Automated Categorization of Systemic Disease and Duration From Electronic Medical Record System Data Using Finite-State Machine Modeling: Prospective Validation Study

Abstract

Background One of the major challenges in the health care sector is that approximately 80% of generated data remains unstructured and unused. Since it is difficult to handle unstructured data from electronic medical record systems, it tends to be neglected for analyses in most hospitals and medical centers. Therefore, there is a need to analyze unstructured big data in health care systems so that we can optimally utilize and unearth all unexploited information from it. Objective In this study, we aimed to extract a list of diseases and associated keywords along with the corresponding time durations from an indigenously developed electronic medical record system and describe the possibility of analytics from the acquired datasets. Methods We propose a novel, finite-state machine to sequentially detect and cluster disease names from patients’ medical history. We defined 3 states in the finite-state machine and transition matrix, which depend on the identified keyword. In addition, we also defined a state-change action matrix, which is essentially an action associated with each transition. The dataset used in this study was obtained from an indigenously developed electronic medical record system called eyeSmart that was implemented across a large, multitier ophthalmology network in India. The dataset included patients’ past medical history and contained records of 10,000 distinct patients. Results We extracted disease names and associated keywords by using the finite-state machine with an accuracy of 95%, sensitivity of 94.9%, and positive predictive value of 100%. For the extraction of the duration of disease, the machine’s accuracy was 93%, sensitivity was 92.9%, and the positive predictive value was 100%. Conclusions We demonstrated that the finite-state machine we developed in this study can be used to accurately identify disease names, associated keywords, and time durations from a large cohort of patient records obtained using an electronic medical record system.