2012 12 06 - LOINC Introduction - Brief
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Daniel Vreeman2012 12 06 - LOINC Introduction - Brief
Uploaded by
Daniel VreemanLaboratory LOINC Workshop - Indianapolis, IN
Introduction and Overview
Daniel J. Vreeman, PT, DPT, MSc
Assistant Research Professor, Indiana University School of Medicine Research Scientist, Regenstrief Institute, Inc
2012.12.06
2012
loinc.org/slideshows
Acknowledgements
LOINC Development Team
Kathy Mercer, Jaci Phillips, Jami Deckard, Kelly Malott, David Baorto, Clem McDonald
RELMA Development Team
John Hook, Anandhi Sowmyan, James Dennis
LOINC Committee Sandy Poremba
Origins of LOINC
The lingua franca of clinical observation exchange
McDonald et al. Canopy Computing: using the Web in Clinical Practice. JAMA. 1998;280(15):1325-1329.
photo via nosha
The rain forest canopy is a seamless web through which arboreal creatures efficiently move to reach the edible fruits without any attention to the individual trees.
McDonald et al. Canopy Computing: using the Web in Clinical Practice. JAMA. 1998;280(15):1325-1329. photo via nosha
photo via beckstei
Arboreal Informatics Pioneers
40 years of EMR work Indiana Network for Patient Care
Nations most comprehensive and longest tenured HIE
Regenstrief
the Data Switzerland
Fundamental challenge:
Local systems have different ways of identifying the same concept.
Only way to corral the innite indiosyncracies is with standards
photo via pfarrell95
A vocabulary standard would serve as the Rosetta Stone.
Image Hans Hillewaert / CC-BY-SA-3.0
Logical Observation Identiers Names and Codes
A universal code system that facilitates exchange, pooling, and processing of results
Established in 1994 by Regenstrief Institute. Vocabulary standard for observation identiers.
Similar name, different meaning
photo via Caption Time
Similar name, different meaning
meerkat meerkat mere cat meerkat
photo via Caption Time
MEASUREMENTS R US
photo via puuikibeach
If an observation is a question and the observation value is an answer
LOINC provides codes for questions Where needed, other vocabularies provide codes for answers
What is my patients 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
photo via Ed Yourdon
Indiana Network for Patient Care
Indiana Network for Patient Care
Indiana Network for Patient Care
HL7 v2.x Message
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|
Indiana Network for Patient Care
HL7 v2.x Message
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|
Indiana Network for Patient Care
HL7 v2.x Message
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|
Indiana Network for Patient Care
HL7 v2.x Message
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|
Indiana Network for Patient Care
HL7 v2.x Message
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|
Indiana Network for Patient Care
HL7 v2.x Message
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|
Indiana Network for Patient Care
HL7 v2.x Message
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|
Indiana Network for Patient Care
HL7 v2.x Message
LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem
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|
Indiana Network for Patient Care
HL7 v2.x Message
LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem
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|
Indiana Network for Patient Care
HL7 v2.x Message
LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem
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|
Indiana Network for Patient Care
HL7 v2.x Message
LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem
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|
Indiana Network for Patient Care
HL7 v2.x Message
LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem
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|
Result with a Coded Value
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
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
OBX||CE|57131-5^Newborn conditions with pos markers^LN||7573000^PKU^SCT
Code identifying this observation (what are these results? Conditions identied by newborn screening )
Result with a Coded Value
Data type of result (OBX-5) is a coded element This code is from LOINC This code is from SNOMED
OBX||CE|57131-5^Newborn conditions with pos markers^LN||7573000^PKU^SCT
Code identifying this observation (what are these results? Conditions identied by newborn screening )
Code identifying the result (Phenylketonuria )
A brief aside about terminology
photo via eye of einstein
LOINC Terminology
LOINC Terminology
LOINC (noun)
LOINC Terminology
LOINC (noun) To LOINC, LOINCing, LOINCed (verb)
LOINC Terminology
LOINC (noun) To LOINC, LOINCing, LOINCed (verb) [Chief, Head, etc] LOINCer (noun)
LOINC Terminology
LOINC (noun) To LOINC, LOINCing, LOINCed (verb) [Chief, Head, etc] LOINCer (noun) LOINCification (noun)
From Standardizing the MDS with LOINC and Vocabulary Matches http:/ /aspe.hhs.gov/daltcp/reports/2007/MDS-LOINC.htm
LOINC Terminology
LOINC (noun)
To LOINC, LOINCing, LOINCed (verb) [Chief, Head, etc] LOINCer (noun) LOINCification (noun)
LOINC Terminology
LOINC (noun) To LOINC, LOINCing, LOINCed (verb) [Chief, Head, etc] LOINCer (noun) LOINCification (noun)
LOINC Terminology
LOINC (noun) To LOINC, LOINCing, LOINCed (verb) [Chief, Head, etc] LOINCer (noun) LOINCification (noun)
SNOMED Terminology
LOINC Terminology
LOINC (noun) To LOINC, LOINCing, LOINCed (verb) [Chief, Head, etc] LOINCer (noun) LOINCification (noun)
SNOMED Terminology
SNOMED (noun)
LOINC Terminology
LOINC (noun) To LOINC, LOINCing, LOINCed (verb) [Chief, Head, etc] LOINCer (noun) LOINCification (noun)
SNOMED Terminology
SNOMED (noun) SNOMEDicated???
LOINC Terminology
LOINC (noun) To LOINC, LOINCing, LOINCed (verb) [Chief, Head, etc] LOINCer (noun) LOINCification (noun)
SNOMED Terminology
SNOMED (noun) SNOMEDicated???
Different standards for different parts of the elephant.
photo via Ludovic Hirlimann
We now return to your regularly scheduled program
photo via x-ray delta one
Laboratory LOINC
Clinical LOINC
LOINC Collections
Panels, forms, surveys, and other patient assessments
photo via LuzA
Standardized Assessments and Collections
Vreeman DJ, McDonald CJ, Huff SM. Representing patient assessments in LOINC. AMIA Annu Symp Proc. 2010;832-836. PMID: 21347095 . Vreeman DJ, McDonald CJ, Huff SM. LOINC - A Universal Catalog of Individual Clinical Observations and Uniform Representation of Enumerated Collections. Int J Funct Inform Personal Med. 2010;3(4):273-291.
Laboratory LOINC Committee Chair: Clem McDonald, MD
Clinical LOINC Committee Chair: Stan Huff, MD
The LOINC Community
Open. Nimble. Pragmatic.
Open Development
Worldwide distribution at no cost New terms from end-users Welcome all comers Committees are volunteers
Open Development
Worldwide distribution at no cost New terms from end-users Welcome all comers Committees are volunteers
Open Development
Worldwide distribution at no cost New terms from end-users Welcome all comers Committees are volunteers
Its free, but invaluable
Regenstrief Institute
Steward Developer of content Developer of tools Developer of community Distributor Voice
Funding Support
Main current sources are:
U.S. National Library of Medicine Regenstrief Foundation Prior support from
Several other U.S. federal agencies, John A. Hartford Foundation
10,000!
LOINC Codes! Lab Codes!
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LOINC Codes Over Time by Release
0!
