2013 06 06 - LOINC Introduction - Brief

7/28/2019 2013 06 06 - LOINC Introduction - Brief

1/136

[email protected]

Laboratory LOINC Workshop - Indianapolis, IN

Introduction and Overview
mailto:[email protected]:[email protected]:[email protected]


2/136
http://loinc.org/slideshowshttp://loinc.org/slideshows


3/136

Acknowledgements

LOINC Development TeamJami Deckard, Kelly Malott, David Baorto, Clem

McDonald

RELMA Development Team

John Hook, Anandhi Sowmyan, James Dennis

LOINC Committee

Sandy Poremba


4/136


5/136


6/136

photo via noshaMcDonald et al. Canopy Computing: using the Web in Clinical Practice.JAMA

. 1998;280(15):1325-1329.

The rain forest canopy is aseamless web through which

arboreal creatures efficientlymove to reach the edible

fruits without any attentionto the individual trees.


7/136photo via beckstei
http://www.flickr.com/photos/beckstei/6269438822/sizes/o/in/photostream/http://www.flickr.com/photos/beckstei/6269438822/sizes/o/in/photostream/


8/136

40 years of EMR workndiana etwork for atient are

Arboreal Informatics Pioneers

Regenstrief

the Data Switzerland

Nations most comprehensive and longest tenured HIE


9/136


10/136


11/136

More than Meets the Eye

photo via chadlewis
http://www.flickr.com/photos/chadlewishttp://www.flickr.com/photos/chadlewishttp://www.flickr.com/photos/chadlewis


12/136

Fundamental challenge:Local systems have different ways of

identifying the same concept.


13/136photo via pfarrell95
http://www.flickr.com/photos/65005341@N03/http://www.flickr.com/photos/65005341@N03/http://www.flickr.com/photos/65005341@N03/


14/136

A vocabulary standard

would serve as theRosetta Stone.

Image Hans Hillewaert /CC-BY-SA-3.0
http://creativecommons.org/licenses/by-sa/3.0/http://creativecommons.org/licenses/by-sa/3.0/http://creativecommons.org/licenses/by-sa/3.0/http://creativecommons.org/licenses/by-sa/3.0/


15/136

ogical

bservation

dentifiers

ames and

odesA universal code system that facilitates exchange,

pooling, and processing of results


16/136


17/136

Established in 1994 byRegenstrief Institute.

Vocabulary standard for

observation identifiers.


18/136

Similar name, different meaning

meerkat meerkat mere cat meerkat

photo via Caption Time
http://captiontime.tumblr.com/http://captiontime.tumblr.com/


19/136

MEASUREMENTS

US

R

photo via puuikibeach
http://www.flickr.com/photos/puuikibeachhttp://www.flickr.com/photos/puuikibeachhttp://www.flickr.com/photos/puuikibeach


20/136

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


21/136

What is my patients

hemoglobin level?718-7:Hemoglobin:MCnc:Pt:Bld:Qn


22/136

How fast does my patient

usually walk?41959-8:Walking speed:Vel:1W^mean:^Patient:Qn:Calculated

photo via Ed Yourdon
http://www.flickr.com/photos/yourdon/http://www.flickr.com/photos/yourdon/http://www.flickr.com/photos/yourdon/


23/136

Indiana Network for Patient Care

HL7 v2.x Message


24/136

Result with a Coded Value

Data type of result

(OBX-5) is a coded

element

This code is

from LOINC

Code identifying thisobservation

(what are these results?

Conditions identified by

newborn screening )

This code is from

SNOMED

Code identifying the result

(Phenylketonuria )


25/136

photo via eye of einstein
http://www.flickr.com/photos/35188692@N00/466404658/sizes/o/in/photostream/http://www.flickr.com/photos/35188692@N00/466404658/sizes/o/in/photostream/http://www.flickr.com/photos/35188692@N00/466404658/sizes/o/in/photostream/http://www.flickr.com/photos/35188692@N00/466404658/sizes/o/in/photostream/http://www.flickr.com/photos/35188692@N00/466404658/sizes/o/in/photostream/


26/136

LOINC(noun)o LOINC, LOINCing, LOINCed (verb)

[Chief, Head, etc] LOINCer(noun)LOINCification (noun)

SNOMED (noun)

SNOMEDicated???


