By Dr. Brian Levy, MD, Vice President and Chief Medical Officer with Health Language, part of Wolters Kluwer Health
With such a strong industry-wide focus on the need to meet meaningful use standards, it’s easy to forget that terminology standardization has value for a provider beyond the big-picture goals of regulatory bodies. This is certainly true in the case of LOINC®, the standardized terminology used for reporting laboratory results.
The average clinician is not even aware of LOINC during their daily workflow of ordering and reviewing labs. The LOINC coding terminology indeed allows a hospital system, for example, to qualify for meaningful use. But the three following characteristics of LOINC show that implementing the terminology will do more than just cross a meaningful use requirement off the list. LOINC can improve and benefit clinical and laboratory environments alike, beyond what is necessitated by meaningful use.
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By Dr. Brian Levy, MD, Vice President and Chief Medical Officer with Health Language, part of Wolters Kluwer Health
With such a strong industry-wide focus on the need to meet meaningful use standards, it’s easy to forget that terminology standardization has value for a provider beyond the big-picture goals of regulatory bodies. This is certainly true in the case of LOINC®, the standardized terminology used for reporting laboratory results.
The average clinician is not even aware of LOINC during their daily workflow of ordering and reviewing labs. The LOINC coding terminology indeed allows a hospital system, for example, to qualify for meaningful use. But the three following characteristics of LOINC show that implementing the terminology will do more than just cross a meaningful use requirement off the list. LOINC can improve and benefit clinical and laboratory environments alike, beyond what is necessitated by meaningful use.
LOINC has granularity – the key to interoperability
Laboratory data is often derived from many different sources in disparate laboratory settings, and can be looked at by different teams of clinicians or researchers. Most of the time today, these lab results from diverse sites are reported using the local lab code, and thus mappings of these local codes to LOINC are required to support meaningful use. Without this mapping, it would be challenging to present all of the patient’s lab tests in a consistent manner to the clinicians thus increasing the chances of ordering duplicate test or missing valuable test results.
LOINC can describe all of the pertinent information that appears in lab work, and its extreme granularity is one of its great strengths—but also one of the challenges to using it. LOINC paints a robust picture of a laboratory result, exceeding what would typically be considered necessary for a clinical interaction. For example, if a patient has undergone three blood draws at three different labs, a LOINC-encoded documentation of the results can tell a clinician the precise nature of the test done in each environment and the units used to measure the results of each test (e.g., mg/dL vs. mmol/L).
With its ability to enable caregivers at different locations and in different clinical settings to read the same lab data and use it to benefit patients, care-wise and financially, LOINC is a powerful and useful tool.
LOINC enables advanced comparative reporting and analytics
When a hospital system, ACO, or HIE has access to an expansive, thorough body of LOINC-encoded results culled from a long history of lab visits, analytics and reports can be run on that data to facilitate:
- Reporting for quality measures that require lab test results
- Submitting lab results to disease registries
- Identifying at-risk patients based on lab result trends such as elevating HbA1C levels in diabetic patients or patients who are not getting their lab tests done at all
- Research into new drugs and therapies
- Identifying patients who may not yet be marked as having certain diseases. For example, if a patient has an elevated HbA1C score, then may indeed have diabetes even if no ICD-9, ICD-10, or SNOMED codes for diabetes are attached to that patient.
This aspect of LOINC is also important for research in areas like epidemiology. Having a repository of data about an entire population in a single, interoperable language is vital for identifying trends across a population that could help show the cause of outbreaks or unearth previously undescribed drug reactions.
LOINC has synergies with other coding terminologies
CPT is primarily used to order lab tests, whereas LOINC is used to report the lab results. CPT-to-LOINC mapping enables querying whether the patient actually had the lab test that was ordered and if the right lab test was performed. Some characteristics of LOINC are already familiar to those who know SNOMED CT. Work continues to be done to map LOINC to SNOMED CT, to further enable seamless semantic interoperability.
In what ways have you seen the implementation of LOINC benefit patient care and research beyond the requirements of meaningful use?