laboratory terms only
4 5/ /24 2 / 6/ 4/ 199 2 1 6/ 3/1 9955 | 1 2 7/ 8/ 995 | 1 .0! .0 1 1 9/ 4/1 995 | 1 a! 12 15 99 | 1.0b /2 /19 5 | .0 ! 8/ 4/2 1/1 95 1.0 c! 2 8 9 | d 12 9/ /1 95 1.0 ! /3 19 99 | 1 e! /1 96 6 | .0 1 9 | 1 f! 10 /8/ 96 1.0 .0g /9 19 | 1. h(2 ! / 9 0 5/ 19 97 h(3)! 9 2/ 1/1 7 | | 1 )! 7/ 12 99 1. .0i! 2 / 8 0 8/ 3/1199 | 1 j-a! 6/ 9 9 .0 9 k 2/ 199 9 | | 1. ! 6/ 4/2 9 | 1. 0l! 13 0 1 0m 1/ /2 00 .0m ! 1/ 1/ 000 | 1 a! 31 20 | .0n 7/ /2 01 1.0 ! 1 0 | 1/ /2 01 2.00! 1 0 | 0 2/ /20 01 2.0 ! 2/ 1/ 02 | 2 1! 19 20 | .03 8/ /2 02 2.0 ! 1 0 | 4 9/ /2 02 2.0 ! 1 0 | 5 5/ /2 02 2.0 ! 10 1/ 002 | 2 6! /1 20 | .07 1/ /2 03 2.0 ! 1 0 | 8 2/ /2 03 2.0 ! 12 1/ 004 | 2 9! 2 .1 12/1/ 004 | 2 0! /1 20 | .11 6/ /2 04 2.1 ! 12 1/ 004 | 2 2! /1 20 | .13 6/ /2 05 2.1 ! 12 1/ 00 | 2 4! /2 20 5 | .15 6/ 1/ 06 2.1 ! 12 21 200 | 2 6! /0 /2 6| .17 7/ 3/ 007 2.1 ! 1 2 1/ 0/2007|2.29! 07 10 00 |2 1! . / 12/06 2008|2 22! /3 /2 9| .24 2/ 0/ 009 2.2 ! 2 2 6/ 6/ 009|2.26! 12 15 201 |2 7! . / 06/29 2010|2 29! / . 12/30 2010|2 30! /3 /2 0| .32 6/ 0/ 011 2.3 ! 30 20 |2 4! /2 11 .3 01 |2 6! 2| .38 2. ! 40 !
10,000!
LOINC Codes! Lab Codes!
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80,000!
LOINC Codes Over Time by Release
0!
Slope = 600
laboratory terms only
4 5/ /24 2 / 6/ 4/ 199 2 1 6/ 3/1 9955 | 1 2 7/ 8/ 995 | 1 .0! .0 1 1 9/ 4/1 995 | 1 a! 12 15 99 | 1.0b /2 /19 5 | .0 ! 8/ 4/2 1/1 95 1.0 c! 2 8 9 | d 12 9/ /1 95 1.0 ! /3 19 99 | 1 e! /1 96 6 | .0 1 9 | 1 f! 10 /8/ 96 1.0 .0g /9 19 | 1. h(2 ! / 9 0 5/ 19 97 h(3)! 9 2/ 1/1 7 | | 1 )! 7/ 12 99 1. .0i! 2 / 8 0 8/ 3/1199 | 1 j-a! 6/ 9 9 .0 9 k 2/ 199 9 | | 1. ! 6/ 4/2 9 | 1. 0l! 13 0 1 0m 1/ /2 00 .0m ! 1/ 1/ 000 | 1 a! 31 20 | .0n 7/ /2 01 1.0 ! 1 0 | 1/ /2 01 2.00! 1 0 | 0 2/ /20 01 2.0 ! 2/ 1/ 02 | 2 1! 19 20 | .03 8/ /2 02 2.0 ! 1 0 | 4 9/ /2 02 2.0 ! 1 0 | 5 5/ /2 02 2.0 ! 10 1/ 002 | 2 6! /1 20 | .07 1/ /2 03 2.0 ! 1 0 | 8 2/ /2 03 2.0 ! 12 1/ 004 | 2 9! 2 .1 12/1/ 004 | 2 0! /1 20 | .11 6/ /2 04 2.1 ! 12 1/ 004 | 2 2! /1 20 | .13 6/ /2 05 2.1 ! 12 1/ 00 | 2 4! /2 20 5 | .15 6/ 1/ 06 2.1 ! 12 21 200 | 2 6! /0 /2 6| .17 7/ 3/ 007 2.1 ! 1 2 1/ 0/2007|2.29! 07 10 00 |2 1! . / 12/06 2008|2 22! /3 /2 9| .24 2/ 0/ 009 2.2 ! 2 2 6/ 6/ 009|2.26! 12 15 201 |2 7! . / 06/29 2010|2 29! / . 12/30 2010|2 30! /3 /2 0| .32 6/ 0/ 011 2.3 ! 30 20 |2 4! /2 11 .3 01 |2 6! 2| .38 2. ! 40 !
