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Understanding patients journeys in healthcare system is a fundamental prepositive task for a broad range of AI-based healthcare applications. This task aims to learn an informative representation that can comprehensively encode hidden dependencies among medical events and its inner entities, and then the use of encoding outputs can greatly benefit the downstream application-driven tasks. A patient journey is a sequence of electronic health records (EHRs) over time that is organized at multiple levels: patient, visits and medical codes. The key challenge of patient journey understanding is to design an effective encoding mechanism which can properly tackle the aforementioned multi-level structured patient journey data with temporal sequential visits and a set of medical codes. This paper proposes a novel self-attention mechanism that can simultaneously capture the contextual and temporal relationships hidden in patient journeys. A multi-level self-attention network (MusaNet) is specifically designed to learn the representations of patient journeys that is used to be a long sequence of activities. The MusaNet is trained in end-to-end manner using the training data derived from EHRs. We evaluated the efficacy of our method on two medical application tasks with real-world benchmark datasets. The results have demonstrated the proposed MusaNet produces higher-quality representations than state-of-the-art baseline methods. The source code is available in https://github.com/xueping/MusaNet.
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Healthcare representation learning on the Electronic Health Record (EHR) is seen as crucial for predictive analytics in the medical field. Many natural language processing techniques, such as word2vec, RNN and self-attention, have been adapted for use in hierarchical and time stamped EHR data, but fail when they lack either general or task-specific data. Hence, some recent works train healthcare representations by incorporating medical ontology (a.k.a. knowledge graph), by self-supervised tasks like diagnosis prediction, but (1) the small-scale, monotonous ontology is insufficient for robust learning, and (2) critical contexts or dependencies underlying patient journeys are never exploited to enhance ontology learning. To address this, we propose an end-to-end robust Transformer-based solution, Mutual Integration of patient journey and Medical Ontology (MIMO) for healthcare representation learning and predictive analytics. Specifically, it consists of task-specific representation learning and graph-embedding modules to learn both patient journey and medical ontology interactively. Consequently, this creates a mutual integration to benefit both healthcare representation learning and medical ontology embedding. Moreover, such integration is achieved by a joint training of both task-specific predictive and ontology-based disease typing tasks based on fused embeddings of the two modules. Experiments conducted on two real-world diagnosis prediction datasets show that, our healthcare representation model MIMO not only achieves better predictive results than previous state-of-the-art approaches regardless of sufficient or insufficient training data, but also derives more interpretable embeddings of diagnoses.
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