LOINC, a Universal Standard for Identifying Laboratory Observations:
LOINC, a Universal Standard for Identifying Laboratory Observations:
If you go to Labcorp or Quest labs website test Menus you see a bunch of numbers sometimes in EHR you find a bunch of lab tests in various permutations and combinations.
They are so many and so confusing most primary care physicians have a few in their Favourites list and use them routinely.
So sometimes more tests are done and sometimes tests which could have been done are missed.
Learn about them so that we can be better informed and may help in patient management
A 5-Year Update
Clement J. McDonald, Stanley M. Huff, Jeffrey G. Suico, Gilbert Hill, Dennis Leavelle, Raymond Aller, Arden Forrey, Kathy Mercer, Georges DeMoor, John Hook, Warren Williams, James Case, Pat Maloney
DOI: 10.1373/49.4.624 Published April 2003
ArticleFigures & DataInfo & Metrics PDF
Abstract
The Logical Observation Identifier Names and Codes (LOINC®) database provides a universal code system for reporting laboratory and other clinical observations. Its purpose is to identify observations in electronic messages such as Health Level Seven (HL7) observation messages, so that when hospitals, health maintenance organizations, pharmaceutical manufacturers, researchers, and public health departments receive such messages from multiple sources, they can automatically file the results in the right slots of their medical records, research, and/or public health systems. For each observation, the database includes a code (of which 25 000 are laboratory test observations), a long formal name, a “short” 30-character name, and synonyms. The database comes with a mapping program called Regenstrief LOINC Mapping Assistant (RELMATM) to assist the mapping of local test codes to LOINC codes and to facilitate browsing of the LOINC results. Both LOINC and RELMA are available at no cost from http://www.regenstrief.org/loinc/. The LOINC medical database carries records for >30 000 different observations. LOINC codes are being used by large reference laboratories and federal agencies, e.g., the CDC and the Department of Veterans Affairs, and are part of the Health Insurance Portability and Accountability Act (HIPAA) attachment proposal. Internationally, they have been adopted in Switzerland, Hong Kong, Australia, and Canada, and by the German national standards organization, the Deutsches Instituts für Normung. Laboratories should include LOINC codes in their outbound HL7 messages so that clinical and research clients can easily integrate these results into their clinical and research repositories. Laboratories should also encourage instrument vendors to deliver LOINC codes in their instrument outputs and demand LOINC codes in HL7 messages they get from reference laboratories to avoid the need to lump so many referral tests under the “send out lab” code.
Today most laboratory and diagnostic systems in the US deliver their results electronically via Health Level Seven (HL7) 1 (1) messages to their hospital, office practice, health maintenance organizations (HMOs), public health departments, and other clients. The HL7 message carries one record for each separate test observation. Within this record is one field that identifies the test, e.g., serum sodium, and another that reports its value, e.g., 142. These observations records carry other fields for reporting the units of measure, the reference interval, normal flag, and other information. In the HL7 nomenclature, the field that carries the observation identifier is called OBX-3, and the field that carries the observation value is called OBX-5. Until recently, most laboratories would send their own local and idiosyncratic codes in OBX-3 to identify the observation. One laboratory would identify serum sodium with the code “C1231” and another with the code “SNA”. Every laboratory had its own unique code for every test observation. This extreme degree of variation is a huge barrier to the development of clinical repositories and research databases for office practices, hospitals, HMOs, and public health departments because mapping these local laboratory codes (thousands of them per laboratory) to the codes used in the receiving systems requires large labor investments. If we had a universal code system for tests and everyone used this system, this barrier probably would vanish, and receiving systems could “understand” and recognize all results that flow to them in HL7 and other electronic messages (2) and efficiently store these results in their medical record or repository system.
Before 1994, no universal pre-coordinated code system for laboratory test names existed, although considerable background work had been done within organizations such as the IFCC/IUPAC Committee/Commission on Properties and Units in Clinical Chemistry (3)(4), and EUCLIDES(5). In 1994, a group of researchers met in Indianapolis at the Regenstrief Institute to begin the development of such a system, which they called the Logical Observation Identifiers Names and Codes (LOINC®) code system. The initial release, in the spring of 1995, included a 70-page Users’ Guide and identifiers and names for more than 6000 laboratory test results (6)(7).
Since this first release, the Regenstrief Institute and the LOINC Committee have delivered 17 releases, increased the size of the database fivefold, added codes for many clinical subjects beyond the laboratory, added short names for laboratory tests, developed and enhanced a free browsing program, the Regenstrief LOINC Mapping Assistant (RELMATM) (8), and watched adoption of the LOINC coding system grow.