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80,000!
LOINC Codes Over Time by Release
0!
Slope = 600 Slope = 2200
laboratory terms only
4 5/ /24 2 / 6/ 4/ 199 2 1 6/ 3/1 9955 | 1 2 7/ 8/ 995 | 1 .0! .0 1 1 9/ 4/1 995 | 1 a! 12 15 99 | 1.0b /2 /19 5 | .0 ! 8/ 4/2 1/1 95 1.0 c! 2 8 9 | d 12 9/ /1 95 1.0 ! /3 19 99 | 1 e! /1 96 6 | .0 1 9 | 1 f! 10 /8/ 96 1.0 .0g /9 19 | 1. h(2 ! / 9 0 5/ 19 97 h(3)! 9 2/ 1/1 7 | | 1 )! 7/ 12 99 1. .0i! 2 / 8 0 8/ 3/1199 | 1 j-a! 6/ 9 9 .0 9 k 2/ 199 9 | | 1. ! 6/ 4/2 9 | 1. 0l! 13 0 1 0m 1/ /2 00 .0m ! 1/ 1/ 000 | 1 a! 31 20 | .0n 7/ /2 01 1.0 ! 1 0 | 1/ /2 01 2.00! 1 0 | 0 2/ /20 01 2.0 ! 2/ 1/ 02 | 2 1! 19 20 | .03 8/ /2 02 2.0 ! 1 0 | 4 9/ /2 02 2.0 ! 1 0 | 5 5/ /2 02 2.0 ! 10 1/ 002 | 2 6! /1 20 | .07 1/ /2 03 2.0 ! 1 0 | 8 2/ /2 03 2.0 ! 12 1/ 004 | 2 9! 2 .1 12/1/ 004 | 2 0! /1 20 | .11 6/ /2 04 2.1 ! 12 1/ 004 | 2 2! /1 20 | .13 6/ /2 05 2.1 ! 12 1/ 00 | 2 4! /2 20 5 | .15 6/ 1/ 06 2.1 ! 12 21 200 | 2 6! /0 /2 6| .17 7/ 3/ 007 2.1 ! 1 2 1/ 0/2007|2.29! 07 10 00 |2 1! . / 12/06 2008|2 22! /3 /2 9| .24 2/ 0/ 009 2.2 ! 2 2 6/ 6/ 009|2.26! 12 15 201 |2 7! . / 06/29 2010|2 29! / . 12/30 2010|2 30! /3 /2 0| .32 6/ 0/ 011 2.3 ! 30 20 |2 4! /2 11 .3 01 |2 6! 2| .38 2. ! 40 !
Lots Cooking
Always more lab tests Genetic reporting Lots of survey instruments, forms, and assessments More radiology reports Structured document titles
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6/ 1/ 08 12 /1 /0 8 6/ 1/ 09 12 /1 /0 9 6/ 1/ 10 12 /1 /1 0 6/ 1/ 11 12 /1 /1 1 6/ 1/ 12
loinc.org members
20,000
15,000
Mental Tipping Point - Oh Snap!
