Loinc - Any thoughts of Mirth including this ?

[shopkins]

http://www.regenstrief.org/medinformatics/loinc/

"The purpose of the LOINC® database is to facilitate the exchange and pooling of results, such as blood hemoglobin, serum potassium, or vital signs, for clinical care, outcomes management, and research. Currently, most laboratories and other diagnostic services use HL7 to send their results electronically from their reporting systems to their care systems. However, most laboratories and other diagnostic care services identify tests in these messages by means of their internal and idiosyncratic code values. Thus, the care system cannot fully "understand" and properly file the results they receive unless they either adopt the producer's laboratory codes (which is impossible if they receive results from multiple sources), or invest in the work to map each result producer's code system to their internal code system. LOINC codes are universal identifiers for laboratory and other clinical observations that solve this problem.

The laboratory portion of the LOINC database contains the usual categories of chemistry, hematology, serology, microbiology (including parasitology and virology), and toxicology; as well as categories for drugs and the cell counts you would find reported on a complete blood count or a cerebrospinal fluid cell count. Antibiotic susceptibilities are a separate category. The clinical portion of the LOINC database includes entries for vital signs, hemodynamics, intake/output, EKG, obstetric ultrasound, cardiac echo, urologic imaging, gastroendoscopic procedures, pulmonary ventilator management, selected survey instruments, and other clinical observations."

[pzelenka]

Re:Loinc - Any thoughts of Mirth including this ?

I look at LOINC as a descriptive code that would be well placed within an HL7 ORU OBX for each test, procedure, monitor date, etc. This would avail the receiving entity of the wealth of detail referred to by the LOINC code for a test, procedure, etc. Mapping will need to be done on each end of the exchange.

In addition, with EMR being a ubiquitous buzzword, I see a natural use for LOINC codes to be a standard ID between disparate systems feeding into a central repository, which is how I think they came to be in the first place.

One of systems I work with is Meditech. One of their recent updates included fields for LOINC codes in the Lab test dictionary. There is a LOINC code dictionary linked to these fields, which ensures entries are known codes. Some pieces are in place, now to find a way to use them.

[pzelenka]

Re:Loinc - Any thoughts of Mirth including this ?

I look at LOINC as a descriptive code that would be well placed within an HL7 ORU OBX for each test, procedure, monitor date, etc. This would avail the receiving entity of the wealth of detail referred to by the LOINC code for a test, procedure, etc. Mapping will need to be done on each end of the exchange.

In addition, with EMR being a ubiquitous buzzword, I see a natural use for LOINC codes to be a standard ID between disparate systems feeding into a central repository, which is how I think they came to be in the first place.

One of systems I work with is Meditech. One of their recent updates included fields for LOINC codes in the Lab test dictionary. There is a LOINC code dictionary linked to these fields, which ensures entries are known codes. Some pieces are in place, now to find a way to use them.

[[email protected]]

Re:Loinc - Any thoughts of Mirth including this ?

The key question here is how, at a detailed level, do you need/want to use LOINC codes? That alone would determine what kind of functionality might make sense in Mirth.

Doing translations between legacy/internal lab codes and LOINC is a non-trivial exercise and probably not something that can be automated without manual analysis and custom code or at least custom translate tables. So that would make it hard to build generic functionality into Mirth that would be useful.

Where I see LOINC starting to become more prevalent would be as HL7 3.0 based messaging starts to become more common (that's likely gonna be a while...there still isn't a spec for Lab Results deliver with 3.0), and thus expect that 3.0 support from Mirth would be the first and more valuable step towards more use of standardized codes like LOINC and SNOMED.

[shopkins]

Re:Loinc - Any thoughts of Mirth including this ?

I look at LOINC as adding some future-proofing for Mirth. Right now I do not *need* the codes in Mirth, but they would be nice. There will be (by the verbage that I see on the local website) a regional lab system that will have LOINC codes included in their data as they are going to be aggregating lab data from many systems (hospital, private lab, etc) and so they need to have an even more common language than HL7. So thinking 2 years down the line when this is supposed to be active I want to be ready ;-)

[[email protected]]

Re:Loinc - Any thoughts of Mirth including this ?

You might want to consider joining your country's HL7 or other medical standards organization. Most of them give you access to other standards like LOINC and SNOMED.

Then you can incorporate the codes to your heart's content. ;-)

[praveen222]

loinc and hl7

LOINC codes are useful to identify the laboratory or clinical results. Few things are regarding LOINC are confused to me.

1. how the LOINC codes are used in hl7 code for identifying the results?
2. We already generated the code by using HAPI (but we are not sure with that).
3. For automatic generation of reports or orders what we can do?
4. Is it better to use HL7 interface or CDA or CCR or anything?
5. what is HL7 interface and HL7 protocol? Where can we use?
6. please give me List of HL7 interface provides (third party vendors).
7. or any implementation idea on HL7 interface and HL7 protocol.
8. Is HL7 interface and HL7 protocol are compulsory for ordering a test to lab (LIS)?
9. or only any one of those are required?
10. I studied we can use CDA in HL7.
11. we are looking on HL7 v. 2.x.

Please provide me above information.

Thanks in Advance.

Praveen.

[gsasquatch]

LOINC lookup

If we had LOINC codes in our hl7 coming from the lab, we could use Mirth to send our lab results to an external agency that tracks clinical trends across the state, and eventually the country. Right now we are just creating a file out of our lab system, and sending that. The better solution would be to have the lab system send the LOINC codes out, but that may also require us to change ordering system to accommodate that as well. The third idea, which is something I think the community could or has accomplished would be something of a translator that would do a look up with our in house code, and return the LOINC code based on a table we maintain. Setting up the table to maintain could be done in a myriad of ways and may be outside the scope of Mirth. What I would like to know, is how do I do a query in a transformer, i.e.


msg['OBR']['OBR.4']['OBR.4.1']= SELECT LOINC from lookup_table where in_house_lookup=in_house_code

The question I have is then, what are the details in making that select work. I'm flexible on the data source as it has yet to exist, and would be fairly small and simple.

[mnowlin]

This is a transformer step I use for one of my channels - populates OBR2.1 with accession numbers looked up from a Postgres table that is keyed off of several patient demographic values. (I removed a bunch of sanity checking to keep this example readable.) Shouldn't be hard to adjust to what you need...

var paramList = Packages.java.util.ArrayList();
var dbConn = DatabaseConnectionFactory.createDatabaseConnection ('org.postgresql.Driver', 'jdbcostgresql://172.17.18.16:5432/mirthmlo', 'uname', 'passwd');

lname = msg['PID']['PID.5']['PID.5.1'].toString();
fname = msg['PID']['PID.5']['PID.5.2'].toString();
dob = msg['PID']['PID.7']['PID.7.1'].toString();
ssn = msg['PID']['PID.19']['PID.19.1'].toString();
dos = msg['OBR']['OBR.7']['OBR.7.1'].toString().substring(0,8);

var criteria = lname + "^" + fname + "^" + dob + "^" + ssn + "^" + dos;
paramList.add(criteria);
var Query = "SELECT info FROM InfoHold WHERE criteria=?";
var result = dbConn.executeCachedQuery(Query, paramList);

if (result.next()) {
acn = result.getString("info");

for each (obr in msg..OBR) {
obr['OBR.2']['OBR.2.1'] = acn;
}
} else {
channelMap.put("nomatchfound", 1);
}