ECHO: A Locally-Deployable Agentic Health Assistant with Temporal Memory, Safety Guardrails, and Speech Assessment
Authors: Abdulkadir Külçe, Alihan Esen, Çağla Fikir, Berke Kurt, Kuzey Arar, Gökhan Ercan, Faik Boray Tek
Organizations: Dept. of Artificial Intelligence and Data Engineering, Istanbul Technical University, Istanbul, Turkey · Dept. of Computer Engineering, Istanbul Technical University, Istanbul, Turkey
Abstract
This paper presents ECHO (Enhanced Care & Health Observer), a locally-deployable conversational health assistant for long-term chronic care management. ECHO integrates three complementary software modules developed under shared supervision as a unified system. The core module is an agentic chatbot built on a ReAct loop orchestrated via LangGraph, equipped with 17 clinical tools and a temporal knowledge graph for persistent cross-session memory; it achieves a 94.9% tool-execution pass rate across a 59-scenario benchmark with GPT-5 Mini. A two-stage hybrid safety layer intercepts all incoming queries: a rule-based layer handles explicit crisis signals and jailbreak attempts in under 1ms, while a signed graph neural network (GNN) with APPNP-style propagation classifies boundary cases by clinical intent, achieving 88.8% accuracy and 90.6% unsafe recall on a 2,537-query annotated Turkish health dataset while outperforming zero-shot LLM baselines including Llama 3.3 70B. A multimodal speech assessment module combining Whisper acoustic encoding and BERT text encoding with cross-attention fusion estimates emotion, depression, and pain, reaching a mean macro F1 of 0.652. The full system is implemented as a web application that can run entirely on consumer hardware, with no patient data transmitted to external services, supporting compliance with GDPR and KVKK.
Personal health management unfolds over repeated encounters, yet most health AI systems treat each request in isolation. We developed HealthClaw, an open-source agent architecture that updates support as a person's routines, preferences, measurements and risks change. It separates shared safety rules and medical knowledge from private longitudinal memory containing profile facts, reusable procedures and episodic traces. After each episode, induction determines what should update the profile, revise a procedure, remain episodic or be excluded. We evaluated HealthClaw with a synthetic year-long benchmark and nine 200-case biomedical tasks. Across 900 longitudinal support probes, answer accuracy increased from 0.2% with current-query prompting to 45.7% with HealthClaw, while prompt-side context exposure was 71.7% lower than with full-history prompting. In 100 privacy probes, HealthClaw produced higher privacy-aware answer quality and fewer unsafe disclosures than both baselines. Across the biomedical tasks, the mean absolute gain in the task-specific primary metric was 27.0 percentage points, and seven gains remained significant after false-discovery-rate correction. These offline benchmarks support governed, self-evolving memory for longitudinal personal health agents, although clinical effectiveness requires prospective evaluation. HealthClaw is publicly available at https://github.com/HC-Guo/HealthClaw.
We present Tell Me, a mental well-being system that leverages advances in large language models to provide accessible, context-aware support for users and researchers. The system integrates three components: (i) a retrieval-augmented generation (RAG) assistant for personalized, knowledge-grounded dialogue; (ii) a synthetic client-therapist dialogue generator conditioned on client profiles to facilitate research on therapeutic language and data augmentation; and (iii) a Well-being AI crew, implemented with CrewAI, that produces weekly self-care plans and guided meditation audio. The system is designed as a reflective space for emotional processing rather than a substitute for professional therapy. It illustrates how conversational assistants can lower barriers to support, complement existing care, and broaden access to mental health resources. To address the shortage of confidential therapeutic data, we introduce synthetic client-therapist dialogue generation conditioned on client profiles. Finally, the planner demonstrates an innovative agentic workflow for dynamically adaptive, personalized self-care, bridging the limitations of static well-being tools. We describe the architecture, demonstrate its functionalities, and report evaluation of the RAG assistant in curated well-being scenarios using both automatic LLM-based judgments and a human-user study. This work highlights opportunities for interdisciplinary collaboration between NLP researchers and mental health professionals to advance responsible innovation in human-AI interaction for well-being.
As large language models empower healthcare, intelligent clinical decision support has developed rapidly. Longitudinal electronic health records (EHR) provide essential temporal evidence for accurate clinical diagnosis and analysis. However, current large language models have critical flaws in longitudinal EHR reasoning. First, lacking fine-grained statistical reasoning, they often hallucinate clinical trends and metrics when quantitative evidence is textually implied, biasing diagnostic inference. Second, non-uniform time series and scarce labels in longitudinal EHR hinder models from capturing long-range temporal dependencies, limiting reliable clinical reasoning. To address the above limitations, this work presents the Probabilistic Chain-of-Thought Completion Agent (COTCAgent), a hierarchical reasoning framework for longitudinal electronic health records. It consists of three core modules. The Temporal-Statistics Adapter (TSA) converts analytical plans into executable code for standardized trend output. The Chain-of-Thought Completion (COTC) layer leverages a symptom-trend-disease knowledge base with weighted scoring to evaluate disease risk, while the bounded completion module acquires structured evidence through standardized inquiries and iterative scoring constraints to ensure rigorous reasoning. By decoupling statistical computation, feature matching, and language generation, the framework eliminates reliance on complex multi-modal inputs and enables efficient longitudinal record analysis with lower computational overhead. Experimental results show that COTCAgent powered by Baichuan-M2 achieves 90.47% Top-1 accuracy on the self-built dataset and 70.41% on HealthBench, outperforming existing medical agents and mainstream large language models. The code is available at https://github.com/FrankDengAI/COTCAgent/.