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Scott, Jeanie

Publications and source records attributed to Scott, Jeanie.

Use of Event-Time Embeddings via RNN to Discern Novel Event Sequences in EHRs

In highly configurable health information technology (HIT) systems, such as VistA of the Veterans Health Administration, the variations in how the system is used among different healthcare facilities and how the data are recorded can be significant. Despite the successful standardization of care efforts, some of these variations can be indicative of HIT hazards and demand further investigation. In this work, we implemented a recurrent neural network (RNN) architecture to learn clinical provider order sequences and their temporal dynamics while predicting the orders' terminal state. We demonstrate model performance and provide a use case for the model discerning novel event sequences. This model is proposed to find novel event sequences in an operational environment.

Ozmen, Ozgur↗

Adaptive Anomaly Detection for Dynamic Clinical Event Sequences

Over the past decade, health information technology (IT) has enabled the amount of digital information stored in electronic health records (EHRs) to expand greatly. However, according to some studies, hazards in health IT can lead to changes in clinical decisions, care processes, and care outcomes, as well as other issues. Thus, the effects of health IT hazards on patient safety have been at the forefront of recent patient safety research. Nonetheless, hazard detection in health IT remains a challenge. In this paper, the authors assume that safety-related issues in health IT would exhibit anomalous characteristics in EHR data. Although all hazards will exhibit some anomalous characteristics, not all anomalies can be regarded as hazards. The authors hypothesize that errors in health IT could lead to interruptions in the sequence of clinical actions. To this end, the problem of detecting anomalous sequences in big EHR data is considered. This paper focuses on dynamic event sequences, which are a series of clinical actions in motion. The authors propose an adaptive anomaly detection approach that uses higher-order network representation to detect anomalous sequences. Furthermore, the authors propose a contiguous subsequence anomaly detection approach that identifies abnormal subsequences in the detected anomalous sequences. The proposed approaches are tested by using synthetic and real-world EHR data. The proposed methods outperform existing state of the art anomaly detection techniques. To reduce the computational complexity associated with the operational implementation of the proposed approaches, the Apache Spark environment was leveraged, and a much shorter run time together with improved performance were achieved, especially for data with more than 60,000 sequences.

Niu, Haoran↗