Introduction to LOINC a universal catalog of clinical observations

Public Laboratory LOINC Workshop and Committee Meeting

Daniel J. Vreeman, PT, DPT, MSc Assistant Research Professor, Indiana University School of Medicine Associate Director of Terminology Services, Regenstrief Institute, Inc

12.07.2010 Copyright © 2010

Origins of LOINC The lingua franca of clinical observation exchange

Pieter Bruegel the Elder – Tower of Babel

Indiana Network for Patient Care

St. Vincent

St. Francis

Clarian

Wishard Memorial

Community

IUMG

Health Departments

Global Patient Index Concept

Dictionary

Referral Labs, RxHub, etc…

Global Provider Index

Logical

Observation

Identifiers

Names and

Codes A universal code system that facilitates exchange,

pooling, and processing of results

If an observation is a question and the observation value is an answer…

LOINC provides codes for questions

Other vocabularies provide codes for the answers

What is my patient’s hemoglobin level? 718-7:Hemoglobin:MCnc:Pt:Bld:Qn

How fast does my patient usually walk? 41959-8:Walking speed:Vel:1W^mean:^Patient:Qn:Calculated

Institutional Repository

A  

A  Message Processor

MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$|||||||| OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|ST|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|ST|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|ST|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|CE|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|

HL7 v.2.X Message

LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem

Indiana Network for Patient Care

Laboratory LOINC

Clinical LOINC

The LOINC Community Open, Nimble, Pragmatic

Open Development Worldwide distribution at no cost

Volunteers! End-user content additions

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000 LOINC Codes

Lab Codes

laboratory terms only

Slope = 600

Slope = 2200

Number of LOINC codes by Release

loinc.org members

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000

10 new members per day 300 new members per month

9040+ users in 140 countries

Downloads: ~1100/month

http://search.loinc.org (beta)

~ 90 Organizations Listed

http://forum.loinc.org

International Adoption Submissions, Translations, Implementations

Submissions (20 mo)

Translators

Existing Translations Spanish – BiTAC – Conceptum Medical Terminology

Center

– Mexican Institute of Social Security

French – Canada Health Infoway – Société Française d'Informatique de

Laboratoires

Existing Translations German – DIMDI

Estonian – Estonian Society for Clinical Chemistry

Portuguese –  Brazilian Federal Agency for Health Plans and

Insurance, Brazilian Clinical Analysis Society, Brazilian Clinical Pathology Society, and Diagnóstico das Américas (DASA)

Existing Translations German, French, Italian, Spanish – CUMUL

Simplified Chinese – Bethune International Peace Hospital

Korean – Korean Ministry for Health, Welfare and

Family Affairs

New/Updated this Release

Estonian

French German

Greek Italian

Spanish (maybe)

In-progress Catalan

Dutch French

Russian

French!

Large Implementations

SIGA Saúde project – São Paulo, Brazil

Canada Health Infoway – 5 Lab Information System Projects

ePSOS

Large Implementations

US Adoption A few key highlights

Consolidated Health Informatics

Goal –  Interoperability standards for all federal health

agencies

Adopted LOINC as standard –  Laboratory result names (2003) –  Laboratory test order names (2006)

–  Meds: structured product labeling sections (2006)

–  Federally-required patient assessment instruments with functioning and disability content (2007)

Other Key US Adoptions

HITSP eLINCS NAACCR CDISC NCQA/HEDIS

Other Key US Adoptions HL7

HIPAA Claims Attachments Many HIEs – Maine Health InfoNet – Florida Health Information Network – Vermont Information Technology Leaders

Large Care Organizations Insurance Companies

EHR “Meaningful Use” •  HITECH Act in ARRA •  Reimbursements for “meaningful

users” of certified EHR technology •  LOINC standard for Lab Results – Phase I: when received from lab and

for patient summaries – Phase II: LOINC

loinc.org/slideshows