10,000
5,000
17 new members per day 520 new members per month
6/ 1/ 08 12 /1 /0 8 6/ 1/ 09 12 /1 /0 9 6/ 1/ 10 12 /1 /1 0 6/ 1/ 11 12 /1 /1 1 6/ 1/ 12
@LOINC
downloads: ~1500/ month
downloads: ~1500/ month
downloads: ~1500/ month
downloads: ~1500/ month
downloads: ~1500/ month
downloads: ~1500/ month
search.loinc.org
search.loinc.org
Alternate Language Search
Alternate Language Search
Everything in Italian!
forum.loinc.org
loinc.org/usage
loinc.org/usage
loinc.org/usage
loinc.org/usage
loinc.org/usage
loinc.org/terms-of-use
photo via 917press
Just kidding. Copyright is a good thing for standards. Its the licensing part that is interesting.
No cost Worldwide In perpetuity
Use Copy Distribute
Any purpose: commercial non-commercial
photo via Refracted Moments
CANNOT use any Licensed Material to develop or promulgate a different standard for orders or observations.
That would defeat the purpose of having a standard!
International Adoption
participation, translation, implementation
LOINC Submitters
105 organizations from 15 countries
Since 2009:
LOINC Translators
22 organizations
Vreeman DJ et al. Enabling international adoption of LOINC through translation. J Biomed Inform (2012), doi:10.1016/j.jbi.2012.01.005
Vreeman DJ et al. Enabling international adoption of LOINC through translation. J Biomed Inform (2012), doi:10.1016/j.jbi.2012.01.005
1 International
st
LOINC PhD student
Vreeman DJ et al. Enabling international adoption of LOINC through translation. J Biomed Inform (2012), doi:10.1016/j.jbi.2012.01.005
Adopted as National Standard
Australia Brazil Canada Cyprus Estonia France Germany Mexico Mongolia The Netherlands Rwanda Thailand Turkey United States
Large Implementations
SIGA Sade project Canada Health Infoway ePSOS Assistance publique - Hpitaux de Paris BiTAC Hong Kong Hospital Authority Philippine Health Insurance Corporation
Many more...
For the last few years, the AP-HP has been using the LOINC international nomenclature Thanks to this catalogue, the AP-HP is able to use the nomenclature in its treatment processes, whenever biology analyses and test results are requested.
Committee have enthusiastically embraced LOINC
Members of the Korean National Standards
Some serious LOINCing in Hong Kong
Some not-so-serious LOINCing
Talking about LOINC at the Thai Ministry of Information and Communication Technology
Dr. Case leading some LOINCing in Cyprus
This agreement further solidifies the wonderful relationship HL7 has enjoyed with Regenstrief for many years.
- Bob Dolin, MD
Chair of HL7 Board of Directors
US Adoption
A few key highlights
Some Key US Adoptions
All the big labs All health-related federal agencies Lots of care organizations HIEs Insurance companies EHR vendors Instrument manufacturers (nascent)
CMS EHR Incentive Program
a.k.a. Meaningful Use
Stage 1
through 2013
Stage 2
starting 2014
LOINC adopted for:
View, download, transmit data to third party 2. Cancer case reporting to state registry 3. Send/receive electronic lab results in ambulatory settings 4. Provide a care summary at care transition 5. Provide clinical summaries for patients 6. Submit reportable lab results to public health
1.
vsac.nlm.nih.gov
Key Lessons for Today
photo via IMLS DCC
Not just an I.T. problem
If Murky, Dont Assume
Units of measure are critical. Sample results can help identify the correct LOINC Scale. Local experts, package inserts can be very informative.
Clean water act
Upstream standardization. Ask instrument or test kit manufacturers.
photo via Fishking_1
ivdconnectivity.org
A journey. Not a destination.
Ongoing Journey
Plan for updating as your testing changes (less common), or your local code identiers change (more common).
Ongoing Journey
Replace mappings to deprecated terms with new LOINC releases. (RELMA can help)
Prioritization
Local or national policies may help prioritize mapping subsets. For example:
common results + panel elements + public health reportable tests
Jump In!
photo via Justin Ornellas
The Race is On!
Happy LOINCing!
photo via ryarwood
photo via milos milosevic
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