An accurate problem list plays the key role of a problem-oriented medical record, which plays a significant role in improving patient care. However, the multi-author, multi-purpose nature of problem list makes it a challenge to maintain, and a single list is difficult, if not impossible, to satisfy all the needs of different practitioners. In this paper, we propose using machine generated problem list to assist a medical practitioner to review a patient's chart. The proposed system scans both structured and unstructured data in a patient's electronic medical record (EMR) and generates a ranked, recall-oriented problem list grouped by body systems. Details of each problem are readily available for the user to assess the correctness and relevance of the problem. The user can then provide feedback to the system on the trustworthiness of each evidence passage retrieved, as well as the validity of the problem as a whole. The user-specific feedback provides new information the system needs to perform active learning to learn the user's preference and produce personalized, and/or domain-specific problem lists.

Both electronic health records and personal health records are typically organized by data type, with medical problems, medications, procedures, and laboratory results chronologically sorted in separate areas of the chart. As a result, it can be difficult to find all of the relevant information for answering a clinical question about a given medical problem. A promising alternative is to instead organize by problems, with related medications, procedures, and other pertinent information all grouped together. A recent effort by Buchanan (2017) manually defined, through expert consensus, 11 medical problems and the relevant labs and medications for each. We show how to use machine learning on electronic health records to instead automatically construct these problem-based groupings of relevant medications, procedures, and laboratory tests. We formulate the learning task as one of knowledge base completion, and annotate a dataset that expands the set of problems from 11 to 32. We develop a model architecture that exploits both pre-trained concept embeddings and usage data relating the concepts contained in a longitudinal dataset from a large health system. We evaluate our algorithms' ability to suggest relevant medications, procedures, and lab tests, and find that the approach provides feasible suggestions even for problems that are hidden during training. The dataset, along with code to reproduce our results, is available at https://github.com/asappresearch/kbc-pomr.

An accurate problem list plays the key role of a problem-oriented medical record, which plays a significant role in improving patient care. However, the multi-author, multi-purpose nature of problem list makes it a challenge to maintain, and a single list is difficult, if not impossible, to satisfy all the needs of different practitioners. In this paper, we propose using machine generated problem list to assist a medical practitioner to review a patient’s chart. The proposed system scans both structured and unstructured data in a patient’s electronic medical record (EMR) and generates a ranked, recall-oriented problem list grouped by body systems. Details of each problem are readily available for the user to assess the correctness and relevance of the problem. The user can then provide feedback to the system on the trustworthiness of each evidence passage retrieved, as well as the validity of the problem as a whole. The user-specific feedback provides new information the system needs to perform active learning to learn the user’s preference and produce personalized, and/or domain-specific problem lists.