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Automated Travel History Extraction From Clinical Notes for Informing the Detection of Emergent Infectious Disease Events | healthcare technology | Scoop.it

From publichealth.jmir.org - June 16, 2021 8:17 PM

Patient travel history can be crucial in evaluating evolving infectious disease events. Such information can be challenging to acquire in electronic health records, as it is often available only in unstructured text.

Objective: This study aims to assess the feasibility of annotating and automatically extracting travel history mentions from unstructured clinical documents in the Department of Veterans Affairs across disparate health care facilities and among millions of patients. Information about travel exposure augments existing surveillance applications for increased preparedness in responding quickly to public health threats.

Methods: Clinical documents related to arboviral disease were annotated following selection using a semiautomated bootstrapping process. Using annotated instances as training data, models were developed to extract from unstructured clinical text any mention of affirmed travel locations outside of the continental United States. Automated text processing models were evaluated, involving machine learning and neural language models for extraction accuracy.

Results: Among 4584 annotated instances, 2659 (58%) contained an affirmed mention of travel history, while 347 (7.6%) were negated. Interannotator agreement resulted in a document-level Cohen kappa of 0.776. Automated text processing accuracy (F1 85.6, 95% CI 82.5-87.9) and computational burden were acceptable such that the system can provide a rapid screen for public health events.

Conclusions: Automated extraction of patient travel history from clinical documents is feasible for enhanced passive surveillance public health systems.

Without such a system, it would usually be necessary to manually review charts to identify recent travel or lack of travel, use an electronic health record that enforces travel history documentation, or ignore this potential source of information altogether.

The development of this tool was initially motivated by emergent arboviral diseases. More recently, this system was used in the early phases of response to COVID-19 in the United States, although its utility was limited to a relatively brief window due to the rapid domestic spread of the virus.

Such systems may aid future efforts to prevent and contain the spread of infectious diseases.

read the study at https://publichealth.jmir.org/2021/3/e26719

Should we diagnose rare diseases with smartphones? | healthcare technology | Scoop.it

From www.bbc.com - October 17, 2014 4:35 PM

An object in your pocket could help diagnose rare diseases like Ebola, finds David Robson – and one day it might even replace the doctor’s surgery too.

As fear of the Ebola virus escalates, Eric Topol thinks that we’re missing an important weapon. And you just need to reach into your pocket to find it. “Most communicable diseases can be diagnosed with a smartphone,” he says. “Rather than putting people into quarantine for three weeks – how about seeing if they harbour it in their blood?” A quicker response could also help prevent mistakes, such as the patient in Dallas who was sent home from hospital with a high fever, only to later die from the infection.

It’s a provocative claim, but Topol is not shy about calling for a revolution in the way we deal with Ebola – or any other health issue for that matter. A professor of genomics at the Scripps Research Institute in California, his last book heralded “the creative destruction of medicine” through new technology. Smartphones are already helping to do away with many of the least pleasant aspects of sickness – including the long hospital visits and agonising wait for treatment. An easier way to diagnose Ebola is just one example of these sweeping changes.

So far, however, few doctors have embraced these possibilities. “The medical cocoon has not allowed a digital invasion,” says Topol, “while the rest of the world has already assimilated the digital revolution into its day-to-day life.” That’s not due to lack of demand: many patients are already monitoring their health through their phone, with apps that check your skin for cancer from a selfie, for example. These programs are not alwaysdesigned with the accuracy most doctors would require, however – and some fear that by missing a diagnosis and offering a false sense of security, they could cost lives. “The slower the healthcare system is in exploring these things, the more people are at risk by doing the exploration on their own,” says Estrin.

more at : http://www.bbc.com/future/story/20141017-the-ebola-detector-in-your-pocket

Automated Travel History Extraction From Clinical Notes for Informing the Detection of Emergent Infectious Disease Events

Should we diagnose rare diseases with smartphones?