The goal of this work is to utilize Electronic Medical Record (EMR) data for real-time Clinical Decision Support (CDS). We present a deep learning approach to combining in real time available diagnosis codes (ICD codes) and free-text notes: Patient Context Vectors. Patient Context Vectors are created by averaging ICD code embeddings, and by predicting the same from free-text notes via a Convolutional Neural Network. The Patient Context Vectors were then simply appended to available structured data (vital signs and lab results) to build prediction models for a specific condition. Experiments on predicting ARDS, a rare and complex condition, demonstrate the utility of Patient Context Vectors as a means of summarizing the patient history and overall condition, and improve significantly the prediction model results.

Severe sepsis and septic shock are conditions that affect millions of patients and have close to 50% mortality rate. Early identification of at-risk patients significantly improves outcomes. Electronic surveillance tools have been developed to monitor structured Electronic Medical Records and automatically recognize early signs of sepsis. However, many sepsis risk factors (e.g. symptoms and signs of infection) are often captured only in free text clinical notes. In this study, we developed a method for automatic monitoring of nursing notes for signs and symptoms of infection. We utilized a creative approach to automatically generate an annotated dataset. The dataset was used to create a Machine Learning model that achieved an F1-score ranging from 79 to 96%.