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AOHC EMR Implementation Toolkit | LOINC Mapping Manual – Version 1.0

LOINC Mapping Manual AOHC EMR Implementation Toolkit

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LOINC Mapping Manual A Guide to assist in the LOINCing of electronic lab results in Nightingale on Demand



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Contents

1.0 Introduction .................................................................................... 3

1.1 LOINC Mapping ............................................................................... 3

1.2 Before you Begin LOINC Mapping .................................................. 3

1.3 How to LOINC an Electronic Lab Result .......................................... 4

1.4 LOINC Mapping Reminders ............................................................. 5

1.5 Common lab names for the CDM Diabetes Flowsheet................... 5

1.6 Common lab names for an INR Flowsheet ................................... 11

1.7 LOINC Names in NOD .................................................................... 11

For questions or comments, please contact: AOHC EMR Project Association of Ontario Health Centres [email protected]

mailto:[email protected]



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1.0 Introduction LOINC Mapping in Nightingale on Demand (NOD) is conducted at an enterprise level, and ensures that the electronic lab results contained in client charts can be viewed/presented to users in a consolidated manner. LOINC stands for ‘Logical Observation Identifiers Names and Codes’ which is a universal code system for identifying laboratory and clinical observations. http://loinc.org

It is recommended that a clinical super user complete LOINC mapping in the production environment during Go Live week. LOINC mapping requires that the user has basic knowledge of lab test language and clinical acronyms.

1.1 LOINC Mapping You can associate lab results from different lab facilities with a common LOINC lab name so all results for the same or similar tests can be included on the same graph, table or flowsheet (including CDM Flowsheets) regardless of the lab facility that performed the test. This is done by including tests from all labs to the single applicable LOINC code name.

LOINCing also associates electronic lab results with lab results that have been manually entered into NOD.

Instructions for the completion of LOINC mapping, a partial list of commonly used codes, and NOD LOINC names is included in this manual.

1.2 Before you Begin LOINC Mapping Ensure you have identified the commercial labs that you will be receiving electronic results from e.g. Lifelabs (MDS), CML, Gamma-Dynacare, Alpha.

If you would like to include lab results from local hospitals, contact Nightingale helpdesk to ensure the setup of the hospital in the Lab Sites listing for inclusion in your LOINC mapping.

If you are migrating lab data from Purkinje to NOD, the Purkinje lab results should also be LOINC mapped.

If your providers conduct queries in Ontario Lab Information System (OLIS), any results filed to your patient charts can also be mapped.

Ensure you complete LOINC mapping for all lab results used in the NOD supplied CDM Flowsheets for Diabetes, Hypertension, Asthma, COPD and Heart Failure.

Identify and prioritize additional lab results that your providers want LOINCed, to ensure complete graph/chart displays regardless of the source lab.

http://loinc.org/



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1.3 How to LOINC an Electronic Lab Result LOINC Mapping is performed in the Enterprise module and therefore applicable to all providers / locations within the enterprise. 1. In the Enterprise module, click the Mapping then the LOINC menu. The Lab Mapping screen displays.

2. In the Lab Name field, select the laboratory from the list. Use the first entry

in the list displayed for CML, Gamma-Dynacare, and MDS (these are the Ontario based providers)

3. In the Test Name field, type the name of the test that you wish to map.

Search using ‘contains the word’ if unsure of the lab test name. The matching results display in the list in the Available Tests field.

4. In the Available Tests field, select the test that you want to map from the

list and click Add. The test displays in the Selected Tests list box.

Select one of each spelling variation/categorization of the desired lab result. Ex: Glucose, GLUCOSE, glucose, (Routine Chemistry), (Chemistry II), (Chemistral)

5. In the Lab Name field, select another laboratory from the list. If the search criteria is unchanged in the Test Name field, all matching results for the newly selected lab display.

6. In the Available Tests field, select the test and click Add. 7. Repeat the steps above until you have selected the same test from all

labs that you receive results from. 8. In the Loinc field, type the equivalent test name. The search results display in the list LOINC Results field.

9. In the LOINC Results field, select the required LOINC test name. 10. Select Map All



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1.4 LOINC Mapping Reminders Keep track of the test results that you have LOINC mapped and monitor flowsheets, graphs and charts to ensure results are flowing and displaying as expected. The application does not display LOINC mapped results to users. PLEASE NOTE: If your lab results are not working as expected or LOINC mapping needs to be edited, the LOINC mapping process must be redone. Ensure that all available tests have been included and the same LOINC name is selected. Each subsequent mapping will replace the prior entered mapping. For example, if Nightingale advises that new lab interfaces are available you will have to repeat the LOINC mapping process if you want these results to be included in the flowsheets, graphs and chart displays – including all prior labs sites and the new lab site in the mapping. If you create CDM Flowsheets, ensure you use the appropriate LOINC name for the lab results that you expect to flow into the flowsheet. If you need assistance to identify an appropriate LOINC name, contact the helpdesk to assist in the identification of the appropriate/available names in the system.

