As the practice, regulation and reimbursement of health care become more complicated, and as the demand for electronic medical records and health information exchange grows, a universal method of identifying test results and other clinical measurement is essential.
INDIANAPOLIS — As the practice, regulation and reimbursement of health care become more complicated, and as the demand for electronic medical records and health information exchange grows, a universal method of identifying test results and other clinical measurement is essential.
The standardized medical terminology system called Logical Observation Identifiers Names and Codes, known as LOINC®, with a 57,000 term code vocabulary meets that need. LOINC provides the lingua franca needed for the creation of an electronic medical record and for health information to be electronically exchanged. The latest version of LOINC will be released in June.
LOINC has been developed by Regenstrief Institute investigators so that results of the same test – cholesterol level, or the same clinical observation - blood pressure reading, for example, can be compared by different institutions for the purposes of patient care, research, quality assessment or outcomes management. It is these codes that also are critical to computerized transmission of medical information.
“Our fragmented health-care system makes it difficult to deliver the best care possible because we lack complete, accurate information about our patients. Interconnected electronic record systems are beginning to overcome some of these challenges. As we move toward a national information infrastructure, LOINC fills a crucial role as a common vocabulary that allows clinical results from different sources to be electronically aggregated in systems for providers when and where they need it” said Regenstrief investigator Daniel Vreeman, PT, DPT, assistant research professor at the Indiana University School of Medicine and director of the LOINC development activities at Regenstrief.
LOINC began in the mid 1990’s when Regenstrief investigators, using their decades of experience with electronic medical records, began the Indiana Network for Patient Care, the nation’s first citywide health information exchange. The researcher clinicians found they could receive data from various INPC member institutions but that the clinical content was difficult to interpret because each used a different code for the same test or observation so it was like receiving messages in French, Spanish and Italian when all they could understand was English.
They decided to develop a lingua franca and LOINC was born. From the beginning it has been a free and open system, encouraging additions, comments and feedback. Two new versions of LOINC are issued annually, with more than 2,000 new terms for tests or clinical observations per release. These new additions are based on requests from end users.
Over the past seven years, more than 130 health-care organizations around the world, including the Centers for Disease Control, the U.S. departments of defense and veterans affairs and individual hospitals have made submissions. In the past two years, users from 131 different countries downloaded the standard more than 23,000 times. LOINC encourages and supports translation of terms and documentation into foreign languages. Currently, portions of the database have been translated into Simplified Chinese, Spanish, French, and Italian and both German and Estonian versions of the documentation also exist.
“With support from the U.S. government and other organizations, the Regenstrief Institute continues to develop LOINC as an open, freely available standard. LOINC’s growing worldwide adoption is a testament to both the need for a common language and the success of this open approach,” said Dr. Vreeman.
LOINC development is performed under the auspices of the Regenstrief Institute, Inc. and is currently supported in part by Regenstrief Institute, Inc., the National Library of Medicine, the HHS Assistant Secretary for Planning and Evaluation, and the Centers for Medicare and Medicaid Services. Present federal funding totals $3.7 million through 2013, with 75 percent of annual support from federal funding and 25 percent from non-federal sources.
Cindy Fox Aisen