LOINC, a Universal Standard for Identifying Laboratory Observations:
If you go to Labcorp or Quest labs website test Menus you see a bunch of numbers sometimes in EHR you find a bunch of lab tests in various permutations and combinations.
They are so many and so confusing most primary care physicians have a few in their Favourites list and use them routinely.
So sometimes more tests are done and sometimes tests which could have been done are missed.
Learn about them so that we can be better informed and may help in patient management
A 5-Year Update
Clement J. McDonald, Stanley M. Huff, Jeffrey G. Suico, Gilbert Hill, Dennis Leavelle, Raymond Aller, Arden Forrey, Kathy Mercer, Georges DeMoor, John Hook, Warren Williams, James Case, Pat Maloney
DOI: 10.1373/49.4.624 Published April 2003
ArticleFigures & DataInfo & Metrics PDF
Abstract
The Logical Observation Identifier Names and Codes (LOINC®) database provides a universal code system for reporting laboratory and other clinical observations. Its purpose is to identify observations in electronic messages such as Health Level Seven (HL7) observation messages, so that when hospitals, health maintenance organizations, pharmaceutical manufacturers, researchers, and public health departments receive such messages from multiple sources, they can automatically file the results in the right slots of their medical records, research, and/or public health systems. For each observation, the database includes a code (of which 25 000 are laboratory test observations), a long formal name, a “short” 30-character name, and synonyms. The database comes with a mapping program called Regenstrief LOINC Mapping Assistant (RELMATM) to assist the mapping of local test codes to LOINC codes and to facilitate browsing of the LOINC results. Both LOINC and RELMA are available at no cost from http://www.regenstrief.org/loinc/. The LOINC medical database carries records for >30 000 different observations. LOINC codes are being used by large reference laboratories and federal agencies, e.g., the CDC and the Department of Veterans Affairs, and are part of the Health Insurance Portability and Accountability Act (HIPAA) attachment proposal. Internationally, they have been adopted in Switzerland, Hong Kong, Australia, and Canada, and by the German national standards organization, the Deutsches Instituts für Normung. Laboratories should include LOINC codes in their outbound HL7 messages so that clinical and research clients can easily integrate these results into their clinical and research repositories. Laboratories should also encourage instrument vendors to deliver LOINC codes in their instrument outputs and demand LOINC codes in HL7 messages they get from reference laboratories to avoid the need to lump so many referral tests under the “send out lab” code.
Today most laboratory and diagnostic systems in the US deliver their results electronically via Health Level Seven (HL7) 1 (1) messages to their hospital, office practice, health maintenance organizations (HMOs), public health departments, and other clients. The HL7 message carries one record for each separate test observation. Within this record is one field that identifies the test, e.g., serum sodium, and another that reports its value, e.g., 142. These observations records carry other fields for reporting the units of measure, the reference interval, normal flag, and other information. In the HL7 nomenclature, the field that carries the observation identifier is called OBX-3, and the field that carries the observation value is called OBX-5. Until recently, most laboratories would send their own local and idiosyncratic codes in OBX-3 to identify the observation. One laboratory would identify serum sodium with the code “C1231” and another with the code “SNA”. Every laboratory had its own unique code for every test observation. This extreme degree of variation is a huge barrier to the development of clinical repositories and research databases for office practices, hospitals, HMOs, and public health departments because mapping these local laboratory codes (thousands of them per laboratory) to the codes used in the receiving systems requires large labor investments. If we had a universal code system for tests and everyone used this system, this barrier probably would vanish, and receiving systems could “understand” and recognize all results that flow to them in HL7 and other electronic messages (2) and efficiently store these results in their medical record or repository system.
Before 1994, no universal pre-coordinated code system for laboratory test names existed, although considerable background work had been done within organizations such as the IFCC/IUPAC Committee/Commission on Properties and Units in Clinical Chemistry (3)(4), and EUCLIDES(5). In 1994, a group of researchers met in Indianapolis at the Regenstrief Institute to begin the development of such a system, which they called the Logical Observation Identifiers Names and Codes (LOINC®) code system. The initial release, in the spring of 1995, included a 70-page Users’ Guide and identifiers and names for more than 6000 laboratory test results (6)(7).
Since this first release, the Regenstrief Institute and the LOINC Committee have delivered 17 releases, increased the size of the database fivefold, added codes for many clinical subjects beyond the laboratory, added short names for laboratory tests, developed and enhanced a free browsing program, the Regenstrief LOINC Mapping Assistant (RELMATM) (8), and watched adoption of the LOINC coding system grow.
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