Logical Observations, Identifiers, Names and Codes (LOINC) Presented by Park Hyeungkeun

Transcription

1 Logical Observations, Identifiers, Names and Codes (LOINC) Presented by Park Hyeungkeun 1

2 What will we cover today? LOINC structure and strategy Who is using LOINC Installing and Running RELMA Loading a Local Observation File (LMOF) Preparing LMOF for Mapping Mapping Local Terms to LOINC Features, functions and fun stuff in RELMA 2

3 What is LOINC? Set of universal names and ID codes for identifying laboratory and clinical observations. facilitates the exchange and pooling of clinical and laboratory results supports clinical care, outcomes management, and research intended to identify the observation, not the value 3

4 Brief Background on LOINC Logical Observation Identifier Names and Codes Organized by Clement McDonald, 1994 Supported by Regenstrief Institute and NLM Create a universal language for observation identifiers Laboratory observations were created first Began creating clinical observations in 1996 Free download from Regenstrief web site 4

5 Important facts LOINC is a standard coding system for laboratory and clinical observations 5

6 Two LOINC committees Laboratory LOINC Clement J. McDonald, Chair All aspects of tests/measurements done on specimens Chemistry, Hematology, Microbiology, Histology, Cytology, etc. Clinical LOINC Stanley M. Huff, Chair All aspects of tests/measurements on a patient Vital signs, Hemodynamic measurements, Physical findings, ECG, Radiology, Ultrasound, etc. Both committees meet at least 3 times each year An annual open public meeting for each committee 6

7 Laboratory LOINC Subject Areas Chemistry Urinalysis Toxicology Hematology Microbiology Antibiotic Susceptibilties Immunology/Serology Molecular Genetics Serology Cell counts Allergy testing Blood Bank Cell Markers Skin tests Coagulation Cytology Fertility Testing HLA antigens Microbiology Sugical Pathology 7

8 Clinical LOINC Subject Areas Vital Signs Hemodynamics Fluid Intake/Output Body Measurements Operative Notes Emergency Department Respiratory Therapy Document sections Standard survey instruments EKG (ECG) Cardiac Ultrasound Obstetrical Ultrasound Discharge Summary History & Physical Pathology Findings Colonoscopy/Endoscopy Radiology reports Clinical Documents Tumor Registry 8

9 LOINC users: International Australia Brazil Estonia Germany - adopted by DIN language translation Netherlands New Zealand Ontario & British Columbia, Province-wide Korea Hong Kong Health Authority ( 95% of hospitalizations Switzerland s laboratory quality assurance project (CUMUL) 3 languages 9

10 Objective of LOINC To provide a universal identifier for laboratory and clinical observations Information about observations in electronic messages can be pooled in electronic medical record systems and research and management databases. Specifically - to provide a universal ID for the OBX field 3 (Observation ID) in HL7 v2.x messages (or the Observation.code value for Version 3). 10

11 What is the LOINC database? Database of >34,000 observation terms Six part formal name Unique code with check digit Mapping/browsing program (RELMA) Copyrighted, but no cost for any purpose Available on internet: /6/98

12 Test comparisons This is what you see in the order list Lab A Test Name: Lyme Disease Serology Measures: B. burgdorferi Ab IgG Method: ELISA Scale: quantitative e.g.: Titer 1:40 Lab B Test Name: Lyme Disease Antibody Measures: B. burgdorferi Ab IgM Method: Immune blot Scale: qualitative e.g.: Positive LOINC Code = LOINC Code =

13 Current use of local code Lab Test Result Site 1 Site 2 Site 3 Anti-HBs Hep B Surface Ag Serology Hepatitis B Antibody- IgG 1:20 1:20 1:20 13

14 Using LOINC Codes Lab Test LOINC Result Site 1 Anti-HBs Hepatitis B Virus Surface AB 1:20 Site 2 Hep B Surface Ag Serology Hepatitis B Virus Surface AB 1:20 Site 3 Hepatitis B Antibody- IgG Hepatitis B Virus Surface AB 1:20 14

15 LOINC in an HL7 OBX segment A code that identifies the datatype as a coded element The code is from LOINC The code is from SNOMED OBX CE 883-9^Blood Group^LN F-D1250^Group O^SMI A code that identifies the data in OBX-5 (ABO Blood Group) OBX-5: Data A code for Group O 15

16 Anatomy of a LOINC Term Code : Component : Property : Timing : Sample : Scale : Method LOINC Code; sequential number plus check digit HEPATITIS B SURFACE AB:ACNC:PT:SER:QN:EIA Component Property Timing Sample Method Scale 16

17 What is NOT part of a LOINC Name? The instrument used in testing Specific details about the specimen Priority (e.g. STAT) Where testing was done Who did the test Test interpretation Anything that is not an intrinsic part of the name of the result Other things that are carried in the OBX segment 17

18 LOINC Codes Assigned Sequentially Check Digit appended (mod10 method) Never reassigned Obsolete or duplicate terms are retired 18

19 Summary of the six primary axes (laboratory) Component Sodium, glucose, red blood cell, ribosomal RNA Kind of property Concentration (mass, substance, number, catalytic) Timing Point in time, 12 hour average, maximum in 8 hours System Serum, plasma, whole blood, urine, stool Scale Quantitative, ordinal, nominal (coded), narrative Method Immune diffusion, latex agglutination, MIC, MBC 19

20 Examples from laboratory LOINC Code Component Prop TIME System Scale Method SODIUM SCNC PT SER/PLAS QN SODIUM SCNC PT UR QN GLUCOSE SCNC PT SER/PLAS QN GLUCOSE SCNC PT UR QN HGB MCNC PT BLDA QN HGB MCNC PT BLDV QN HGB MCNC PT BLDC QN FACTOR VIII ACT ACNC PT PPP QN FACTOR VIII AG ACNC PT PPP QN 20

21 Summary of the six primary axes (clinical) Component heart beats, cardiac output, circumference Kind of property Angle, area, length, mass, pressure, temperature Timing Point in time, study minimum, maximum in 8 hours System Head of fetus, tricuspid valve, ventilator setting Scale Quantitative, ordinal, nominal (coded), narrative Method Stated, measured, estimated, ultrasound 21

22 Examples from clinical LOINC Code Component Prop TIME System Scale Method BODY HGHT LEN PT ^PATIENT QN BODY SURF AREA PT ^PATIENT QN DERIVED BODY TEMP TEMP PT MOUTH QN Q WAVE DPT ELPOT PT HEART QN EKG QRS AXIS ANGLE PT HEART QN EKG PUPIL DIA LEN PT EYE.RIGHT QN AUTO AGE TIME PT ^PATIENT QN EST AGE TIME PT ^PATIENT QN REPORT CAPACITY.VITAL VOL PT RESP SYS QN BREATHS NRAT PT RESP SYS QN GENDER FIND PT ^FETUS NOM US 22

23 LOINC Timing The interval of time over which the observation or measurement was made*. PT - at a point in time 12H - a twelve hour collection 24H - a twenty four hour collection 23

24 QN - quantitative LOINC Scale Continuous numeric (real, integer, ratio) Optional operator (>,,, <) ORD - ordinal a ranked set of possible values (1+, 2+, 3+) NOM - nominal an unranked collection of possible values a taxonomy (e.g list of bacteria) NAR - narrative free text narrative (e.g., visit note) 24