I was wondering why orders for microbiology cultures are typically the same as the results for ‘Bacteria identified’. While I understand that if orders were forced to piggyback on a result codes, this would be the best choice, but why not create separate order-only items for culture orders? The standard blood culture frequently grow yeast, and while they aren’t the special ‘fungal blood culture’ orders, it isn’t really appropriate to call them ‘bacterial blood cultures’. And the current setup precludes the use of LOINC values to automatically populate order names.
I waited to post a response until after the Lab LOINC submitter’s collaboration call today. So we have the benefit of multiple LOINC committee members contributing here…The codes are named for their intention; the clinician may be asking for blood cultures; but the lab will always go beyond the code name and always report whatever is there. It’s not taken literally in operational processes. In past versions, the ‘bacteria identified’ codes were ‘microorganisms identified’. Several still reside, including 11475-1. I checked the User’s Guide for further explanation, but didnt find it specifically addressed.
I do understand from an ordering perspective, LOINC long and short names may be too granular for a clinician’s use. It may infer they are constraining to only one type of microbe. 3M clients to date are using their local code and display name, with the LOINC code and display adjoining in the HL7 message. I have heard of one instance where an EHR system implementer was trying to force the LOINC display as the only display. I have also heard of a CCR document being produced from a local site, that used only LOINC displays. Your message sounds like your setup is driving in this direction as well. In both instances, the laboratories involved wanted further discussion on having additional displays available.
Will try to get this on the June agenda for the Lab LOINC Committee.