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Objective: To determine the prevalence of individual-level social risk factors documented in unstructured data from electronic health records (EHRs) and the relationship between social risk factors and adverse clinical outcomes. Study setting: Inpatient encounters for adults (≥18 years) at the University of Virginia Medical Center during a 12-month study period between July 2018 and June 2019. Inpatient encounters for labor and delivery patients were excluded, as well as encounters where the patient was discharged to hospice, left against medical advice, or expired in the hospital. The study population included 21,402 inpatient admissions, representing 15,116 unique patients who had at least one inpatient admission during the study period. Study design: We identified measures related to individual social risk factors in EHRs through existing workflows, flowsheets, and clinical notes. Multivariate binomial logistic regression was performed to determine the association of individual social risk factors with unplanned inpatient readmissions, post-discharge emergency department (ED) visits, and extended length of stay (LOS). Other predictors included were age, sex, severity of illness, location of residence, and discharge destination. Results: Predictors of 30-day unplanned readmissions included severity of illness (OR = 3.96), location of residence (OR = 1.31), social and community context (OR = 1.26), and economic stability (OR = 1.37). For 30-day post-discharge ED visits, significant predictors included location of residence (OR = 2.56), age (OR = 0.60), economic stability (OR = 1.39), education (OR = 1.38), social and community context (OR = 1.39), and neighborhood and built environment (OR = 1.61). For extended LOS, significant predictors were age (OR = 0.51), sex (OR = 1.18), severity of illness (OR = 2.14), discharge destination (OR = 2.42), location of residence (OR = 0.82), economic stability (OR = 1.14), neighborhood and built environment (OR = 1.31), and education (OR = 0.79). Conclusions: Individual-level social risk factors are associated with increased risk for unplanned hospital readmissions, post-discharge ED visits, and extended LOS. While individual-level social risk factors are currently documented on an ad-hoc basis in EHRs, standardized SDoH screening tools using validated metrics could help eliminate bias in the collection of SDoH data and facilitate social risk screening.

Background. During the COVID-19 pandemic, mobile sensing and data analytics techniques have demonstrated their capabilities in monitoring the trajectories of the pandemic, by collecting behavioral, physiological, and mobility data on individual, neighborhood, city, and national scales. Notably, mobile sensing has become a promising way to detect individuals’ infectious status, track the change in long-term health, trace the epidemics in communities, and monitor the evolution of viruses and subspecies. Methods. We followed the PRISMA practice and reviewed 60 eligible papers on mobile sensing for monitoring COVID-19. We proposed a taxonomy system to summarize literature by the time duration and population scale under mobile sensing studies. Results. We found that existing literature can be naturally grouped in four clusters, including remote detection, long-term tracking, contact tracing, and epidemiological study. We summarized each group and analyzed representative works with regard to the system design, health outcomes, and limitations on techniques and societal factors. We further discussed the implications and future directions of mobile sensing in communicable diseases from the perspectives of technology and applications. Conclusion. Mobile sensing techniques are effective, efficient, and flexible to surveil COVID-19 in scales of time and populations. In the post-COVID era, technical and societal issues in mobile sensing are expected to be addressed to improve healthcare and social outcomes.

The wide implementation of electronic health record (EHR) systems facilitates the collection of large-scale health data from real clinical settings. Despite the significant increase in adoption of EHR systems, these data remain largely unexplored, but present a rich data source for knowledge discovery from patient health histories in tasks, such as understanding disease correlations and predicting health outcomes. However, the heterogeneity, sparsity, noise, and bias in these data present many complex challenges. This complexity makes it difficult to translate potentially relevant information into machine learning algorithms. In this paper, we propose a computational framework, Patient2Vec, to learn an interpretable deep representation of longitudinal EHR data, which is personalized for each patient. To evaluate this approach, we apply it to the prediction of future hospitalizations using real EHR data and compare its predictive performance with baseline methods. Patient2Vec produces a vector space with meaningful structure, and it achieves an area under curve around 0.799, outperforming baseline methods. In the end, the learned feature importance can be visualized and interpreted at both the individual and population levels to bring clinical insights.

This paper presents an ultra-low swing level converter with integrated charge pumps that shows measured conversion in a 130-nm CMOS test chip from an input at a 145-mV swing to a 1.2-V output. Lowering the input allowable for a single-ended level converter supports energy harvesting systems that need to use very low voltages.