LOINC Conference Spring 2019 Clinical

February 19-20, 2019
Intermountain Healthcare WTC Utah, Salt Lake City

Workshop & Presentation Schedule

TUESDAY, FEBRUARY 19, 2019

Streaming videos and slide downloads for each session will be made available to workshop registrants after the event.

8:30

Registration

Please arrive early to pick up your registration packet. Full continental breakfast will be provided.

9:00

Plenary

Welcome to LOINC

  • Daniel Vreeman, PT, DPT, MS
    Regenstrief Institute

An overview and welcome to our new event format, the LOINC community, the standard, and how it's being used around the world.

9:30

Your
Choice

LOINC for Beginners

  • Stan Huff, MD
    Intermountain Healthcare, University of Utah

LOINC is the universal standard for identifying health measurements, observations, and documents. It is now ubiquitous in health data systems worldwide, and is an essential ingredient of system interoperability. This tutorial presents an overview of LOINC and its use around the world, discusses the LOINC concept model and data structures, and describes the resources available for implementing LOINC. If you are new(ish) to LOINC, this session should be your starting point.

Clinical Documents in LOINC

  • Swapna Abhyankar, MD
    Regenstrief Institute

This session provides a detailed introduction to LOINC content for health-related documents. We'll cover the purpose and development of the detailed concept model for clinical document titles known as the LOINC Document Ontology. We will explore how you can make use of these terms in your IT systems, the lessons others have gleaned from implementing, and future directions for this ever-evolving content area.

10:45

Break

Refreshments will be available outside the meeting room.

11:00

Your
Choice

RELMA Part 1

  • Daniel Vreeman, PT, DPT, MS
    Regenstrief Institute

RELMA is the gold standard tool for mapping your local observation codes to LOINC. In Part 1, we’ll cover a high level roadmap of mapping with RELMA, how to setup and load your local terms into RELMA, and keys for mapping success with RELMA.

LOINC: A Clinician's Perspective

  • Susan Matney, PhD, RNC-OB, FAAN, FACMI, FHIMSS
    Intermountain Healthcare
  • Lisa Anderson, MS, RN-BC
    The Joint Commission

Learn how LOINC is used to document different parts of the clinical process including assessments and outcomes. and how LOINC is used for continual data use including quality measures, eMeasures, registries, and research.

12:15

Lunch

Catered lunch including vegetarian options to be provided outside the meeting room.

1:00

Plenary

Creation of a Core Set of Standard Radiology Procedures

  • Sarah Maulden, MD, MS
    Department of Veterans Affairs

Standard value sets are critical infrastructure for effective management of electronic health data. VA recognized an unmet need for standard Radiology procedure terms suitable both for clinical display and for computable data exchange. We created a standards-based Core Value Set for Radiology Procedures intended to meet various needs: clinical display of report names with links to reimbursement codes, research, utilization review, quality improvement, patient safety, and data exchange/interoperability.

VA analysts extracted non-standard data containing all radiologic imaging procedures recorded across the VA for 3 years (January 2014-January 2017). After de-duplication and analysis, the top 90% of procedures by frequency for each modality (X-ray, CT, MRI, etc) were identified. We then used formal methodology to create standard Radiology Procedure Names suitable for clinical display and mapped them to Current Procedural Terminology (CPT®) and (LOINC). The recent completion of a collaborative effort between LOINC and Radiologic Society of North America (RSNA) was crucial to the success of this endeavor as it harmonizes RadLex™ Playbook and LOINC and establishes LOINC as the standard for Radiology procedure terminology going forward.

This Core Radiology Value Set may be of interest to the wider community for several reasons: it was developed from a large data set spanning the US; it is based on current standards relevant to Radiology procedure coding (CPT®, RadLex™, and LOINC); it can be made publicly available; and it has the potential to promote greater interoperability through wider adoption. Potential limitations are relative underrepresentation of OB/GYN and pediatric procedures, and the maintenance burden imposed by the need to maintain mappings to both LOINC (for clinical and interoperability purposes) and CPT® (for reimbursement).

1:45

Break

Refreshments will be available outside the meeting room.

2:00

Your
Choice

RELMA Part 2

  • Daniel Vreeman, PT, DPT, MS
    Regenstrief Institute

In Part 2 of mapping with RELMA series, we’ll dive deep into how to optimize the mapping process with RELMA, become a search syntax ninja, and how to set yourself up for success in the long run.

Panels and Forms

  • Jami Deckard, MS
    Regenstrief Institute

In this session, we will explain how panels are modeled in LOINC, and discuss the difference between panels for lab orders, reports, and forms/surveys. We will also walk through the advanced attributes of LOINC panels, including optionality, cardinality, skip logic, override answer lists, and more. We will take a deep dive into two LOINC accessory files, the Panels and Forms File and Answer File. Finally, we will cover the current best practices for mapping to LOINC panels including business rules about required versus optional elements and methodless terms versus codes with methods, making you an expert in mapping to these important terms.

3:15

Break

Refreshments will be available outside the meeting room.

3:30

Your
Choice

Social and Behavioral Determinants of Health

  • Ruth E. Wetta, RN, PhD, MPH, MSN
    Cerner Corporation Population Health, University of Kansas School of Nursing
  • Roberta D. Severin, RN, MSN
    Cerner Corporation Population Health

Social and behavioral determinants of health (SBDH) are central to a successful population health management strategy. There are many obstacles associated with the assessment, storage and use of SBDH in the electronic health record (EHR) that include: (1) multiple, conflicting recommendations, (2) multiple instruments with varying SBDH domains, scoring and cut points and (3) lack of terminology code sets to store an assessment. This lack of holistic vision has contributed significantly to confusion for healthcare systems, providers and electronic health record vendors.

This presentation will describe a strategy that permits scoring by domain to create equivalency across instruments, settings and populations. The three-tier scoring strategy was designed to: (1) be used immediately at point of care by identifying potential risk for a SBDH deficit, (2) be consumed within analytics, algorithms and for secondary analysis, and (3) produce a composite score that reflects total SBDH burden across settings within a healthcare system. The SBDH domain scores that contribute to the composite score would be most appropriately encoded with LOINC, the universal standard for identifying health measurements, observations, and documents. The scoring strategy supports the six uses recommended by the National Academy of Medicine (2014) and leverages the power of SBDH data in relationship to healthcare delivery.

LOINC Codes for Cancer Registry Reporting in the US

  • W. Ted Klein, MS, FHL7
    Klein Consulting Informatics

The Cancer community and NAACCR (North American Association of Central Cancer Registries) has been working on the short list of LOINC codes to use for Cancer Registry Reports and their sections. The reporting laboratories are increasingly using LOINC codes to label separate portions of a cancer registry report carried in HL7 v2.5.1 ORU messages. This talk will illustrate the coding being used, and the emerging recommendations being published in the Volume V Implementation Guide.

4:45

End

This concludes the day's workshops and presentations. Attendees may pick up their P.A.C.E. certificates from the registration area.