Clinical documentation increasingly uses automatic speech recognition and summarization, yet converting conversations into actionable medical orders for Electronic Health Records remains unexplored. A solution to this problem can significantly reduce the documentation burden of clinicians and directly impact downstream patient care. We introduce the MEDIQA-OE 2025 shared task, the first challenge on extracting medical orders from doctor-patient conversations. Six teams participated in the shared task and experimented with a broad range of approaches, and both closed- and open-weight large language models (LLMs). In this paper, we describe the MEDIQA-OE task, dataset, final leaderboard ranking, and participants’ solutions.

Large language models (LLMs) such as GPT-4o and o1 have demonstrated strong performance on clinical natural language processing (NLP) tasks across multiple medical benchmarks. Nonetheless, two high-impact NLP tasks — structured tabular reporting from nurse dictations and medical order extraction from doctor-patient consultations — remain underexplored due to data scarcity and sensitivity, despite active industry efforts. Practical solutions to these real-world clinical tasks can significantly reduce the documentation burden on healthcare providers, allowing greater focus on patient care. In this paper, we investigate these two challenging tasks using private and open-source clinical datasets, evaluating the performance of both open- and closed-weight LLMs, and analyzing their respective strengths and limitations. Furthermore, we propose an agentic pipeline for generating realistic, non-sensitive nurse dictations, enabling structured extraction of clinical observations. To support further research in both areas, we release SYNUR and SIMORD, the first open-source datasets for nurse observation extraction and medical order extraction.