{"id":"https://openalex.org/W4400724798","doi":"https://doi.org/10.1093/jamia/ocae194","title":"The incremental design of a machine learning framework for medical records processing","display_name":"The incremental design of a machine learning framework for medical records processing","publication_year":2024,"publication_date":"2024-07-17","ids":{"openalex":"https://openalex.org/W4400724798","doi":"https://doi.org/10.1093/jamia/ocae194","pmid":"https://pubmed.ncbi.nlm.nih.gov/39018499"},"language":"en","primary_location":{"id":"doi:10.1093/jamia/ocae194","is_oa":false,"landing_page_url":"https://doi.org/10.1093/jamia/ocae194","pdf_url":null,"source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11413426/pdf/ocae194.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5062406995","display_name":"Christopher Streiffer","orcid":"https://orcid.org/0000-0003-0684-4354"},"institutions":[{"id":"https://openalex.org/I79576946","display_name":"University of Pennsylvania","ror":"https://ror.org/00b30xv10","country_code":"US","type":"education","lineage":["https://openalex.org/I79576946"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Christopher Streiffer","raw_affiliation_strings":["Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA 19104, United States"],"raw_orcid":"https://orcid.org/0000-0003-0684-4354","affiliations":[{"raw_affiliation_string":"Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA 19104, United States","institution_ids":["https://openalex.org/I79576946"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5015379814","display_name":"Divya Saini","orcid":null},"institutions":[{"id":"https://openalex.org/I79576946","display_name":"University of Pennsylvania","ror":"https://ror.org/00b30xv10","country_code":"US","type":"education","lineage":["https://openalex.org/I79576946"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Divya Saini","raw_affiliation_strings":["Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA 19104, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA 19104, United States","institution_ids":["https://openalex.org/I79576946"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5073114657","display_name":"Gideon Whitehead","orcid":null},"institutions":[{"id":"https://openalex.org/I79576946","display_name":"University of Pennsylvania","ror":"https://ror.org/00b30xv10","country_code":"US","type":"education","lineage":["https://openalex.org/I79576946"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Gideon Whitehead","raw_affiliation_strings":["Center for Health Care Transformation and Innovation, University of Pennsylvania , Philadelphia, PA 19104, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Center for Health Care Transformation and Innovation, University of Pennsylvania , Philadelphia, PA 19104, United States","institution_ids":["https://openalex.org/I79576946"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5113292296","display_name":"Jency M. Daniel","orcid":null},"institutions":[{"id":"https://openalex.org/I79576946","display_name":"University of Pennsylvania","ror":"https://ror.org/00b30xv10","country_code":"US","type":"education","lineage":["https://openalex.org/I79576946"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jency Daniel","raw_affiliation_strings":["Center for Health Care Transformation and Innovation, University of Pennsylvania , Philadelphia, PA 19104, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Center for Health Care Transformation and Innovation, University of Pennsylvania , Philadelphia, PA 19104, United States","institution_ids":["https://openalex.org/I79576946"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5104632810","display_name":"Carolina Garzon-Mrad","orcid":null},"institutions":[{"id":"https://openalex.org/I79576946","display_name":"University of Pennsylvania","ror":"https://ror.org/00b30xv10","country_code":"US","type":"education","lineage":["https://openalex.org/I79576946"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Carolina Garzon-Mrad","raw_affiliation_strings":["Center for Health Care Transformation and Innovation, University of Pennsylvania , Philadelphia, PA 19104, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Center for Health Care Transformation and Innovation, University of Pennsylvania , Philadelphia, PA 19104, United States","institution_ids":["https://openalex.org/I79576946"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5104632811","display_name":"Laura Kavanaugh","orcid":null},"institutions":[{"id":"https://openalex.org/I79576946","display_name":"University of Pennsylvania","ror":"https://ror.org/00b30xv10","country_code":"US","type":"education","lineage":["https://openalex.org/I79576946"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Laura Kavanaugh","raw_affiliation_strings":["Center for Health Care Transformation and Innovation, University of Pennsylvania , Philadelphia, PA 19104, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Center