2013 10 11 - LOINC Introduction and relevance to eHealth Standards

7/27/2019 2013 10 11 - LOINC Introduction and relevance to eHealth Standards

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[email protected]

Evoluzione e interoperabilit tecnologica del Fascicolo Sanitario Elettronico

Sorrento, Italy

a universal catalog of laboratoryand clinical observations
mailto:[email protected]:[email protected]:[email protected]


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Strong evidence that

smart EHRs can improvehealthcare qualityand

efficiency

I can help!

Chaudhry B, Wang J, Wu S, et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med

2006;144.


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Patients move

fasterand furtherthan their health

information


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Fundamental challenge:

Local systems have different ways ofidentifying the same concept.

And, things that appear to be the

same really are not.


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Same or Different?

Lab ATest Name: Lyme Disease Serology

Lab BTest Name:Lyme Disease Antibody

What you see in the test catalog


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Same or Different?

Lab ATest Name: Lyme Disease Serology

Measures: B. burgdorferi Ab IgG

Method: ELISA

Scale: quantitative

e.g.: Titer 1:40

Lab BTest Name:Lyme Disease Antibody

Measures:B. burgdorferi Ab IgM

Method: Immune blot

Scale: qualitative

e.g.: Positive

What you see in the test catalog


7/34photo via pfarrell95
http://www.flickr.com/photos/65005341@N03/http://www.flickr.com/photos/65005341@N03/http://www.flickr.com/photos/65005341@N03/


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ogical

bservation

dentifiers

ames and

odesA universal code system that facilitates exchange,

pooling, and processing of results


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MEASUREMENTS

US

R

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


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Born in 1994 by Regenstrief Institute.

Worldwide distribution at no cost.

Copyrighted, but open license.

Released twice per year.


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Its free, but invaluable.


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Its free, but invaluable.

Just dont use it to make another standard!


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

4/24/

1995

|1.0

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/199

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/199

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2)

12/3/1

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3)

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10/9/

1997

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1999

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2/19/2

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12/21/

2006

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6/21/

2007

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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

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2011

|2.3

8

6/30/

2012

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0

12/30/

2012

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2

06/29/

2013

|2.4

4

LOINC Codes

Only Lab LOINC Codes

LOINC Codes Over Time by Release

laboratory terms onlynot a lab cliff, just no data available


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Data standards are like telephones.

They require a critical mass of users

before they become useful.

photo via iboy_daniel

- Clem McDonald, MD 1998
http://www.flickr.com/photos/iboy_daniel/http://www.flickr.com/photos/iboy_daniel/


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26,000+ users in 156 countries


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0

5,000

10,000

15,000

20,000

25,000

6/1/0

8

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6/1/1

0

12/1/1

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loinc.org members


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0

5,000

10,000

15,000

20,000

25,000

6/1/0

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loinc.org members

18 new members per day

550 new members per month

Doubled in 19 months!


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LOINC Translators

22 organizations.

Currently translations into 17 variants of 11 languages


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Vreeman DJ et al. Enabling international adoption of LOINC through translation. J Biomed Inform 2012 Aug;45(4):667-73.

doi: 10.1016/j.jbi.2012.01.005. Epub 2012 Jan 21. PubMed PMID: 22285984
http://www.ncbi.nlm.nih.gov/pubmed/22285984http://www.ncbi.nlm.nih.gov/pubmed/22285984http://www.ncbi.nlm.nih.gov/pubmed/22285984


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Vreeman DJ et al. Enabling international adoption of LOINC through translation. J Biomed Inform 2012 Aug;45(4):667-73.

doi: 10.1016/j.jbi.2012.01.005. Epub 2012 Jan 21. PubMed PMID: 22285984
http://www.ncbi.nlm.nih.gov/pubmed/22285984http://www.ncbi.nlm.nih.gov/pubmed/22285984http://www.ncbi.nlm.nih.gov/pubmed/22285984


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Adopted as National Standard

AustraliaAustria

Belgium

Brazil

Canada

Cyprus

Estonia

Finland

France

Germany

Iceland

Mexico

MongoliaThe Netherlands

New Zealand

Philippines

Portugal

Rwanda

Slovakia

Slovenia

Spain

Thailand

Turkey

United States


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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.


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progressive requirements for data standards


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L b ti t EHR


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Lab reporting to EHRs


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U i Q lit M


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Use in Quality Measures


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LOINC Adopted ForPatient Characteristics[Non-lab] Diagnostics studies

Patient experience

Family history

Functional status

Health record component

Interventions (that produce an assessment or measured results)

Laboratory testsPhysical exam

Patient preference

Risk evaluation

System resources (healthcare resources)


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An Example Quality Measure

National Committee for Quality Assurance

Diabetes: Hemoglobin A1c

Poor Control

Percentage of patients 18-75 years of age with diabetes who had

hemoglobin A1c > 9.0% during the measurement period.


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Find HbA1c in the EHR with LOINC


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2013 10 11 - LOINC Introduction and relevance to eHealth Standards

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