Although physicians and nurses work closely together, electronic health records (EHRs) only contain physician discharge summaries, which don't reflect nursing care. To gain a better understanding of interprofessional care, researchers developed a computational metric using the Unified Medical Language System (UMLS) network to identify similarities, related concepts, and differences in physician and nursing care.

The researchers collected data from the EHRs of an urban academic hospital. From a random sample of eight years of discharge documentation, they used documentation by physicians and nurses of 58 deidentified patient cases. Physician data were extracted from free-text physician summaries and processed via a language and coding system into "physician terms." Since there was minimal nursing documentation in this hospital, nursing plans of care were constructed using the HANDS nursing documentation software from cases similar to those in the physician summaries from four midwestern hospitals. HANDS uses structured terminologies-nursing diagnosis, outcomes, and interventions-to create "nursing terms." Using the UMLS network, physicians' and nurses' terms were compared for relatedness to reveal the relationship between the care provided to patients by physicians and nurses.

Physicians' discharge summaries contained 27 terms on average, whereas nurses' documentation contained 18. The average number of synonyms (terms used in both physician and nurse documentation) between the two groups per patient hospitalization was 0.4. Physicians and nurses used synonyms in the documentation of only 26% of patients. On average, only four terms per patient were related to both nursing and physician care.

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