Electronic health records (EHRs) are longitudinal records of a patients interactions with healthcare systems. A patients EHR data is organized as a three-level hierarchy from top to bottom: patient journey - all the experiences of diagnoses and treatments over a period of time; individual visit - a set of medical codes in a particular visit; and medical code - a specific record in the form of medical codes. As EHRs begin to amass in millions, the potential benefits, which these data might hold for medical research and medical outcome prediction, are staggering - including, for example, predicting future admissions to hospitals, diagnosing illnesses or determining the efficacy of medical treatments. Each of these analytics tasks requires a domain knowledge extraction method to transform the hierarchical patient journey into a vector representation for further prediction procedure. The representations should embed a sequence of visits and a set of medical codes with a specific timestamp, which are crucial to any downstream prediction tasks. Hence, expressively powerful representations are appealing to boost learning performance. To this end, we propose a novel self-attention mechanism that captures the contextual dependency and temporal relationships within a patients healthcare journey. An end-to-end bidirectional temporal encoder network (BiteNet) then learns representations of the patients journeys, based solely on the proposed attention mechanism. We have evaluated the effectiveness of our methods on two supervised prediction and two unsupervised clustering tasks with a real-world EHR dataset. The empirical results demonstrate the proposed BiteNet model produces higher-quality representations than state-of-the-art baseline methods.
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