Search. The result: fast access to coded policy data for AI apps. 🧾 Notebook - Creating Coded Policies Knowledge Stores Transform payer policies into machine-readable formats. This use case includes: Preprocessing and cleaning PDF documents Building custom OCR skills Leveraging out-of-the-box Indexer capabilities and embedding skills Enabling real-time AI-assisted querying for ICDs, payer names, drug names, and policy logic Why it matters: This streamlines prior authorization and coding workflows for providers and payors, reducing manual effort and increasing transparency. 🩻 Creating X-ray Knowledge Stores In radiology workflows, X-ray reports and image metadata contain valuable clinical insights—but these are often underutilized. Traditionally, they’re stored as static entries in PACS systems or loosely connected databases. The goal of this use case is to turn those X-ray reports into a searchable, intelligent asset that clinicians can explore and interact with in meaningful ways. This diagram illustrates a full retrieval pipeline where radiology reports are uploaded, enriched through foundational models, embedded, and indexed. The output powers an AI-driven web app for similarity search and decision support. 🧾 Notebook - Creating X-rays Knowledge Stores Turn imaging reports and metadata into a searchable knowledge base. This includes: Leveraging push APIs with custom event-driven indexing pipeline triggered on new X-ray uploads Generating embeddings using Microsoft Healthcare foundation models Providing an AI-powered front-end for X-ray similarity search Why it matters: Supports clinical decision-making by retrieving similar past cases, aiding diagnosis and treatment planning with contextual relevance. 📣 Join Us for the Next Session Help shape the future of healthcare by sharing AI HLS Ignited with your network—and don’t miss what’s coming next! 📅 Register for the upcoming session → AI HLS Ignited Event Page 💻 Explore the code, demos, and architecture → AI HLS Ignited GitHub Repository
