Jennifer Erickson1, Kenneth Abbott2, Lucinda Susienka2. 1. Minnesota Disability Determination Services, 121 7th Place E, Saint Paul, MN 55101, United States. Electronic address: jennifer.erickson@ssa.gov. 2. Minnesota Disability Determination Services, 121 7th Place E, Saint Paul, MN 55101, United States.
Abstract
OBJECTIVE: Homeless patients face a variety of obstacles in pursuit of basic social services. Acknowledging this, the Social Security Administration directs employees to prioritize homeless patients and handle their disability claims with special care. However, under existing manual processes for identification of homelessness, many homeless patients never receive the special service to which they are entitled. In this paper, we explore address validation and automatic annotation of electronic health records to improve identification of homeless patients. MATERIALS AND METHODS: We developed a sample of claims containing medical records at the moment of arrival in a single office. Using address validation software, we reconciled patient addresses with public directories of homeless shelters, veterans' hospitals and clinics, and correctional facilities. Other tools annotated electronic health records. We trained random forests to identify homeless patients and validated each model with 10-fold cross validation. RESULTS: For our finished model, the area under the receiver operating characteristic curve was 0.942. The random forest improved sensitivity from 0.067 to 0.879 but decreased positive predictive value to 0.382. DISCUSSION: Presumed false positive classifications bore many characteristics of homelessness. Organizations could use these methods to prompt early collection of information necessary to avoid labor-intensive attempts to reestablish contact with homeless individuals. Annually, such methods could benefit tens of thousands of patients who are homeless, destitute, and in urgent need of assistance. CONCLUSION: We were able to identify many more homeless patients through a combination of automatic address validation and natural language processing of unstructured electronic health records.
OBJECTIVE: Homeless patients face a variety of obstacles in pursuit of basic social services. Acknowledging this, the Social Security Administration directs employees to prioritize homeless patients and handle their disability claims with special care. However, under existing manual processes for identification of homelessness, many homeless patients never receive the special service to which they are entitled. In this paper, we explore address validation and automatic annotation of electronic health records to improve identification of homeless patients. MATERIALS AND METHODS: We developed a sample of claims containing medical records at the moment of arrival in a single office. Using address validation software, we reconciled patient addresses with public directories of homeless shelters, veterans' hospitals and clinics, and correctional facilities. Other tools annotated electronic health records. We trained random forests to identify homeless patients and validated each model with 10-fold cross validation. RESULTS: For our finished model, the area under the receiver operating characteristic curve was 0.942. The random forest improved sensitivity from 0.067 to 0.879 but decreased positive predictive value to 0.382. DISCUSSION: Presumed false positive classifications bore many characteristics of homelessness. Organizations could use these methods to prompt early collection of information necessary to avoid labor-intensive attempts to reestablish contact with homeless individuals. Annually, such methods could benefit tens of thousands of patients who are homeless, destitute, and in urgent need of assistance. CONCLUSION: We were able to identify many more homeless patients through a combination of automatic address validation and natural language processing of unstructured electronic health records.
Authors: Daniel J Feller; Oliver J Bear Don't Walk Iv; Jason Zucker; Michael T Yin; Peter Gordon; Noémie Elhadad Journal: Appl Clin Inform Date: 2020-03-04 Impact factor: 2.342
Authors: Braja G Patra; Mohit M Sharma; Veer Vekaria; Prakash Adekkanattu; Olga V Patterson; Benjamin Glicksberg; Lauren A Lepow; Euijung Ryu; Joanna M Biernacka; Al'ona Furmanchuk; Thomas J George; William Hogan; Yonghui Wu; Xi Yang; Jiang Bian; Myrna Weissman; Priya Wickramaratne; J John Mann; Mark Olfson; Thomas R Campion; Mark Weiner; Jyotishman Pathak Journal: J Am Med Inform Assoc Date: 2021-11-25 Impact factor: 7.942