The concept of the Internet of Medical Things brings a promising option to utilize various electronic health records stored in different medical devices and servers to create practical but secure clinical decision support systems. To achieve such a system, we need to focus on several aspects, most notably the usability aspect of deploying it using low-end devices. This study introduces one such application, namely FedSepsis, for the early detection of sepsis using electronic health records. We incorporate several cutting-edge deep learning techniques for the prediction and natural-language processing tasks. We also explore the multimodality aspect for the better use of electronic health records. A secure distributed machine learning mechanism is essential to building such a practical internet of medical things application. To address this, we analyze two federated learning techniques. Moreover, we use two different kinds of low-computational edge devices, namely Raspberry Pi and Jetson Nano, to address the challenges of using such a system in a practical setting and report the comparisons. We report several critical system-level information about the devices, namely CPU utilization, disk utilization, process CPU threads in use, process memory in use (non-swap), process memory available (non-swap), system memory utilization, temperature, and network traffic. We publish the prediction results with the evaluation metrics area under the receiver operating characteristic curve, the area under the precision-recall curve, and the earliness to predict sepsis in hours. Our results show that the performance is satisfactory, and with a moderate amount of devices, the federated learning setting results are similar to the single server-centric setting. Multimodality provides the best results compared to any single modality in the input features obtained from the electronic health records. Generative adversarial neural networks provide a clear superiority in handling the sparsity of electronic health records. Multimodality with the generative adversarial neural networks provides the best result: the area under the precision-recall curve is 96.55%, the area under the receiver operating characteristic curve is 99.35%, and earliness is 4.56 h. FedSepsis suggests that incorporating such a concept together with low-end computational devices could be beneficial for all the medical sector stakeholders and should be explored further.
Keywords: Internet of Medical Things; clinical decision support system; deep learning; early sepsis detection; electronic health records; federated learning; multi-modality; natural language processing; smart healthcare.