Physician nurse care: A new use of UMLS to measure professional contribution: Are we talking about the same patient a new graph matching algorithm?
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 phys...
| Publicado en: | International Journal of Medical Informatics Vol. 113; pp. 63 - 72 |
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| Autores principales: | , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
May2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=128719807&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 128719807 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13865056 JR4 jtl: International Journal of Medical Informatics issn: 13865056 maglogo: N pubinfo: dt: May2018 vid: 113 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 128719807 128719807 NLM29602435 128719807 10.1016/j.ijmedinf.2018.02.002 NLM29602435 128719807 ppf: 63 ppct: 9 formats: tig: atl: Physician nurse care: A new use of UMLS to measure professional contribution: Are we talking about the same patient a new graph matching algorithm? aug: au: Boyd, Andrew D. Dunn Lopez, Karen Lugaresi, Camillo Macieira, Tamara Sousa, Vanessa Acharya, Sabita Balasubramanian, Abhinaya Roussi, Khawllah Keenan, Gail M. Lussier, Yves A. Li, Jianrong ‘John’ Burton, Michel Di Eugenio, Barbara Li, Jianrong 'John' affil: 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 sug: subj: Unified Medical Language System Health Care Delivery Standards Algorithms Patient Care Plans Standards Natural Language Processing Software Human Validation Studies Comparative Studies Evaluation Research Multicenter Studies Clinical Assessment Tools Impact of Events Scale Scales Funding Source ab: 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. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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