When Patients Cut In: Extending Clinical Conversational AI Safety to Interruptions
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Computer Science > Computation and Language
arXiv:2608.29241 (cs)
[Submitted on 29 Aug 2026]
Title:When Patients Cut In: Extending Clinical Conversational AI Safety to Interruptions
View a PDF of the paper titled When Patients Cut In: Extending Clinical Conversational AI Safety to Interruptions, by Zachary Ellis and 5 other authors
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Abstract:Clinical voice agents are now deployed in routine care, where real patients do not wait their turn: they interrupt. These systems typically use a cascaded architecture (speech-to-text -> LLM -> text-to-speech), so when a patient cuts the agent off mid-utterance, clinically required content can be lost even when the model handles cooperative transcripts well. Yet clinical conversational-AI benchmarks almost universally assume patients wait for the agent to finish, missing interruption-induced loss of required content. We present a transcript-based evaluation of interruption recovery, adapting conversation-analytic overlap categories into three operational types (recognitional, competitive, transitional sub-unit) and testing four deployment-oriented, non-reasoning LLM configurations across four cells spanning history-taking (information gathering) and FAQ (information provision), scored on whether the agent preserves the clinically required content. In the gathering cells, target-question failure varied across models; in the provision cells, where arms are directly comparable, failure rose for every model. Rankings differ across cells, and competitive FAQ interruption produced 30/30 provision-coverage failures for all four models (Wilson 95% CI: 88.6-100.0%; baseline 0/30 for three, 4/30 for Llama). A brief apology marker ("sorry to interrupt") shifts recovery by tens of percentage points, inconsistently across models, and for one it reduces recovery. Interruption robustness therefore cannot be a single score: evaluation must be content-grounded, reported per cell, and matched to the deployment's interruption profile.
| Comments: | Accepted to Findings of EMNLP 2026 |
| Subjects: | Computation and Language (cs.CL) |
| Cite as: | arXiv:2608.29241 [cs.CL] |
| (or arXiv:2608.29241v1 [cs.CL] for this version) | |
| https://doi.org/10.48550/arXiv.2608.29241
arXiv-issued DOI via DataCite (pending registration)
|
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View a PDF of the paper titled When Patients Cut In: Extending Clinical Conversational AI Safety to Interruptions, by Zachary Ellis and 5 other authors
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