Introduction to LOINC® Code Mapping
Contents
1. Introduction to LOINC Code Mapping e What are they and why are they important August 26 2011 Tim Wilkins Senior Consultant Introduction to LOINC code Mapping a CONSULTING What are they and why are they important Why are LOINC Codes Important MEANINGFUL USE 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important Introduction to LOINC code Mapping a CONSULTING What are they and why are they important 8 26 2011 Current issues problems with understanding laboratory results What are LOINC codes What information is contained in a LOINC code How to get LOINC codes Uploading LOINC codes to MEDITECH Ways to map LOINC codes Tips and Pitfalls References and Acknowledgements Questions Introduction to LOINC Code Mapping What are they and why are they important Introduction to LOINC code Mapping a CONSULTING What are they and why are they important Current issues problems with understanding laboratory results Laboratories around the world use their own internal codes to identify laboratory tests and results This makes it difficult for receiving systems to fully understand the results coming from the testing facility If laboratories all used LOINC to identify their tests and results these problems would disappear e Receiving facilities would be able to fully id2. Introduction to LOINC code Mapping What are they and why are they important Ways to Map LOINC Codes RELMA Mapping Tool Battery Local Term Details Test WHITE BLOOD COUNT oo Eeke ekee i 2 Leukocytes NCne Manual COUNT secu aaa Nn LD Gn atomais COUN 2 6 62239 9 Leukocytes Ntne Pt BLD fetus On Automated co UN a 2 6 513636 Leukocytes other NCnc Pt BLD Qn Automated COUN 2 6 T29 4 Leukocytes other Ntne Pt BLD Qn Manual COUNT o 2 9 332756 9 Leukocytes corrected for nucleated erythrocytes Nne Pt BLD Qn Automated COUN el 1 3 264643 Leukocytes NCnc Pt BLD Qn o 1 4 529990 Leukocytes disintegrated Ntne Pt BLD Qn m 1 4 30406 3 Leukocytes other NCnc Pt BLD Qn LJ 1 4 20564 9 Leukocytes NCnc Pt AAN Qn Automated COUN Introduction to LOINC code Mapping a CONSULTING What are they and why are they important Ways to Map LOINC Codes RELMA Mapping Tool e Continue this process until all tests have been mapped e Once mapped the information can be exported back into a text file Ext Local Terris E a e Once the terms have been exported back into a text file they can be scripted back into MEDITECH using a scripting tool Boston Workstation Summit 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important Introduction to LOINC code Mapping What are they and why are they important Tips and Pitf
3. Code Entry Routine e All Lab Tests will appear in a spreadsheet format Enter LOINC codes for each test directly in the spreadsheet e Accessing each test one by one in the Test Dictionary will not be necessary e All LOINC codes are entered using the spreadsheet will flow directly to the appropriate test e The spreadsheet will track what has and has not been mapped e A utility is available to move mapped tests from TEST directly into LIVE This method is only usable by systems at a level to meet Meaningful Use e C S 5 64 SR21 e MAGIC 5 64 SR6 e 6 x will be available soon Unfortunately I do not have any screen shots of this process 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important Introduction to LOINC code Mapping a CONSULTING What are they and why are they important Ways to Map LOINC Codes RELMA Mapping Tool Regenstrief LOINC Mapping Assistant Can be downloaded free of charge from the LOINC website Can be downloaded as a package with the LOINC codes My preferred method for mapping LOINC codes Works in conjunction with LOINC to facilitate mapping LOINC codes Much like MEDITECH s LOINC Code Entry Routine Once tests are loaded into the program the tool will create a ranked list of appropriate codes for the test After all tests have been mapped they can be loaded back into MEDITECH using a scripting tool Will work for both C S and
4. MEAN CORPUSCULAR VOLUME MEAN CORPUSCULAR HEMOGLOBIN MEAN CORPUSCULAR HGB CONC RED CELL DISTRIBUTION WIDTH PLATELET COUNT MEAN PLATELET VOLUME LYMPH AUTO MONO AUTO GRANULOCYTE AUTO rect oT oe Paes os tor Case sensitive Import Import Terms Exi C Users Tim Wilkins Desktop TEST TAT c r Introduction to LOINC code Mapping a CONSULTING What are they and why are they important Ways to Map LOINC Codes RELMA Mapping Tool e Once the terms are important the program will look for any unrecognized terms 4 These could be special characters amp or 2 Could also be unique letter combinations that aren t understandable e The program will allow the user give definitions to any unknown terms e Once these have been resolved the mapping can begin 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important Introduction to LOINC code Mapping ye im SantaRosa What are they and why are they important ONS ULTING Ways to Map LOINC Codes RELMA Mapping Tool e Mapping Local Terms e Start off by using the Lab Auto Mapper Function at the top of the page i Map Local Terms loinc test Part Search 3 bo Name D EE OBR 4 Code OBX 3 Code Units Sample Values Limit to Default Specimen ae ae l Etra Search Words Accept or enter OBR name and or OBX name WHITE BLOOD COUNT View Clear Input
