ReadmitGuard
Real-time 30-day hospital readmission prevention on FHIR/HL7 clinical data.
Problem
Medicare penalizes hospitals up to 3% of reimbursement for excess 30-day readmissions (the HRRP program), but the signal is buried in siloed, standards-heavy clinical systems and boxed in by strict patient-privacy rules. Most analytics never touch real hospital data formats.
Solution
A real-time clinical platform that ingests hospital data in its native interoperability standards, strips protected health information, and scores each patient's readmission risk at discharge — returning the result as a standard FHIR resource that a clinician's system can consume directly.
Architecture
HL7 v2 ADT messages and FHIR R4 resources stream through Kafka into a Spark-processed medallion lakehouse on Apache Iceberg. PHI is removed at the silver boundary via HIPAA Safe Harbor de-identification — MRN tokenization, date shifting, ZIP truncation. dbt builds the gold feature mart using real clinical instruments (LACE index, Charlson comorbidity, CMS-HRRP cohorts), and an XGBoost model is served through FastAPI as a FHIR RiskAssessment. Dagster orchestrates. All data is synthetic, Synthea-style — no real PHI.