Ivan Girardi

Chiara Marchiori, Douglas Dykeman, Ivan Girardi et al.

Applying state-of-the-art machine learning and natural language processing on approximately one million of teleconsultation records, we developed a triage system, now certified and in use at the largest European telemedicine provider. The system evaluates care alternatives through interactions with patients via a mobile application. Reasoning on an initial set of provided symptoms, the triage application generates AI-powered, personalized questions to better characterize the problem and recommends the most appropriate point of care and time frame for a consultation. The underlying technology was developed to meet the needs for performance, transparency, user acceptance and ease of use, central aspects to the adoption of AI-based decision support systems. Providing such remote guidance at the beginning of the chain of care has significant potential for improving cost efficiency, patient experience and outcomes. Being remote, always available and highly scalable, this service is fundamental in high demand situations, such as the current COVID-19 outbreak.

Ivan Girardi, Pengfei Ji, An-phi Nguyen et al.

We present an operational component of a real-world patient triage system. Given a specific patient presentation, the system is able to assess the level of medical urgency and issue the most appropriate recommendation in terms of best point of care and time to treat. We use an attention-based convolutional neural network architecture trained on 600,000 doctor notes in German. We compare two approaches, one that uses the full text of the medical notes and one that uses only a selected list of medical entities extracted from the text. These approaches achieve 79% and 66% precision, respectively, but on a confidence threshold of 0.6, precision increases to 85% and 75%, respectively. In addition, a method to detect warning symptoms is implemented to render the classification task transparent from a medical perspective. The method is based on the learning of attention scores and a method of automatic validation using the same data.