LOINC!Introduction and Overview!

Daniel J. Vreeman, PT, DPT, MSc!Assistant Research Professor, Indiana University School of Medicine!

Research Scientist, Regenstrief Institute, Inc!

Laboratory LOINC Workshop – Indianapolis, IN!

06.06.2011! © 2011!dvreeman@regenstrief.org!

http://loinc.org/slideshows!

Origins of LOINC!The lingua franca of clinical observation exchange!

Similar name, di"erent meaning…!

meerkat! meerkat! mere cat! meerkat!photo via Caption Time!

Logical

Observation

Identi#ers

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!

!"

!"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|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|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!

OBX||CE|57131-5^Newborn conditions with pos markers^LN||7573000^PKU^SCT

Result with a Coded Value!

Data type of result (OBX-5) is a

coded element!

This code is from LOINC!

Code identifying this observation !

(what are these results? Conditions identi"ed by

newborn screening )!

This code is from SNOMED!

Code identifying the result (Phenylketonuria )!

A brief aside about terminology…!

LOINC Terminology!LOINC (noun)!To LOINC, LOINCing, LOINCed (verb)![Chief, Head, etc] LOINCer (noun)!LOINCi"cation (noun)!!!SNOMED Terminology!SNOMED (noun)!SNOMEDicated??? !!

From “Standardizing the MDS with LOINC® and Vocabulary Matches”

http://aspe.hhs.gov/daltcp/reports/2007/MDS-LOINC.htm

Laboratory LOINC!

Clinical LOINC!

The LOINC Community!Open. Nimble. Pragmatic.!

Open Development!Worldwide distribution at no cost!

End-user content additions!Welcome all comers!

Volunteers!!

Regenstrief Institute!Steward!Developer of content!

Developer of tools!Developer of community!Distributor!

Voice!!

LOINC Codes Over Time By Release!

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!

0!

2,000!

4,000!

6,000!

8,000!

10,000!

12,000!

loinc.org members!

11 new members per day!330 new members per month!

11,100+ users in 141 countries!

Downloads: ~1400/month!

The LOINC Distribution!

http://search.loinc.org!

7,900 views!!

120 views!280 views!

http://forum.loinc.org!

http://loinc.org/usage!

a.k.a. “Top 300 Orders”!

International Adoption!participation, translation, implementation!

LOINC Submitters!

Since 2009, 84 organizations from 14 countries!

LOINC Translators!

18 organizations!

New and Updated!

Estonian!

French!German!

Greek!Italian!

Spanish!

In-progress!Catalan!

Dutch!French!

Russian!!

Large Implementations!

SIGA Saúde project !Canada Health Infoway!ePSOS!Assistance publique - Hôpitaux de Paris!Hong Kong Hospital Authority!Red Agrolab!BiTAC!

Lots more…success is often silent!

US Adoption!A few key highlights!

US Federal Agencies!NLM!VA!

DoD!IHS!NCI!

CDC!

Other Key US Adoptions!

HITSP!eLINCS!

NAACCR!CDISC!

NCQA/HEDIS, NQF!

HL7!

HIPAA!

HIE’s!

EHR Incentive Program

a.k.a. “Meaningful Use”!

New Frontiers in Content Modeling!

Standardized Assessments!

Assessments are widely used…!

…and not unlike other clinical observations!!

Purpose!

LOINC could be a !!

master question #le and

uniform representation !

Panels/Forms Available as Separate Download!

Currently in LOINC!US Government Forms!

CARE, MDSv2, MDSv3, OASIS B1, OASIS C, RFC!US Surgeon General’s Family Health Portrait!

Brief Interview for Mental Status (BIMS)!

Confusion Assessment Method (CAM)!

Geriatric Depression Scale (GDS)!

HIV Signs and Symptoms Checklist!

Home Health Care Classi"cation!howRU!

Living with HIV (LIV-HIV)!

Morse Fall Scale!

OMAHA!

PHQ (9 and 2)!Quality Audit Marker (QAM)!

!

Translational Research Variables!

Big Picture Ideas for Today!

photo via Ludovic Hirlimann!

Not just an IT problem!photo via wake"elddavid!

Get real.!units, results, experts!

Don’t be a one hit wonder.!

photo via gsz!

photo via milos milosevic!

The Race is On!!

Get LOINCing!! photo via ryarwood!