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LOINC Encoded Results to EHRs - continued –Consider deprecating some method distinctions where they are clearly not contributory to clinical interpretation. –Examples: ALBUMIN in Serum – Bromocresol green vs. Bromocresol purple vs. method-less HEMOGLOBIN (qualitative) in Urine – Test strip vs. automated Test strip vs. method-less Use LOINC part hierarchies to group together (“lump”) results that should be reported as a more generic reporting code (in the same line/column in a clinician’s flowsheet). © 2015 College of American Pathologists. All rights reserved. 3
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LOINC Committee Meeting June 4, 2015LOINC Challenges and Recommendations
Raymond D. Aller, MD, FCAPCarolyn A. Knapik, BS, MT(ASCP)
June 4, 2015
LOINC Encoded Results to EHRs
• Fundamental mismatch: most specific vs. generalized
• Principle concern voiced by CAP members• Recommend “roll-up” from detailed LOINCs to more
inclusive/generalized LOINCs• First step: roll-up method specific LOINCs to
method-less LOINCs, providing results are not clinically different
– Is there an available list of analytes whose methods yield markedly different result values?
© 2015 College of American Pathologists. All rights reserved. 2
LOINC Encoded Results to EHRs - continued– Consider deprecating some method distinctions where
they are clearly not contributory to clinical interpretation.– Examples:
• ALBUMIN in Serum – Bromocresol green vs. Bromocresol purple vs. method-less
• HEMOGLOBIN (qualitative) in Urine – Test strip vs. automated Test strip vs. method-less
• Use LOINC part hierarchies to group together (“lump”) results that should be reported as a more generic reporting code (in the same line/column in a clinician’s flowsheet).
© 2015 College of American Pathologists. All rights reserved. 3
LOINC Encoding Orders • General Rule: Use method-less codes with OrderObs flag of either “Order” or “Both”
–If no method-less code available, use method-specific code
•This code will not generally dictate what testing methodology will be employed•These “double-duty” method specific codes should be flagged as such (generic order code use)
–Is there an available short list of those method-specific codes that actually do require a particular methodology?
•Hepatitis serologies?
© 2015 College of American Pathologists. All rights reserved. 4
LOINC Encoding Orders - continued – Can LOINC hierarchy tables be used?
•If a laboratory order matches a common laboratory order with associated LOINC code, then the matching LOINC code should be used (regardless of vocabulary variations).• The absence of a LOINC order code should not prevent the use of a local code for orders•LOINC codes can be requested for orders lacking an existing LOINC code
© 2015 College of American Pathologists. All rights reserved. 5