5. BBK will not be able to be mapped However these are not reported and would not appear in an HL7 message Reena e errr errr errr ere eee creer reer eee e reer erence eer ee ee eee 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important 32 Introduction to LOINC code Mapping CONSULTING What are they and why are they important References All of the information presented was gathered from information from the following sources e LOINC website www loinc org e LOINC online user s manual e RELMA online user s manual e MEDITECH Knowledge Base Articles 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important 33 Introduction to LOINC code Mapping ne CONSULTING What are they and why are they important Acknowledgements A Special Thank You to Onslow Memorial Hospital in Jacksonville NC for allowing us to utilize screen shots from their facility OnsloW sora HOSPITAL Where People Care www onslow org Thanks again to Hope Daugherty LIS Specialist Mike House ClO Introduction to LOINC code Mapping a CONSULTING What are they and why are they important Questions 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important Introduction to LOINC code Mapping CONSULTING What are they and why are they important If you have further questio
6. MAGIC platforms that can utilize LOINC coding 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important 19 Introduction to LOINC code Mapping a What are they and why are they important Ways to Map LOINC Codes RELMA Mapping Tool P RE iA ad Fie Tool HIPAA Loabdwto Mapper Hoel welome b RELMA the Regenstrief LOINC Mapping assistant p f Search LOINC a Propose New LOINC Term A Map Local Terms te LOINC Y g Panel Forms amp Surveys import Local Terms A View Add Edit Local Terms pe Export Local Terms Report Local Tenma User Preferences J Exit Program Copynght 1725 30 1 Regenstnef cpta AD nights recerved DPE SOL IOS ikem bo RELHA drr A r Dore Eas help Cc Alte Dell 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important Introduction to LOINC code Mapping What are they and why are they important Ways to Map LOINC Codes RELMA Mapping Tool e The first step is to import local test codes into the tool e The easiest way to do this is with a simple pipe delimited NPR report that pulls out 2 The test mnemonic 2 The test description 2 The test s unit of measurement 2 A place holder for the LOINC code e The report does not have to be pretty MNEMONIC DESCRIPTION MEASUREMENT LOINC EOS EOSINOPHIL MANUAL DIFF M
7. and other clinical observations Neen e errr errr errr reece reer cerca errr e renee eee eee eee ee 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important 6 Introduction to LOINC code Mapping ae CONSULTING What are they and why are they important What information is contained in a LOINC code Analyte Component Mind of property of observation or measurement Sodium SCnc Pt Ser Plas Qn Sodium SCnc Pt Urine Qn Sodium SRat 24H Urine Qn Neen r reer errr rere eee reer ee errr ee eee ee eee ee ee 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important 7 Introduction to LOINC code Mapping a What are they and why are they important rc z 0 What information is contained in a LOINC code Analyte Component e Can be divided into three subparts 2 Principle Name 2 Challenge time delay amount administered route 2 Any standardization or adjustments adjust result to temperature pH Kind of property of observation or measurement e Distinguishes between different types of quantities for the same substance 4 Determine differences in mass or substance molar concentrations 4 Absolute counts versus percent counts for cell counts e Mass Substance Catalytic Activity Arbitrary and Number Time Aspect e Point or moment in time versus a time interval Reena reer rere reer reer eer reece errr eee rere rere ee errr ee
8. ee 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important 8 Introduction to LOINC code Mapping a CONSULTING What are they and why are they important What information is contained in a LOINC code System e Distinguish between blood urine serum plasma body fluid CSF etc Scale e Quantitative exact number e g 4 5 e Ordinal categorical response e g 1 positive reactive Narrative free text responses gram stain culture results Method e Used to distinguish between two different methodologies for the same analyte e Not usually used in common chemistry coagulation or hematology procedures 2a EIA vs IF vs IB Neen reer rere errr rere erence reer reece ee reer eee re eee eee ee ee 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important 9 Introduction to LOINC code Mapping CONSULTING What are they and why are they important How to get LOINC codes The LOINC code database can be downloaded free of charge from the LOINC website e www loinc org For MEDITECH users the ASCII Text format needs to be downloaded User Guides and other documentation can also be downloaded from the website Online training is available Neen errr rere errr reer reer ere eee ee reer rere reer reer eee eee ee eee 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important
