Daniel J. Vreeman, PT, DPT, MScAssociate Research Professor, Indiana University School of Medicine

Associate Director for Terminology Services, Regenstrief Institute, Inc

@djvreeman

© 2015

International Perspectives and Strategies for LOINC Adoption

MedInfo 2015- São Paulo, Brazil

PanelistsMarivan Santiago Abrahão, MD

Professor, Faculdade de Medicina, Universidade São Camilo, São Paulo, Brazil

Chair, Health Level Seven – Brazil

Boonchai Kijsanayotin, MD, PhD Health Informatician, Thai Health Information Standards Development Center, Health Systems Research Institute, Ministry of Public Health, Bangkok, Thailand

Co-Chair, Asia eHealth Information Network (AeHIN), Manila, Philippines

Maria Teresa Chiaravalloti, PhD Technologist, Consiglio Nazionale delle Ricerche (CNR), Istituto di Calcolo e Reti ad Alte Prestazioni (ICAR), Rende (Cosenza), Italy

Technical manager, LOINC Italia workgroup

Sends  his  regrets

Session Overview

1. Global overview of LOINC

2. LOINC in Brazil

3. LOINC in Italy

4. Themes in national approaches

5. Discussion

photo via Vernio77

LOINC is a universal code system for tests, measurements, and observations.

LOINC makes health data more fluid and understandable to different computer systems.

LOINC is like a bar code for test data…

A non-profit research organization in Indianapolis, USA

Overall steward and owner of LOINC

Develops and licenses LOINC to promote widespread global adoption

The LOINC DistributionLOINC Table, Accessory Files, and Tools and Resources for Implementers

loinc.org/downloads

Tools for Implementers

photo via Robert S Donovan

search.loinc.org

Everything  in  Italian!Alternate Language Search

forum.loinc.org

RELMA®REgenstrief LOINC Mapping Assistant

RELMA FeaturesThe “Gold Standard” LOINC mapping tool

Browse LOINC content

Map local terms to LOINC import/export translate local words to LOINC-speak manual/automated mapping

Search in translated languages (and English)

LOINC in action today

LOINC Codes Over Time by Release

laboratory terms only

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

4/24/1

995 | 1.0

5/24/1

995 | 1.0

a

6/23/1

995 | 1.0

b

6/28/1

995 | 1.0

c

7/14/1

995 | 1.0

d

9/15/1

995 | 1.0

e

12/21/1

995 | 1.0

f

4/28/1

996 | 1.0

g

8/29/1

996 | 1.0

h(2)

12/3/1

996 | 1.0

h(3)

1/8/1

9997 | 1.0

i

10/9/1

997 | 1.0

j-a

5/1/1

998 | 1.0

k

2/12/1

999 | 1.0

l

7/23/1

999 | 1.0

m

8/6/1

999 | 1.0

ma

2/4/2

000 | 1.0

n

6/13/2

000 | 1.0

0

1/1/2

001 | 2.0

0

1/31/2

001 | 2.0

1

7/1/2

001 | 2.0

3

1/1/2

002 | 2.0

4

2/1/2

002 | 2.0

5

2/19/2

002 | 2.0

6

8/1/2

002 | 2.0

7

9/1/2

002 | 2.0

8

5/1/2

003 | 2.0

9

10/1/2

003 | 2.1

0

1/1/2

004 | 2.1

1

2/1/2

004 | 2.1

2

12/1/2

004 | 2.1

3

12/1/2

004 | 2.1

4

6/1/2

005 | 2.1

5

12/1/2

005 | 2.1

6

6/1/2

006 | 2.1

7

12/21/2

006|2.1

9

6/21/2

007|2.2

1

12/03/2

007|2.2

2

7/10/2

008|2.2

4

1/10/2

009|2.2

6

07/06/2

009|2.2

7

12/30/2

009|2.2

9

2/26/2

010|2.3

0

6/15/2

010|2.3

2

12/29/2

010|2.3

4

06/30/2

011|2.3

6

12/30/2

011|2.3

8

6/30/2

012|2.4

0

12/30/2

012|2.4

2

06/29/2

013|2.4

4

12/26/2

013|2.4

6

06/26/2

014|2.4

8

12/22/2

014|2.5

0

06/29/2

015|2.5

2

LOINC Codes

Only Lab LOINC Codes

Our vision is for LOINC to be integrated into every clinical information system that shares or aggregates data.

39,500+ registered users in 169 countries

Newest  country  with  registered  user:  Guyana

LOINC Translators

22  organizations.    Currently  translations  into  18  variants  of  12  languages

loinc.org/international

loinc.org/international

Vreeman DJ, Chiaravalloti MT, Hook J, McDonald CJ. Enabling international adoption of LOINC through translation. J Biomed Inform. 2012 Aug;45(4):667-73. PMID: 22285984.

31201-7:HIV 1+2 Ab:ACnc:Pt:Ser/Plas:Ord:EIA

31201-7 LOINC Code

HIV 1+2 Ab

ACnc

Pt

Ser/Plas

Ord

EIA

Component

Property Measured

Timing

System

Scale

Method

Regenstrief has tools to break down each term into Parts that can be translated separately and re-used.

Anatomy of a LOINC Term

translate  “Ab”  once

Australia

Austria

Belgium

Brazil

Canada

Cyprus

Estonia

Finland

France

Germany

Iceland

India

Malaysia

Mexico

Mongolia

The Netherlands

New Zealand

Philippines

Portugal

Qatar

Rwanda

Saudi Arabia

Slovakia

Slovenia

Spain

Thailand

Turkey

United States

Adopted as National Standard

Large ImplementationsSIGA Saúde project

7+ Provincial systems in Canada

8+ Regional Health Information Exchanges in Spain

ePSOS

Assistance publique - Hôpitaux de Paris

Hong Kong Hospital Authority

Philippine Health Insurance Corporation

InFSE Project in 5 regions in Italy (LOINC Italia)

Many  more...

In USA, major driver of eHealth standards adoption is

EHR Incentive Program

a.k.a. “Meaningful Use”

Blumenthal D, Tavenner M. The "meaningful use" regulation for electronic health records. N Engl J Med. 2010 Aug 5;363(6):501-4. Epub 2010 Jul 13. PubMed PMID: 20647183.

U.S. Food and Drug Administration (FDA)

Support for LOINC from Instrument VendorsA growing trend pushing standardization upstream

ivdconnectivity.org

Novel LOINCing contract with IVD company

Phase 1 launched in January 2015

Joint communication coming soon

International Perspectives on LOINC Adoption

Context-specific Adoption

Approaches tailored to local context

Contributing factors

Use of English (or not) in healthcare

Differences in health system organization

Political climate around eHealth

Capabilities and penetration of electronic systems

Readiness of the workforce