for Health Care Transformation and Innovation, University of Pennsylvania , Philadelphia, PA 19104, United States","institution_ids":["https://openalex.org/I79576946"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5022190967","display_name":"Emeka Anyanwu","orcid":"https://orcid.org/0000-0001-6143-4994"},"institutions":[{"id":"https://openalex.org/I79576946","display_name":"University of Pennsylvania","ror":"https://ror.org/00b30xv10","country_code":"US","type":"education","lineage":["https://openalex.org/I79576946"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Emeka Anyanwu","raw_affiliation_strings":["Center for Health Care Transformation and Innovation, University of Pennsylvania , Philadelphia, PA 19104, United States","Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA 19104, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Center for Health Care Transformation and Innovation, University of Pennsylvania , Philadelphia, PA 19104, United States","institution_ids":["https://openalex.org/I79576946"]},{"raw_affiliation_string":"Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA 19104, United States","institution_ids":["https://openalex.org/I79576946"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5062406995"],"corresponding_institution_ids":["https://openalex.org/I79576946"],"apc_list":{"value":4332,"currency":"USD","value_usd":4332},"apc_paid":null,"fwci":0.6971,"has_fulltext":true,"cited_by_count":3,"citation_normalized_percentile":{"value":0.7529482,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":94,"max":97},"biblio":{"volume":"31","issue":"10","first_page":"2236","last_page":"2245"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.48980000615119934,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.48980000615119934,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.1737000048160553,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11652","display_name":"Imbalanced Data Classification Techniques","score":0.041999999433755875,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.6537035703659058},{"id":"https://openalex.org/keywords/medical-record","display_name":"Medical record","score":0.5497536659240723},{"id":"https://openalex.org/keywords/artificial-intelligence","display_name":"Artificial intelligence","score":0.41379106044769287},{"id":"https://openalex.org/keywords/data-science","display_name":"Data science","score":0.3530055284500122},{"id":"https://openalex.org/keywords/machine-learning","display_name":"Machine learning","score":0.33166682720184326},{"id":"https://openalex.org/keywords/medicine","display_name":"Medicine","score":0.1756979525089264}],"concepts":[{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.6537035703659058},{"id":"https://openalex.org/C195910791","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Medical record","level":2,"score":0.5497536659240723},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.41379106044769287},{"id":"https://openalex.org/C2522767166","wikidata":"https://www.wikidata.org/wiki/Q2374463","display_name":"Data science","level":1,"score":0.3530055284500122},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.33166682720184326},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.1756979525089264},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000069550","descriptor_name":"Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000069550","descriptor_name":"Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000069550","descriptor_name":"Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000069550","descriptor_name":"Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000069550","descriptor_name":"Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000069550","descriptor_name":"Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000069550","descriptor_name":"Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000069550","descriptor_name":"Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000554","descriptor_name":"Ambulatory Care Facilities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000554","descriptor_name":"Ambulatory Care Facilities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000554","descriptor_name":"Ambulatory Care Facilities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000554","descriptor_name":"Ambulatory Care Facilities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000554","descriptor_name":"Ambulatory Care Facilities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000554","descriptor_name":"Ambulatory Care Facilities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000554","descriptor_name":"Ambulatory Care Facilities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000554","descriptor_name":"Ambulatory Care Facilities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1093/jamia/ocae194","is_oa":false,"landing_page_url":"https://doi.org/10.1093/jamia/ocae194","pdf_url":null,"source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},{"id":"pmid:39018499","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/39018499","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association : JAMIA","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:11413426","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11413426","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11413426/pdf/ocae194.