The large amount of time clinicians spend sifting through patient notes and documenting in electronic health records (EHRs) is a leading cause of clinician burnout. By proactively and dynamically retrieving relevant notes during the documentation process, we can reduce the effort required to find relevant patient history. In this work, we conceptualize the use of EHR audit logs for machine learning as a source of supervision of note relevance in a specific clinical context, at a particular point in time. Our evaluation focuses on the dynamic retrieval in the emergency department, a high acuity setting with unique patterns of information retrieval and note writing. We show that our methods can achieve an AUC of 0.963 for predicting which notes will be read in an individual note writing session. We additionally conduct a user study with several clinicians and find that our framework can help clinicians retrieve relevant information more efficiently. Demonstrating that our framework and methods can perform well in this demanding setting is a promising proof of concept that they will translate to other clinical settings and data modalities (e.g., labs, medications, imaging).

通过利用电子病历审计日志，我们的工作在特定的临床背景和特定时间点上，将机器学习作为便签相关性的监督源进行概念化，以降低临床医生在记录过程中查找相关病史所需的努力。我们的评估集中在急诊部动态检索，这是一个具有独特信息检索和记录编写模式的高急症设置。我们展示了我们的方法在预测哪些便签将在个人记录会话中被阅读方面可以达到0.963的AUC。此外，我们对数名临床医生进行了用户研究，发现我们的框架可以帮助临床医生更有效地检索相关信息。在这个要求高的环境中展示我们的框架和方法表现良好是一个有希望的概念验证，表明它们将适用于其他临床设置和数据模态（例如实验室、药物、影像）。

电子健康记录笔记的动态信息检索的机器学习概念化