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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