1.5 Common lab names for the CDM Diabetes Flowsheet The following tables provide a list of lab test names frequently used by laboratories and utilized in the NOD supplied CDM Flowsheet for Diabetes. This list is not 100% complete and includes examples of available tests that you may see when you conduct LOINC mapping for commercial labs and



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migrated Purkinje lab results. Hospital test names have not been included in the listing.

Name Gamma Dynacare

Life Labs(MDS)

CML Manual lab tests (ONLY for former Purkinje sites)

HbA1C Search “A1C”. See results like: Hemoglobin

A1c ( . )

HEMOGLOBIN

A1C ( . )

Hemoglobin

A1C ( . )

Hemoglobin

A1c (

HEMOGLOBIN

A1C )

Hemoglobin

A1C (

HEMOGLOBIN

A1C )

HEMOGLOBIN

A1C ( Other )

Hemoglobin

A1C ( Other )

Hemoglobin

A1c ( Other )

Search “A1C”. See results like: HbA1C

HbA1C (

ROUTINE

CHEMISTAL )

HbA1C (

ROUTINE

CHEMISTRY I

)

HBA1C (

ROUTINE

CHEMISTRY I)

Search “A1C”. See results like: Hemoglobin

A1C

HEMOGLOBI

N A1C (

CHEMISTRY

)

Hemoglobin

A1c (

CHEMISTRY

)

Hemoglobin

A1C (

CHEMISTRY

)

Search “A1C”. See results like: 42302-MDS_HBA1C (

MASTER LIST)

4240-_A1C ( MASTER

LIST)

4240-BIOT_A1C (

Master List )

4241-_HEMOGLOBIN

A1C ( MASTER LIST )

4241-

BIOT_HEMOGLOBIN

A1C ( Master List )

4243-_A1CHB

CALCULATION (

MASTER LIST )

4243-BIOT_A1CHB

CALCULATION (

Master List )

4244-_A1CHB2

CALCULATION (

Master List )

4244-BIOT_A1CHB2

CALCULATION (

Master List )

GLYCOSYLATED

HEMOGLIB (HBA1C) (

CHEMISTRY )

GLYCOSYLATED

HEMOGLIB (HBA1C) (

Master List )

HBA1C ( Master List )

HEMOGLOBIN A1C (

Master List )

HEMOGLOBIN

A1C(CML) ( Master



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Name Gamma Dynacare

Life Labs(MDS)


List )

SUBTITLE_HEMOGLO

BIN A1C(CML) (

Master List )

LDL Search “LDL”. See results like: LDL

CHOLESTEROL CALC.

LDL CHOLESTEROL CALC. (LDL CHOLESTEROL CALC.

LDL CHOLESTEROL CALC.( OTHER )

Search “LDL”. See results like: LDL

CHOLESTEROL (Calculated)

LDL CHOLESTEROL ( CALCULATED )

LDL CHOLESTEROL ( ROUTINE CHEMISTAL )

LDL CHOLESTEROL ( ROUTINE CHEMISTRY I )

LDL CHOLESTEROL ( CVD RISK )

LDL CHOLESTEROL ( CVD ORONTOHDL )

Search “LDL”. See results like: LDL

CHOLESTEROL

LDL Cholesterol ( CHEMISTRY)

LDL CHOLESTEROL ( CHEMISTRY )

LDL cholesterol ( CHEMISTRY )

Search “LDL”. See results like:

4102-_LDL

(RAND) ( Master

List )

4223-_LDL

(FAST) ( Master

List )

4224-BIOT_LDL

(FAST) ( Master

List )

4224-_LDL

(FASTING)

CALCULATION (

Master List )

4224-BIOT_LDL

(FASTING)

CALCULATION (

Master List )

4225-_LDL

(RANDOM)

CALCULATION (

Master List )

42748-MDS_LDL

CHOLESTEROL(C

ALCULATED) (

Master List )

LDL ( Master List

)

LDL

CHOLESTEROL (

Master List )

LDL

CHOLESTEROL

CALC. ( Master

List )



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Name Gamma Dynacare

Life Labs(MDS)


LDL

CHOLESTEROL(C

ML) ( Master List

)

We do NOT include:

SUBTITLE_HDL/

LDL(CML) (

Master List )

HDL

Search “HDL”. See results like: HDL

Cholesterol ( . )