9. 10 Introduction to LOINC code Mapping Santa What are they and why are they important r z 0 Logical Obse noatia you are here home Navigation Downloads OIN Learn LOINC amp Get Involved Background Forum C FAQ WebSearch Users Guide Online Training Download LOINC EEE Meetings E k s Email List Directory of Adopters Submissions International Screenshot from www LOINC org 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important Introduction to LOINC code Mapping ae CONSULTING What are they and why are they important Uploading LOINC codes to MEDITECH Once the LOINC database has been downloaded from the LOINC website they must be uploaded to MEDITECH for mapping Unzip the LOINC file so the LOINCDB text is available Load the text file using the LOINC Dictionary Routine LOINC234 LOINCDB Introduction to LOINC code Mapping What are they and why are they important Uploading LOINC codes to MEDITECH Test HCIS TEST 6 05 WILKINS TIM EDT HIM Dept OMO Facility OMO aging and Therapeutic Services boratory armacy Derating Room Management lv vw v Desktops Requisitions Specimen Collections Specimen Edits Laboratory Microbiology Blood Bank Pathology Inquiry Patient Reports Admissions EMR Labora
10. BIL BILIRUBIN TOTAL MG DL Neen err errr errr reer erence reer reece reer rece eee ee eee eee ee Introduction to LOINC Code Mapping What are they and why are they important 21 8 26 2011 Introduction to LOINC code Mapping ae CONSULTING What are they and why are they important Ways to Map LOINC Codes RELMA Mapping Tool e Import Local Terms i EE import Local Terms A 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important 22 Introduction to LOINC code Mapping What are they and why are they important Ways to Map LOINC Codes RELMA Mapping Tool Import Local Terms GB pot Loca Terms oD Fe Name ofLocal Term File eS r Default Lab Section Choose the delimiter that separates your fields F Tab F Fe Semicolon S Comma Space First Row Contains Column Heades ou may create anewlabsection by typing a name inthe box E Other Tetouan C To assign acolumn of data to one ofthe fields clickon the second headerrow ofthe grid clickon the arrow to the right ofthedrop down list andselectthe field into which you desire your datato be imported TestCode and Test Description are required fidds r TEST DESCRIPTION UNIT OF MEASURE LOINC Sa iz Ignore Field Ignore Field Ignore Field Ignore Field Ignore Field TRANSFUSED WHITE BLOOD COUNT WEC CORRECTED RED BLOOD COUNT HEMOGLOBIN HEMATOCRIT
11. alls Tips e Once the TEST database has been mapped there is no need to start over from scratch with the LIVE database 2 Use the Exported file from the TEST database and use it for scripting back into the LIVE Database 2 May not be exact but should only have a few holes that will need to be mapped 4 Run the NPR reports again and import back into RELMA to begin mapping e Remember LOINC codes for the Microbiology Antibiotics will have to be mapped once for MIC codes and again for KB codes e Sometimes it is better to give a more general code for esoteric tests as reference lab methods may change without notice 2 IB vs EIA vs IF Reena errr eee r rere e reer eee ee reer rere eer eee ee ree er 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important 31 Introduction to LOINC code Mapping What are they and why are they important Tips and Pitfalls Pitfalls Much of the Microbiology Procedure and Organism Dictionaries cannot be mapped to an exact code Only organism specific tests Legionella Shigella etc and stains can be mapped Others will have to be mapped as aerobic anaerobic fungal or AFB cultures Most of the organisms are not in the LOINC database O O O DO Again these will have to be mapped as aerobic anaerobic AFB or Fungal organism identified e Any tests that are used for internal use only Sent to State Lab will not be able to be mapped Check Cells in
12. entify understand and file lab results from other facilities e Government agencies such as state health departments would be able to pool and track results that may have an effect on the community 2 MRSA VRE HIV Hepatitis etc Reena errr errr rere errr rere nee erence reer reer reece cece rece ee er ee eee 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important 4 Introduction to LOINC code Mapping a CONSULTING What are they and why are they important What are LOINC codes L aboratory s Logical Old and Observation inconsiderate Identifiers Naming of Names and Chemistry _ Codes Neen r rere reer errr reer een reer reer reer eee eee eee ee 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important 5 Introduction to LOINC code Mapping a CONSULTING What are they and why are they important What are LOINC codes LOINC was initiated in 1994 by the Regenstrief Institute and developed by Regenstrief and the LOINC committee as a response to the demand for electronic movement of clinical data The laboratory portion of the LOINC database categories for e Chemistry e Hematology e Serology e Microbiology e Toxicology Categories for drugs cell counts and antibiotic susceptibilities are also available There is also a clinical portion for vital signs intake output EKG
13. ns MEDITECH Tim Wilkins Senior Consultant 936 537 1053 timwilkins santarosaconsulting com Santa Rosa Consulting a MEDITECH approved vendor for Advanced Clinical Consulting htto www meditech com AdvancedClinicalResources pages cons ultant htm htto www santarosaconsulting com Healthcare IlT Meditech Services aSpx 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important