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"J Am Med Inform Assoc","raw_type":"Text"}],"best_oa_location":{"id":"pmh:oai:pubmedcentral.nih.gov:11413426","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11413426","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11413426/pdf/ocae194.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"J Am Med Inform Assoc","raw_type":"Text"},"sustainable_development_goals":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4400724798.pdf","grobid_xml":"https://content.openalex.org/works/W4400724798.grobid-xml"},"referenced_works_count":18,"referenced_works":["https://openalex.org/W2020278455","https://openalex.org/W2099119910","https://openalex.org/W2609923048","https://openalex.org/W2754518417","https://openalex.org/W2807614571","https://openalex.org/W2989566471","https://openalex.org/W2998702515","https://openalex.org/W3092930902","https://openalex.org/W3097185229","https://openalex.org/W3208292737","https://openalex.org/W4205212656","https://openalex.org/W4239025696","https://openalex.org/W4282933928","https://openalex.org/W4312220150","https://openalex.org/W4366439799","https://openalex.org/W4384561707","https://openalex.org/W6770292386","https://openalex.org/W6851736760"],"related_works":["https://openalex.org/W2961085424","https://openalex.org/W4306674287","https://openalex.org/W3046775127","https://openalex.org/W3107602296","https://openalex.org/W4394896187","https://openalex.org/W3170094116","https://openalex.org/W4386462264","https://openalex.org/W4364306694","https://openalex.org/W4312192474","https://openalex.org/W4283697347"],"abstract_inverted_index":{"OBJECTIVES:":[0],"This":[1],"work":[2],"presents":[3],"the":[4,28,31,45,87,204],"development":[5],"and":[6,38,54,66,75,114,172,194],"evaluation":[7],"of":[8,30,47,144,156,163,170,179,206],"coordn8,":[9],"a":[10,21,68,99,128,177,238],"web-based":[11],"application":[12],"that":[13],"streamlines":[14],"fax":[15,35,77,133],"processing":[16,36,78,134],"in":[17,62,106,131],"outpatient":[18,64],"clinics":[19,65,111,216],"using":[20],"\"human-in-the-loop\"":[22],"machine":[23,41,88,197,235],"learning":[24,42,89,198,236],"framework.":[25],"We":[26,59,81,97],"demonstrate":[27,116],"effectiveness":[29],"platform":[32],"at":[33],"reducing":[34],"time":[37,69,100,135,193],"producing":[39],"accurate":[40,196],"inferences":[43],"across":[44,91],"tasks":[46,233],"patient":[48,158],"identification,":[49],"document":[50,56,174,182],"classification,":[51,53],"spam":[52,165],"duplicate":[55,173],"detection.":[57],"METHODS:":[58],"deployed":[60],"coordn8":[61,189],"11":[63],"conducted":[67,98],"savings":[70],"analysis":[71,102,126,143],"by":[72,136,186],"observing":[73],"users":[74],"measuring":[76],"event":[79,141],"logs.":[80],"used":[82],"statistical":[83],"methods":[84],"to":[85,94,103,115,119,214,244],"evaluate":[86],"components":[90],"different":[92],"datasets":[93],"show":[95,104],"generalizability.":[96],"series":[101],"variations":[105],"model":[107,121,211,225],"performance":[108,219],"as":[109],"new":[110,215],"were":[112],"onboarded":[113],"our":[117,140],"approach":[118],"mitigating":[120],"drift.":[122],"RESULTS:":[123],"Our":[124,200,228],"observation":[125],"showed":[127],"mean":[129],"reduction":[130],"individual":[132],"147.5":[137],"s,":[138],"while":[139],"log":[142],"over":[145],"7000":[146],"faxes":[147],"reinforced":[148],"this":[149],"finding.":[150],"Document":[151],"classification":[152,166,183],"produced":[153,160,167,176,195],"an":[154,161,168],"accuracy":[155,162,169,185],"81.6%,":[157],"identification":[159],"83.7%,":[164],"98.4%,":[171],"detection":[175],"precision":[178],"81.0%.":[180],"Retraining":[181],"increased":[184],"10.2%.":[187],"DISCUSSION:":[188],"significantly":[190],"decreased":[191],"fax-processing":[192],"inferences.":[199],"human-in-the-loop":[201],"framework":[202,229],"facilitated":[203],"collection":[205],"high-quality":[207],"data":[208],"necessary":[209],"for":[210,230,240],"training.":[212],"Expanding":[213],"correlated":[217],"with":[218,234],"decline,":[220],"which":[221],"was":[222],"mitigated":[223],"through":[224],"retraining.":[226],"CONCLUSION:":[227],"automating":[231],"clinical":[232],"offers":[237],"template":[239],"health":[241],"systems":[242],"looking":[243],"implement":[245],"similar":[246],"technologies.":[247]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2025,"cited_by_count":2}],"updated_date":"2026-08-22T07:34:49.880490","created_date":"2025-10-10T00:00:00"}