HDL

cholesterol ( . )

HDL

CHOLESTEROL

( . )

HDL

CHOLESTEROL

( HDL

CHOLESTEROL

)

HDL

Cholesterol (

HDL

CHOLESTEROL

)

HDL

Cholesterol (

Other )

HDL

CHOLESTEROL

( OTHER )


cholesterol (

CVD

ORONTOHDL

)

HDL

CHOLESTERO

L ( CVD RISK )

HDL

cholesterol (

CVD RISK )

HDL

CHOLESTERO

L ( ROUTINE

CHEMISTAL )

HDL

cholesterol (

ROUTINE

CHEMISTAL )

HDL

cholesterol (

ROUTINE

CHEMISTRY I

)

HDL

CHOLESTERO

L ( ROUTINE

CHEMISTRY I


Cholesterol (

CHEMISTRY

)

HDL

CHOLESTER

OL (

CHEMISTRY

)

HDL CHOLIS

(

CHEMISTRY

)

HDL

CHOLESTTT

TTT<32010

9/L6 (

CHEMSITRY

)

Search “HDL”. See results like: 2023-_HDL (RAND) (

Master List )

4009-_HDL (FAST) (

Master List )

4009-BIOT_HDL

(FAST) ( Master List )

42769-MD_HDL

CHOLESTEROL (

Master List )

HDL ( Master List )

HDL CHOLESTEROL (

Master List )

HDL

CHOLESTEROL(CML)

( Master List )

Assume we don’t include:

SUBTITLE_HDL/LDL(

CML) ( Master List )

ACR

Search “MICROALB”

Search “ALBUMIN”,

Search “MICROALB

Search “microalb” See results like:



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Name Gamma Dynacare

Life Labs(MDS)


See results like: MICROALB/CR

EAT RATIO (

MICROALBUMI

N 24h U)

MICROALB/CR

EAT RATIO (

MICROALBUMI

N R U)

MICROALBUMI

N (24H U) (

MICROALBUMI

N 24h U)

MICROALBUMI

N (RDM U) (

MICROALBUMI

N R U)

MICROALBUMI

N (24H U) (

OTHER )

MICROALBUMI

N R U (.)

MICROALBUMI

N R U

(MICROALBU

MIN R U)

MICROALBUMI

N R U ( OTHER

)

See results like: ALBUMIN

CREATINE

RATIO U (

CHEMISTRY

III )

ALBUMIN/GL

OBULIN

RATIO (

ROUTINE

CHEMISTRY II

)

MICROALBUM

IN ( AER )

MICROALBUM

IN (RANDOM)

( CHEMISTRY

III )

MICROALBUM

IN

EXCRETION

RATE ( AER )

See results like: MICROALB/

CREAT.

(CHEMISTR

Y)

ALBUMIN (

IMMUNOCH

EMISTRY )

Albumin (

IMMUNOCH

EMISTRY )

MICROALBU

MIN (RUR) (

CHEMISTRY

)

MICROALBU

MIN (UR) (

CHEMISTRY

)

Albumin;

Urine (

CHEMISTRY

)

8134-

_MICROALBUMIN/CR

EAT. RATIO (URINE) (

Master List )

8134-

BIOT_MICROALBUMI

N/CREAT. RATIO

(URINE) ( Master List)

MICROALB/CREATE

RATIO ( Master List )

MICROALB/CREAT.(C

ML) ( Master List )

MICROALBUMIN (

Master List )

MICROALBUMIN (24H

U) ( Master List )

MICROALBUMIN

(RDM U) ( Master List

)

MICROALBUMIN

(RUR)(CML) ( Master

List)

MICROALBUMIN

(UR)(CML) ( Master

List)

MICROALBUMIN 24H

U ( Master List )

MICROALBUMIN R U (

Maser List )

MICROALBUMINURIA

( Master List )

Fasting Glucose

Search “GLUCOSE SERUM FASTING” See results like: GLUCOSE

SERUM

FASTING (.)

