I am an Information Specialist for Pathologists’ Regional Laboratory and we are about to begin LOINC implemenation. Currently this project is in the hands of the IT department and we are having difficulty understanding the scope of this project as well as the terminology. We have limited resources from the Medical Technologist department, that is to say we will be doing most of this ourselves until we get to the mapping portion. Are there any suggestions you may have as far as learning LOINC and moving forward, wading through this seemingly daunting project? How long with this take, realistically speaking?
Hope you’re registered to attend the LOINC meeting in December? Teleconferencing might be available. There’ll be a new RELMA version and LOINC version coming out.
Here’s a few other thoughts for your consideration:
1. Are you going to map from HL7 messages or from a test catalog extract? There have been publications in AMIA by Dan Vreeman on this tactic.
2. If going via a test catalog, get a thorough extract file – listing all lab departments to be mapped, and determine where in the LIS their test elements are stored. In some systems, micro and blood bank are stored in different locations than chemistry or hematology. Additional findings elements for hematological differentials or microscopic urinalysis may be stored in different location as well.
3. Consider a merger of several queries to become one input file. Orderable tests and panels: include mnemonic, display and specimen collected. Resultable tests: include mnemonic, display, where linked to orders, result type (numeric, titer or alpha), units of measure, etc. While there’s not a one-for-one match of an LIS field to each LOINC attribute.
4. Create a change management system as soon as you’re satisfied with the input file. You’ll have to create a benchmark from the date that file is created.
5. Create a set of mapping guidelines… how granular will you go in mapping? Evaluate how the result fields are used. Are multiple specimen types possible for the same result mnemonic? Are both screens and confirmations reported in the same result mnemonic? This is helpful if multiple people will be dividing up the work.
6. There’ll be a learning curve for those mapping, but as they get more experienced, it’ll go faster. One piece of hindset is to know when NOT to keep trying to find a mapping. Typically 85-89% of a LIS catalog result fields will map to LOINC. The other 11-15% may be QA, troubleshooting, internal tracking that is not applicable to LOINC.
Good luck with your project! Let us know any other questions as you proceed. We have a master planning document, if you’d like to receive it, please email me at firstname.lastname@example.org