TRACER: A Multimodal Harness for Patient Care in Hospitals

Abstract

Continuous video and clinical records provide complementary information for understanding how patient behavior evolves over a hospital stay. A central challenge is how to represent behavior across the entire stay while preserving access to fine-grained visual and clinical evidence. We introduce TRACER, a training-free multimodal harness that constructs minute-level action records from video and combines them with clinical records into hourly reports. The harness equips an LLM agent with tools to query this hierarchy, inspect relevant video, and retrieve clinical records. To evaluate TRACER, we construct two benchmarks. The first contains 397 annotated one-minute clips spanning 15 atomic actions; the second poses 144 clinician-informed multiple-choice questions, grounded in 264 hours of video and clinical records from two ICU patients. TRACER achieves up to 84.8% accuracy for action detection and 61.0% QA accuracy versus 49.3% for the strongest baseline using the same backbone. Across 280 patients spanning approximately 60,000 camera-hours, TRACER identifies significantly less purposeful activity in patients with a positive delirium assessment during their stay than in those without (p < 0.0001). Our results show that combining continuous video with clinical records can support understanding of patient behavior over time and across patient cohorts without training on protected health data.