GLUCOSE

Search “GLUCOSE-FASTING” and “FASTING GLUCOSE” See results like: FASTING

GLUCOSE (

SPECIAL /

Search GLUCOSE FASTING-SER See results like: Glucose

Fasting (

CHEMISTRY

)

See results like:

42011-

MDS_GLUCOSE-

FASTING ( Master List

)

42115-

MDS_GLUCOSE-




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Name Gamma Dynacare

Life Labs(MDS)


SERUM

FASTING

(OTHER)

GLUCOSE

SERUM

FASTING

(GLUCOSE

SERUM

FASTING)

ROUTINE II )

GLUCOSE-

FASTING (

ROUTINE

CHEMISTRY )

GLUCOSE-

FASTING (

ROUTINE

CHEMISTRY I

)

GLUCOSE-

FASTING (

ROUTINE

CHEMISTRAL

)

GLUCOSE-

FASTING (

ROUTINE

CHEMISTRY-

GTT )

GLUCOSE

FASTING (

CHEMISTRY

)

Glucose

Fasting (

GLUCOSE

CHALLENGE

75mg)

Glucose

Fasting (

GLUCOSE

TOLERANCE

75G: )

Glucose

Fasting (

GTT-

GESTATION

AL 100G: )

GLUCOSE

FASTING (

LACTOSE

TOLERANCE

TEST: )

GLUCOSE

FASTING-SE

(

CHEMISTRY

)

GLUCOSE

FASTING-

SER (

CHEMISTRY

)

)

42210-

MDS_GLUCOSE-


)

Glucose Fasting

(Master List)

Glucose Fasting(CML)

( Master List)

GLUCOSE FASTING-

SER(CML) ( Master

List )

SUBTITLE_GLUCOSE

FASTING(CML) (

Master List )

Glucose Serum Fasting

( Master List )

GLUCOMETER –

FASTING GLUCOSE (

Master List )

Some of the same lab tests will appear within NOD supplied CDM flowsheets. Once the LOINC mapping is completed once for the specific test, the lab results with flow into all associated flowsheets which contain that lab test.



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1.6 Common lab names for an INR Flowsheet An INR flowsheet may be developed by your Centre if desired, as there is no pre-developed INR flowsheet available in NOD. It is not recommended to LOINC prothrombin time into your INR tests. Although they measure the same thing, they are on different scales. Combining prothrombin time results alongside INR results will make your flowsheet very difficult to interpret. Name Gamma

Dynacare Life Labs(MDS)


INR Search “INR”. See results like: INR ( . )

inr ( . )

INR ( INR )

INR ( Other)

Inr ( Other)

Search “INR”. See results like: inr (

HEMATOLOG

Y IV)

INR (

HEMATOLOG

Y IV )

Search “I.N.R.”. See results like: I.N.R. (

HEMATOLOG

Y IV )

Search “INR” and “I.N.R.”. See results like: I.N.R.(CML) (

Master List)

1069-_INR (

Master List )

1069-BIOT_INR

( Master List)

18402-

MDS_INR (

Master List)

18414-

MDS_INR (

Master List)

INR ( Master

List )

1.7 LOINC Names in NOD

The following chart provides the LOINC names you will require for all NOD supplied CDM Flowsheets and your custom developed INR Flowsheet. Once a LOINC name is entered, the LOINC results pick list will be generated, and the appropriate name must be selected before the ‘Map All’ button is clicked to complete the mapping process.



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CDM Flowsheet: Diabetes: Lab Test Name NOD LOINC Name: HbA1C HEMOGLOBIN A1C/HEMOGLOBIN.TOTAL Fasting Glucose GLUCOSE CSF/GLUCOSE PLAS Blood Gas Studies BLOOD GAS STUDIES LDL Cholesterol CHOLESTEROL.IN LDL HDL Cholesterol CHOLESTEROL.IN HDL TC:HDL-C Ratio CHOLESTEROL.IN HDL /CHOLESTEROL.TOTAL

NOTE: This LOINC name is being investigated for accuracy by NIC Support

Triglycerides TRIGLYCERIDE ACR ALBUMIN/CREATININE eGRF GLOMERULAR FILTRATION RATE CDM Flowsheet: Heart Failure: Lab Test Name NOD LOINC Name: Sodium SODIUM Potassium POTASSIUM Creatinine CREATININE eGRF GLOMERULAR FILTRATION RATE CDM Flowsheet: Hypertension: Lab Test Name NOD LOINC Name: Fasting Glucose GLUCOSE CSF/GLUCOSE PLAS ACR ALBUMIN/CREATININE eGFR GLOMERULAR FILTRATION RATE TC:HDL-C Ratio CHOLESTEROL.TOTAL/CHOLESTEROL.IN HDL

LDLC CHOLESTEROL.IN LDL Triglycerides TRIGLYCERIDE CDM Flowsheet: Asthma: Lab Test Name NOD LOINC Name: PEFR EXPIRATORY VOLUME.FORCED AT 1.0 S/VITAL

CAPACITY.FORCED CDM Flowsheet: COPD: Lab Test Name NOD LOINC Name: Oxygen Saturation % OXYGEN SATURATION



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Centre-developed Flowsheet: INR Lab Test Name NOD LOINC Name: INR COAGULATION TISSUE FACTOR INDUCED.INR

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