Ensuring clinical data privacy while preserving utility is critical for AI-driven healthcare and data analytics. Existing de-identification (De-ID) methods, including rule-based techniques, deep learning models, and large language models (LLMs), often suffer from recall errors, limited generalization, and inefficiencies, limiting their real-world applicability. We propose a fully automated, multi-modal framework, RedactOR for de-identifying structured and unstructured electronic health records, including clinical audio records. Our framework employs cost-efficient De-ID strategies, including intelligent routing, hybrid rule and LLM based approaches, and a two-step audio redaction approach. We present a retrieval-based entity relexicalization approach to ensure consistent substitutions of protected entities, thereby enhancing data coherence for downstream applications. We discuss key design desiderata, de-identification and relexicalization methodology, and modular architecture of RedactOR and its integration with Oracle Health Clinical AI system. Evaluated on the i2b2 2014 De-ID dataset using standard metrics with strict recall, our approach achieves competitive performance while optimizing token usage to reduce LLM costs. Finally, we discuss key lessons and insights from deployment in real-world AI-driven healthcare data pipelines.

Voice-controlled AI dialogue systems are susceptible to noise from phonetic variations and failure to resolve ambiguous entities. Typically, personalized entity resolution (ER) and/or query rewrites (QR) are deployed to recover from these error modes. Previous work in this field achieves personalization by constraining retrieval search space to personalized indices built from user’s historical interactions with the device. While constrained retrieval achieves high precision, predictions are limited to entities in recent user history, which offers low coverage of future requests. Further, maintaining individual indices for millions of users is memory intensive and difficult to scale. In this work, we propose a personalized entity retrieval system that is robust to phonetic noise and ambiguity but is not limited to a personalized index. We achieve this by embedding user listening preferences into a contextual query embedding used in retrieval. We demonstrate our model’s ability to correct multiple error modes and show 91% improvement over baseline on the entity retrieval task. Finally, we optimize the end-to-end approach to fit within online latency constraints while maintaining gains in performance.