27/136

Different standards for differentparts of the elephant.

photo via Ludovic Hirlimann
http://www.flickr.com/photos/lhirlimann/http://www.flickr.com/photos/lhirlimann/http://www.flickr.com/photos/lhirlimann/http://www.flickr.com/photos/lhirlimann/http://www.flickr.com/photos/lhirlimann/http://www.flickr.com/photos/lhirlimann/http://www.flickr.com/photos/lhirlimann/


28/136

photo via x-ray delta one

L b LOINC
http://www.flickr.com/photos/x-ray_delta_onehttp://www.flickr.com/photos/x-ray_delta_onehttp://www.flickr.com/photos/x-ray_delta_one


29/136

Laboratory LOINC

Cli i l LOINC


30/136

Clinical LOINC


31/136

Laboratory LOINC Committee Chair:

Clem McDonald, MD

Clinical LOINC Committee Chair:

Stan Huff, MD


32/136

photo via LuzA

Standardized Assessments and Collections
http://www.flickr.com/photos/luchilu/http://www.flickr.com/photos/luchilu/


33/136

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 InformPersonal Med. 2010;3(4):273-291.


34/136


35/136

Open Development

Worldwide distribution at no cost

New terms from end-users

Welcome all comersCommittees are volunteers

Its free, but invaluable


36/136

Regenstrief Institute

StewardDeveloper of content

Developer of toolsDeveloper of community

DistributorVoice


37/136

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

LOINC Codes Over Time by Release


38/136

010,00020,00030,00040,00050,00060,00070,00080,000

4/2

4/19

95|1

.0

5/24/

1995

|1.0

a

6/23

/199

5|1

.0b

6/28/

1995

|1.0

c

7/14

/199

5|1

.0d

9/15

/199

5|1

.0e

12/21/

1995

|1.0

f

4/28

/199

6|1

.0g

8/29/1

996

|1.0h(

2)

12/3/1

996

|1.0h(

3)

1/8/1

9997

|1.0i

10/9/19

97|1

.0j-a

5/1

/199

8|1

.0k

2/12/

1999

|1.0l

7/23/1

999

|1.0

m

8/6/19

99|1

.0m

a

2/4

/200

0|1

.0n

6/13

/200

0|1

.00

1/1

/200

1|2

.00

1/31

/200

1|2

.01

7/1

/200

1|2

.03

1/1

/200

2|2

.04

2/1

/200

2|2

.05

2/19

/200

2|2

.06

8/1

/200

2|2

.07

9/1

/200

2|2

.08

5/1

/200

3|2

.09

10/1

/200

3|2

.10

1/1

/200

4|2

.11

2/1

/200

4|2

.12

12/1

/200

4|2

.13

12/1

/200

4|2

.14

6/1

/200

5|2

.15

12/1

/200

5|2

.16

6/1

/200

6|2

.17

12/21/

2006

|2.1

9

6/21/

2007

|2.2

1

12/03/

2007

|2.2

2

7/10/

2008

|2.2

4

1/10/

2009

|2.2

6

07/06/

2009

|2.27

12/30/

2009

|2.2

9

2/26/

2010

|2.3

0

6/15/

2010

|2.3

2

12/29/

2010

|2.3

4

06/30/

2011

|2.3

6

12/30/

2011

|2.3

8

6/30/

2012

|2.4

0

12/30/

2012

|2.4

2

LOINC Codes

Only Lab LOINC Codes

LOINC Codes Over Time by Release

Slope = 600

Slope = 2200

laboratory terms onlynot a lab cliff, just no data available


39/136

photo via liber
http://www.flickr.com/photos/liberhttp://www.flickr.com/photos/liber


40/136

23 300+ i 153 t i


41/136

23,300+ users in 153 countries

loinc org members


42/136

0

5,000

10,000

15,000

20,000

25,000

6/1/08

12/1/08

6/1/09

12/1/09

6/1/10

12/1/10

6/1/11

12/1/11

6/1/12

12/1/12

6/1/13

loinc.org members

18 new members per day

550 new members per month

Doubled in 19 months!


43/136

downloads: ~1500/month

search loinc org


44/136

search.loinc.org

search loinc org


45/136

search.loinc.org


46/136

Alternate Language Search


47/136




48/136


Everything in Italian!


49/136


50/136


51/136


52/136

forum loinc org


53/136

forum.loinc.org

loinc org/usage


54/136

loinc.org/usage


55/136


56/136


57/136

photo via 917press
http://www.flickr.com/photos/917press/http://www.flickr.com/photos/917press/http://www.flickr.com/photos/917press/


58/136

Just kidding.

Copyright is agoodthing for

standards.

Its the licensing part that isinteresting.