14. s to begin the real fun j Lab Auto Mapper LAM This process scans the Local Term File using a recommendation engine to propose probable LOINC terms Once completed you may use the probable list to easily map your terms via the Choose From screen to LOINC codes Warning This function is optimized for processing of lab terms Using this function on other ty may produce unexpected results The statistical data used by this function is based ona U Process only unmapped local terms Maximum number of clase LOINC term matches to return 10 Prefer Common Tests This may be a lengthy process please be patent OBR 4 Battery Code Description OBX 3 Test Code BASO Description BASOPHILS AUTO DIFF Finished processing local term file Process took 0 37 minutes to complete loinc test 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important Introduction to LOINC code Mapping What are they and why are they important rc z 0 Ways to Map LOINC Codes RELMA Mapping Tool e To map the test select the best result that matches the test in question 2 Be sure to look closely to select the correct o Property o Scale o Method o Time o System 4 Not every test will match perfectly 2 Will have to generalize at times if there is not an exact match 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important 28
15. s Clear Most Limits Common tests 99 Stile Lookup Term By Introduction to LOINC code Mapping samanvsa NSULTING What are they and why are they important Ways to Map LOINC Codes e RELMA Mapping Tool e Select the Process function will look at each term individually to see if there is an appropriate LOINC code i Lab Auto Mapper LAM This process scans the Local Term File using a recommendation engine to propose probable LOINC terms Once completed you may use the probable listto easily map your terms via the Choose From screen to LOINC codes Warning This function is optimized for processing of lab i s Using this function on other types of codes may produce unexpected results The statistical data by this function is based ona US sample Process only unmapped local tems Maximum number of cla ING term matches to return 10 Prefer Common Tests This may be a lengthy process please be patent OBR 4 Battery Code Description OBA 3 Test Code BASO Description BASOPHIL g Process Terms Map to Results Finished processing local term file Process took 0 37 minutes to complete loinc test 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important Introduction to LOINC code Mapping a CONSULTING What are they and why are they important Ways to Map LOINC Codes RELMA Mapping Tool e When processing is complete e Select Map to Result
16. to search for the appropriate LOINC code Save the dictionary entry With over 2000 tests in the dictionaries this will be very time consuming 8 26 2011 Introduction to LOINC Code Mapping What are they and why are they important Introduction to LOINC code Mapping ne CONSULTING What are they and why are they important Ways to Map LOINC Codes One by one Method Introduction to LOINC code Mapping What are they and why are they important Ways to Map LOINC Codes One by one Method Enter Edit LAB Test Dictionary Test TIM WILKINS K POTASSIUM Print Number 400 0300 MIS LOINC Term Lookup Search POTASSI Name POTASSIUM RBC SCNC POTASSIUM SAL SCNC POTASSIUM SERPL MCNC Number 2824 1 2825 8 22760 3 42569 4 POTASSIUM SERPL MSCNC POT CNC POTASSIUM SP2 SERPL SCNC POTASSIUM SP3 SERPL SCNC POTASSIUM STL SCNC POTASSIUM STL SCNT POTASSIUM SWEAT SCNC POTASSIUM TISS MCNT POTASSIUM TPN SCNC POTASSIUM UR SCNC POTASSIUM VITF SCNC POTASSIUM WAT MCNC POTASSIUM XXX SCNC POTASSIUM CREAT 24H UR MRTO POTASSIUM CREAT 24H UR RTO POTASSIUM CREAT 24H UR SRTO 14172 1 12812 4 12813 2 15202 5 25506 7 2827 4 59733 6 30549 0 2828 2 12814 0 9482 1 32336 0 13798 4 56971 5 56143 1 Cancel X c Introduction to LOINC code Mapping a CONSULTING What are they and why are they important Ways to Map LOINC Codes MEDITECH LOINC
17. tory System Operations Dictionaries BBK A M PTH L Zz Report gt gt b gt gt gt gt A 08 04 11 22 12 EDT Access Bar Code Set Bill Code Canned Text Client Collection Category Container Custom Parameters Data Fields List Defaults Desktop Preferences Device Dictionary Audit List Form Label Format Label Printer Lab Site _LOINC Term vv v vvvv v Load __ Frequent b e Enter Edit Back List Home ey By View ul Introduction to LOINC code Mapping What are they and why are they important Uploading LOINC codes to MEDITECH Load MIS LOINC Text File Test TIM WILKINS The LOINC database may be downloaded for free from this web site as of May 2006 gt gt http www regenstrief org loinc download lt lt The tab delimited text file ASCII is the one that must be downloaded gt gt LOINC Version 2 16 ASCII 2 8M lt lt There may be a newer version Note that you must UNZIP the zip file to create the text file for loading e g LOINCDB TXT Continue i E Filename c o rm Introduction to LOINC code Mapping a CONSULTING What are they and why are they important Ways to Map LOINC Codes One by one Method Must enter each test in the dictionary Find the default LOINC code field If LOINC code is known it can be manually entered or A F9 look up can be performed
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