Building a Clinically-Focused Problem List From Medical Notes

Abstract

Clinical notes often contain useful information not documented in structured data, but their unstructured nature can lead to critical patient-related information being missed. To increase the likelihood that this valuable information is utilized for patient care, algorithms that summarize notes into a problem list have been proposed. Focused on identifying medically-relevant entities in the free-form text, these solutions are often detached from a canonical ontology and do not allow downstream use of the detected text-spans. Mitigating these issues, we present here a system for generating a canonical problem list from medical notes, consisting of two major stages. At the first stage, annotation, we use a transformer model to detect all clinical conditions which are mentioned in a single note. These clinical conditions are then grounded to a predefined ontology, and are linked to spans in the text. At the second stage, summarization, we develop a novel algorithm that aggregates over the set of clinical conditions detected on all of the patient’s notes, and produce a concise patient summary that organizes their most important conditions.