ABSTRACT
Background
There is a shortage of medical informatics and data science platforms using cloud computing on electronic health record (EHR) data, and with computing capacity for analyzing big data. We implemented, described, and applied a cloud computing solution utilizing the fast health interoperability resources (FHIR) standardization and state-of-the-art parallel distributed computing platform for advanced analytics.
Methods
We utilized the architecture of the modern predictive analytics platform called Cerner HealtheDataLabTM and described the suite of cloud computing services and Apache Projects that it relies on. We validated the platform by replicating and improving on a previous single pediatric institution study/model on readmission and developing a multi-center model of all-cause readmission for pediatric-age patients using the Cerner Health Facts Deidentified Database (now updated and referred to as the Cerner Real World DataTM). We retrieved a subset of 1.4 million pediatric encounters consisting of 48 hospitals’ data on pediatric encounters in the database based on a priori inclusion criteria. We built and analyzed corresponding random forest and multilayer perceptron (MLP) neural network models using HealtheDataLab.
Results
Using the HealtheDataLab platform, we developed a random forest model and multi-layer perceptron model with AUC of 0.8446 (0.8444, 0.8447) and 0.8451 (0.8449, 0.8453) respectively. We showed the distribution in model performance across hospitals and identified a set of novel variables under previous resource utilization and generic medications that may be used to improve existing readmission models.
Conclusion
Our results suggest that high performance, elastic cloud computing infrastructures such as the platform presented here can be used for the development of highly predictive models on EHR data in a secure and robust environment. This in turn can lead to new clinical insights/discoveries.