I fully agree that nurses should be informed about the impact of big data, artificial intelligence processes, and natural language processing methods on care delivery and analysis of care interventions and patient outcomes ("Nursing Orientation to Data Science and Machine Learning," April). I was saddened, however, to read the following in the article: "As Moon and colleagues have stated, 'Creating a standardized approach to measuring individual nurse contribution in patient outcomes is innovative' and will make the value of nursing more recognizable."

Three major nursing terminologies have been available for more than 15 years now. These are the North American Nursing Diagnosis Association (NANDA), Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) system; Saba's Clinical Care Classification (CCC) System; and the International Council of Nurses' International Classification for Nursing Practice (ICNP). All are in use in selected U.S. and/or international health care systems thanks in large part to dedicated nurses. And yet, until and unless electronic health record (EHR) system developers in the United States understand that nursing needs, wants, and is willing to codevelop a standard and interoperable nursing language integrated with EHRs, we will not have reliable and valid data about the work of nursing. If our work is invisible, our profession is invisible.

Claudia Bartz, PhD, RN

Suring, WI