Standards enable interoperability

Health data needs to be portable. It needs to be structured so it can be exchanged between systems and used effectively. This concept is called interoperability. Standards allow for health data to be identified and exchanged through common means.

LOINC is an internationally recognized standard, one of several systems used to identify health data. LOINC is a database of identifiers for lab tests, vital signs, clinical documents, and other health information. Once data is identified with unique LOINC codes it can be exchanged with full understanding between disparate computer networks.

LOINC's important role

LOINC codes can be thought of as the "question" for a test or measurement. Using this analogy, the question could be "What is the patient's cholesterol level?" or "Does the patient smoke?" Each LOINC term carries enough detail to be meaningful and distinguish it from others. LOINC codes are used in conjunction with other data standards (such as SNOMED CT® for non-quantitative "answers") and then transferred between systems using messaging and resource standards like HL7® FHIR® and HL7® Version 2.

Responding to global needs at a critical time

Google is where much of the world goes for information. LOINC's rise in Google search results during 2020 highlights the influence of LOINC's response to the pandemic and provision of answers to emerging needs for information. The following graph shows the total number of times LOINC appeared in users' Google search results by week. Increased searches related to LOINC corresponded to significant events in the year.

New terms created in response to COVID-19 were only a fraction of the LOINC clinical terminology developers' work in 2020. The team gave top priority to requests related to SARS-CoV-2, often creating new terms in a matter of a few days, while at the same time processing a large volume of requests for new LOINC codes unrelated to the pandemic.

LOINC received a record number of term requests in 2020. A total of 514 requests representing 5,568 potential LOINC terms were received, an increase of 40% over 2019 and nearly double the 2018 total. Following a principle of transparency, all codes in development are detailed on the website. LOINC publishes detailed statistics about submissions including median turnaround time.

Each request—including those given high priority—goes through rigorous quality assurance review. Some requests require review by the LOINC Committee and/or subject domain experts. This thorough development ensures a high level of quality.

LOINC's clinical terminology developers also made adjustments to existing terms. Some of these changes involve the Component or another of the six primary LOINC Parts. Most changes involve updates to secondary fields, such as the Long and Short names and term descriptions. LOINC's overarching policy allows a term to be modified as long as it does not change the meaning of the concept. No terms are ever deleted from the LOINC table. A total of 440 status changes and 10,626 term edits were made in 2020.

Total terms in LOINC database

Ancillary content

In addition to LOINC terms, Regenstrief Institute publishes other content related to the primary database. Ancillary content serves numerous purposes including aiding the adoption of LOINC and supporting research. These accessory files can be downloaded à la carte from the LOINC website or as part of the complete LOINC package.

Changes to accessory files

The LOINC Part File had its LoincPartLink.csv file split into primary and supplementary files. Detailed information regarding these files is available as a LOINC Knowledge Base article.

LOINC continues to evolve other release artifacts. Feedback is requested promote production maturity. The Change Snapshot file, Consumer Name file, Group file, and Multiaxial Hierarchy file are in need of user input.

SearchLOINC and RELMA®

The inherent granularity of LOINC can make finding an appropriate term challenging. The web-based SearchLOINC application addresses this through a robust search syntax.

In December 2020, LOINC released a public Beta of its next-generation SearchLOINC application. This redesigned tool, available in tandem with the existing version, provides a more user-friendly interface for LOINC users while also allowing discovery of LOINC Parts, Groups, and Answer Lists.

RELMA is a free Windows application also allowing sophisticated searching and aiding users in mapping local terms to LOINC codes.

FHIR Terminology Service

The HL7® FHIR® standard provides a common API for sharing resources. LOINC leverages this platform to make available its terminology via programmatic means.

In 2020, LOINC created several Groups and value sets of terms for not only detection of SARS-CoV-2 but also for public health case reporting.

The LOINC team is a finely-tuned collection of clinical terminology developers, software and systems engineers, and project management staff. Each member brings unique talents and skills to a unified mission.

A truly international standard

LOINC is in nearly every country around the world and has been adopted as a national standard in more than a dozen countries.

LOINC surpassed 100,000 registered users in 2020. The countries highlighted in blue on the map indicate those with at least one LOINC registered user.

Translations enable adoption of LOINC

LOINC views the translation of terms into multiple language as the key to international adoption. LOINC takes a novel approach to this monumental feat. Rather than translating each term in its entirety, volunteers translate the unique pieces ("Parts") that make up LOINC terms. These atomic pieces are then compiled to create a full LOINC name for each term.

LOINC is indebted to its global network of volunteer translators. The standard has been translated from the original English into 15 linguistic variants. Additional translations are always welcomed.

LOINC participates in several collectives of organizations with a common goal of data interoperability. In 2020, LOINC was invited to join the Joint Initiative Council (JIC). This group of nine standards development organizations (SDOs) transcend national boundaries to work collaboratively to provide global, coordinated—not competitive—standards that address real-world healthcare issues. JIC published a white paper explaining how the nine SDOs work together to transform the global healthcare system.

Other ways to interact and receive information include the LOINC mailing list, Twitter, LinkedIn, and User Forum.

The LOINC Team had been accustomed to holding in-person conferences twice annually. Restrictions on travel and in-person events drastically altered this course. The LOINC Conference scheduled for March in Indianapolis had to be scrapped. In its place a special virtual meeting was held on March 26 to distribute information and answer questions regarding the use of LOINC in SARS-CoV-2/COVID-19 lab tests. This three-hour webinar included guests from the Association of Public Health Laboratories (APHL), The Office of the National Coordinator for Health Information Technology (ONC), SNOMED International, and Intermountain Healthcare.

In lieu of a typical LOINC Conference held outside the U.S., the team put together its first virtual LOINC Conference. The result was beyond expectations. Participants from 40 countries joined, dwarfing the draw of previous conferences. The four-day schedule preserved many hallmarks of LOINC's in-person conferences including the keynote address known as the Clem McDonald Lecture, educational workshops, presentations from LOINC community members, and the Laboratory and Clinical LOINC Committee meetings.

LOINC Webinar for SARS-CoV-2/COVID-19

This three-hour webinar was held on March 26, 2020. Nearly 700 individuals signed up to attend the event.

Watch Recording