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Boyd AD, Dunn Lopez K, Lugaresi C, Macieira T, Sousa V, Acharya S, Balasubramanian A, Roussi K, Keenan GM, Lussier YA, Li J'J, Burton M, Di Eugenio B. Physician nurse care: A new use of UMLS to measure professional contribution: Are we talking about the same patient a new graph matching algorithm? Int J Med Inform 2018; 113:63-71. [PMID: 29602435 PMCID: PMC5909845 DOI: 10.1016/j.ijmedinf.2018.02.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 12/22/2017] [Accepted: 02/03/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Physician and nurses have worked together for generations; however, their language and training are vastly different; comparing and contrasting their work and their joint impact on patient outcomes is difficult in light of this difference. At the same time, the EHR only includes the physician perspective via the physician-authored discharge summary, but not nurse documentation. Prior research in this area has focused on collaboration and the usage of similar terminology. OBJECTIVE The objective of the study is to gain insight into interprofessional care by developing a computational metric to identify similarities, related concepts and differences in physician and nurse work. METHODS 58 physician discharge summaries and the corresponding nurse plans of care were transformed into Unified Medical Language System (UMLS) Concept Unique Identifiers (CUIs). MedLEE, a Natural Language Processing (NLP) program, extracted "physician terms" from free-text physician summaries. The nursing plans of care were constructed using the HANDS© nursing documentation software. HANDS© utilizes structured terminologies: nursing diagnosis (NANDA-I), outcomes (NOC), and interventions (NIC) to create "nursing terms". The physician's and nurse's terms were compared using the UMLS network for relatedness, overlaying the physician and nurse terms for comparison. Our overarching goal is to provide insight into the care, by innovatively applying graph algorithms to the UMLS network. We reveal the relationships between the care provided by each professional that is specific to the patient level. RESULTS We found that only 26% of patients had synonyms (identical UMLS CUIs) between the two professions' documentation. On average, physicians' discharge summaries contain 27 terms and nurses' documentation, 18. Traversing the UMLS network, we found an average of 4 terms related (distance less than 2) between the professions, leaving most concepts as unrelated between nurse and physician care. CONCLUSION Our hypothesis that physician's and nurse's practice domains are markedly different is supported by the preliminary, quantitative evidence we found. Leveraging the UMLS network and graph traversal algorithms, allows us to compare and contrast nursing and physician care on a single patient, enabling a more complete picture of patient care. We can differentiate professional contributions to patient outcomes and related and divergent concepts by each profession.
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Affiliation(s)
- Andrew D Boyd
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W Taylor St., Chicago, IL 60612, United States.
| | - Karen Dunn Lopez
- Department of Health System Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL 60612, United States
| | - Camillo Lugaresi
- Department of Computer Science, College of Engineering, University of Illinois at Chicago, 851 South Morgan Street, Chicago, IL 60607, United States
| | - Tamara Macieira
- Department of Health System Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL 60612, United States
| | - Vanessa Sousa
- Department of Health System Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL 60612, United States
| | - Sabita Acharya
- Department of Computer Science, College of Engineering, University of Illinois at Chicago, 851 South Morgan Street, Chicago, IL 60607, United States
| | - Abhinaya Balasubramanian
- Department of Computer Science, College of Engineering, University of Illinois at Chicago, 851 South Morgan Street, Chicago, IL 60607, United States
| | - Khawllah Roussi
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W Taylor St., Chicago, IL 60612, United States
| | - Gail M Keenan
- Department of Health Care Environments and Systems, College of Nursing, University of Florida, PO Box 100187, Gainesville, FL 32610, United States
| | - Yves A Lussier
- Department of Medicine, College of Medicine, University of Arizona, 1501 N. Campbell Dr, Tucson, AZ 85724, United States; The University of Arizona Health Sciences Center, 1295 North Martin Ave, Tucson, AZ 85721, United States
| | - Jianrong 'John' Li
- Department of Medicine, College of Medicine, University of Arizona, 1501 N. Campbell Dr, Tucson, AZ 85724, United States; The University of Arizona Health Sciences Center, 1295 North Martin Ave, Tucson, AZ 85721, United States
| | - Michel Burton
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W Taylor St., Chicago, IL 60612, United States
| | - Barbara Di Eugenio
- Department of Computer Science, College of Engineering, University of Illinois at Chicago, 851 South Morgan Street, Chicago, IL 60607, United States
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Roussi K, Soussa V, Dunn Lopez K, Balasubramanian A, Keenan GM, Burton M, Bahroos N, DiEugenio B, Boyd AD. Are we talking about the same patient? Stud Health Technol Inform 2015; 216:1059. [PMID: 26262358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The objective of this study is to determine the degree of similarities between the clinical terms used by physicians and nurses in their documentation.
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Affiliation(s)
- Khawllah Roussi
- Department of Biomedical and Health Information Sciences, University of Illinois at Chicago (UIC), Chicago, Illinois, USA
| | | | | | | | - Gail M Keenan
- Department of Health Care Environments and Systems, University of Florida, Gainesville, FL, USA
| | | | | | | | - Andrew D Boyd
- Department of Biomedical and Health Information Sciences, University of Illinois at Chicago (UIC), Chicago, Illinois, USA
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