Death is an inevitable part of life and while it cannot be delayed indefinitely it is possible to predict with some certainty when the health of a person is going to deteriorate. In this paper, we predict risk of mortality for patients from two large hospital systems in the Pacific Northwest. Using medical claims and electronic medical records (EMR) data we greatly improve prediction for risk of mortality and explore machine learning models with explanations for end of life predictions. The insights that are derived from the predictions can then be used to improve the quality of patient care towards the end of life.

Congestive Heart Failure (CHF) is a serious chronic condition often leading to 50% mortality within 5 years. Improper treatment and post-discharge care of CHF patients leads to repeat frequent hospitalizations (i.e., readmissions). Accurately predicting patient's risk-of-readmission enables care-providers to plan resources, perform factor analysis, and improve patient quality of life. In this paper, we describe a supervised learning framework, Dynamic Hierarchical Classification (DHC) for patient's risk-of-readmission prediction. Learning the hierarchy of classifiers is often the most challenging component of such classification schemes. The novelty of our approach is to algorithmically generate various layers and combine them to predict overall 30-day risk-of-readmission. While the components of DHC are generic, in this work, we focus on congestive heart failure (CHF), a pressing chronic condition. Since healthcare data is diverse and rich and each source and feature-subset provides different insights into a complex problem, our DHC based prediction approach intelligently leverages each source and feature-subset to optimize different objectives (such as, Recall or AUC) for CHF risk-of-readmission. DHC's algorithmic layering capability is trained and tested over two real world datasets and is currently integrated into the clinical decision support tools at MultiCare Health System (MHS), a major provider of healthcare services in the northwestern US. It is integrated into a QlikView App (with EMR integration planned for Q2) and currently scores patients everyday, helping to mitigate readmissions and improve quality of care, leading to healthier outcomes and cost savings.

In this paper, we describe a novel framework to recommend personalized intervention strategies to minimize 30-day readmission risk for heart failure (HF) patients, as they move through the provider's cardiac care protocol. We design principled solutions by learning the structure and parameters of a multi-layer hierarchical Bayesian network from underlying high-dimensional patient data. Next, we generate and summarize the rules leading to personalized interventions which can be applied to individual patients as they progress from admit to discharge. We present comprehensive experimental results as well as interesting case studies to demonstrate the effectiveness of our proposed framework using large real-world patient datasets on Microsoft Azure for Research platform.

Developing holistic predictive modeling solutions for risk prediction is extremely challenging in healthcare informatics. Risk prediction involves integration of clinical factors with socio-demographic factors, health conditions, disease parameters, hospital care quality parameters, and a variety of variables specific to each health care provider making the task increasingly complex. Unsurprisingly, many of such factors need to be extracted independently from different sources, and integrated back to improve the quality of predictive modeling. Such sources are typically voluminous, diverse, and vary significantly over the time. Therefore, distributed and parallel computing tools collectively termed big data have to be developed. In this work, we study big data driven solutions to predict the 30-day risk of readmission for congestive heart failure (CHF) incidents. First, we extract useful factors from National Inpatient Dataset (NIS) and augment it with our patient dataset from Multicare Health System (MHS). Then, we develop scalable data mining models to predict risk of readmission using the integrated dataset. We demonstrate the effectiveness and efficiency of the open-source predictive modeling framework we used, describe the results from various modeling algorithms we tested, and compare the performance against baseline non-distributed, non-parallel, non-integrated small data results previously published to demonstrate comparable accuracy over millions of records.

We present a system called Risk-O-Meter to predict and an- alyze clinical risk via data imputation, visualization, predic- tive modeling, and association rule exploration. Clinical risk calculators provide information about a person's chance of having a disease or encountering a clinical event. Such tools could be highly useful to educate patients to understand and monitor their health conditions. Unlike existing risk calcu- lators that are primarily designed for domain experts, Risk- O-Meter is useful to patients who are unfamiliar with medi- cal terminologies, or providers who have limited information about a patient. Risk-O-Meter is designed in a way such that it is flexible enough to accept limited or incomplete data in- puts, and still manages to predict the clinical risk efficiently and effectively. Current version of Risk-O-Meter evaluates 30-day risk of hospital readmission. However, the proposed system framework is applicable to general clinical risk pre- dictions. In this demonstration paper, we describe different components of Risk-O-Meter and the intelligent algorithms associated with each of these components to evaluate risk of readmission using incomplete patient data inputs.