59/136

No cost

Worldwide

In perpetuity


60/136

Use

Copy

Distribute


61/136

Any purpose:

commercial

non-commercial

photo via Refracted Moments
http://www.flickr.com/photos/refractedmoments/http://www.flickr.com/photos/refractedmoments/http://www.flickr.com/photos/refractedmoments/


62/136

CANNOT use anyLicensed Material to

develop or promulgate adifferent standard for

orders or observations.


63/136

That would defeat

the purpose of

having a standard!


64/136

LOINC Submitters


65/136

Since 2009: 150+ organizations LOINC Translators


66/136

22 organizations


67/136


68/136

Vreeman DJ et al. Enabling international adoption of LOINC through translation. J Biomed Inform (2012), doi:10.1016/j.jbi.2012.01.005

1st International

LOINC PhD student
http://dx.doi.org/10.1016/j.jbi.2012.01.005http://dx.doi.org/10.1016/j.jbi.2012.01.005http://dx.doi.org/10.1016/j.jbi.2012.01.005http://dx.doi.org/10.1016/j.jbi.2012.01.005http://dx.doi.org/10.1016/j.jbi.2012.01.005http://dx.doi.org/10.1016/j.jbi.2012.01.005http://dx.doi.org/10.1016/j.jbi.2012.01.005http://dx.doi.org/10.1016/j.jbi.2012.01.005


69/136


70/136

L I l i


71/136

Large Implementations

SIGA Sade project7+ Provincial systems in Canada

8+ Regional Health Information Exchanges in Spain

ePSOSAssistance publique - Hpitaux de Paris

Hong Kong Hospital Authority

Philippine Health Insurance Corporation

InFSE Project in 5 regions in Italy (LOINC Italia)

M ny


72/136

For the last few years, the AP-HP has

been using the LOINC internationalnomenclature

Thanks to this catalogue, the AP-HP isable to use the nomenclature in itstreatment processes, whenever

biology analyses and test results arerequested.


73/136

Vandenbussche PY, Cormont S, Andr C, et al. Implementation and management of a biomedical observation dictionary in a large healthcare information system.J Am Med Inform Assoc. 2013 May 1. PMID: 23635601.

The results of our workvalidate the choice made to

develop a local dictionaryaligned with LOINC.
http://www.ncbi.nlm.nih.gov/pubmed/23635601http://www.ncbi.nlm.nih.gov/pubmed/23635601http://www.ncbi.nlm.nih.gov/pubmed/23635601


74/136


75/136

Members of the Korean National StandardsCommittee have enthusiastically embraced LOINC


76/136


77/136

S me n t s seri s LOINCing


78/136


79/136

Dr Case leading some LOINCing in Cyprus


80/136


81/136

US AdoptionA few key highlights


82/136


83/136


84/136


85/136


86/136


87/136

CMS EHR Incentive

Program

a.k.a. Meaningful Use


88/136


89/136


90/136


91/136


92/136


93/136


94/136


95/136


96/136

photo via mccaughan
http://www.flickr.com/photos/mccaughan/3484111996/http://www.flickr.com/photos/mccaughan/3484111996/http://www.flickr.com/photos/mccaughan/3484111996/


97/136


98/136


99/136

Clean water act


100/136

Clean water act

photo via Fishking_1

Upstream standardization.

Ask instrument or test kitmanufacturers.

ivdconnectivity.org
http://www.flickr.com/photos/fishking1/5304638016/sizes/o/in/photostream/http://www.flickr.com/photos/fishking1/5304638016/sizes/o/in/photostream/http://www.flickr.com/photos/fishking1/5304638016/sizes/o/in/photostream/


101/136


102/136


103/136


104/136


105/136


106/136


107/136


108/136

Our newest ideas...

photo via cblue98
http://www.flickr.com/photos/cblue98/7254347346/http://www.flickr.com/photos/cblue98/7254347346/


109/136


110/136


111/136


112/136


113/136


114/136


115/136


116/136


117/136


118/136

RELMA Users Survey


119/136


120/136


121/136


122/136


123/136


124/136


125/136


126/136

Now you can just log in with your loinc.org ID


127/136

y j g y g

# of codes and institutions mapped to this LOINC


128/136

Click here to see the local codes!


129/136

When youve got a decent number of mappings,share them back with the community


130/136

share them back with the community


131/136


132/136


133/136


134/136


135/136

photo via milos milosevic
http://www.flickr.com/photos/21496790@N06/http://www.flickr.com/photos/21496790@N06/http://www.flickr.com/photos/21496790@N06/http://www.flickr.com/photos/21496790@N06/http://www.flickr.com/photos/21496790@N06/


136/136

2013 06 06 - LOINC Introduction - Brief

Documents

Transcript of 2013 06 06 - LOINC Introduction - Brief