The coronavirus disease 2019 (COVID-19) has led to a global pandemic of significant severity. In addition to its high level of contagiousness, COVID-19 can have a heterogeneous clinical course, ranging from asymptomatic carriers to severe and potentially life-threatening health complications. Many patients have to revisit the emergency room (ER) within a short time after discharge, which significantly increases the workload for medical staff. Early identification of such patients is crucial for helping physicians focus on treating life-threatening cases. In this study, we obtained Electronic Health Records (EHRs) of 3,210 encounters from 13 affiliated ERs within the University of Pittsburgh Medical Center between March 2020 and January 2021. We leveraged a Natural Language Processing technique, ScispaCy, to extract clinical concepts and used the 1001 most frequent concepts to develop 7-day revisit models for COVID-19 patients in ERs. The research data we collected from 13 ERs may have distributional differences that could affect the model development. To address this issue, we employed a classic deep transfer learning method called the Domain Adversarial Neural Network (DANN) and evaluated different modeling strategies, including the Multi-DANN algorithm, the Single-DANN algorithm, and three baseline methods. Results showed that the Multi-DANN models outperformed the Single-DANN models and baseline models in predicting revisits of COVID-19 patients to the ER within 7 days after discharge. Notably, the Multi-DANN strategy effectively addressed the heterogeneity among multiple source domains and improved the adaptation of source data to the target domain. Moreover, the high performance of Multi-DANN models indicates that EHRs are informative for developing a prediction model to identify COVID-19 patients who are very likely to revisit an ER within 7 days after discharge.

Transfer learning has become a pivotal technique in machine learning and has proven to be effective in various real-world applications. However, utilizing this technique for classification tasks with sequential data often faces challenges, primarily attributed to the scarcity of class labels. To address this challenge, we introduce Multi-Source Adaptive Weighting (MSAW), an online multi-source transfer learning method. MSAW integrates a dynamic weighting mechanism into an ensemble framework, enabling automatic adjustment of weights based on the relevance and contribution of each source (representing historical knowledge) and target model (learning from newly acquired data). We demonstrate the effectiveness of MSAW by applying it to detect Respiratory Syncytial Virus cases within Emergency Department visits, utilizing multiple years of electronic health records from the University of Pittsburgh Medical Center. Our method demonstrates performance improvements over many baselines, including refining pre-trained models with online learning as well as three static weighting approaches, showing MSAW's capacity to integrate historical knowledge with progressively accumulated new data. This study indicates the potential of online transfer learning in healthcare, particularly for developing machine learning models that dynamically adapt to evolving situations where new data is incrementally accumulated.