Investigating the semantic interoperability of laboratory data exchanged using LOINC codes in three large institutions.

LOINC codes are seeing increased use in many organizations. In this study, we examined the barriers to semantic interoperability that still exist in electronic data exchange of laboratory results even when LOINC codes are being used as the observation identifiers. We analyzed semantic interoperability of laboratory data exchanged using LOINC codes in three large institutions. To simplify the analytic process, we divided the laboratory data into quantitative and non-quantitative tests. The analysis revealed many inconsistencies even when LOINC codes are used to exchange laboratory data. For quantitative tests, the most frequent problems were inconsistencies in the use of units of measure: variations in the strings used to represent units (unrecognized synonyms), use of units that result in different magnitudes of the numeric quantity, and missing units of measure. For non-quantitative tests, the most frequent problems were acronyms/synonyms, different classes of elements in enumerated lists, and the use of free text. Our findings highlight the limitations of interoperability in current laboratory reporting.

[1]  O Bodenreider,et al.  Biomedical ontologies in action: role in knowledge management, data integration and decision support. , 2008, Yearbook of medical informatics.

[2]  Robert A. Greenes,et al.  Clinical Decision Support: The Road Ahead , 2006 .

[3]  Jeffrey P. Krischer,et al.  Research Paper: Variation of SNOMED CT Coding of Clinical Research Concepts among Coding Experts , 2007, J. Am. Medical Informatics Assoc..

[4]  David Raths.  ELINCS gets adopted. HL 7 is taking over ELINCS to ensure lab data and EHRs continue towards interoperability. , 2007, Healthcare informatics : the business magazine for information and communication systems.

[5]  Daniel J. Vreeman,et al.  A Rationale for Parsimonious Laboratory Term Mapping by Frequency , 2007, AMIA.

[6]  Scott Gustafson,et al.  caCORE: A common infrastructure for cancer informatics , 2003, Bioinform..

[7]  Stanley M. Huff,et al.  Research Paper: Automated Mapping of Observation Codes Using Extensional Definitions , 2000, J. Am. Medical Informatics Assoc..

[8]  C. McDonald,et al.  Logical observation identifier names and codes (LOINC) database: a public use set of codes and names for electronic reporting of clinical laboratory test results. , 1996, Clinical chemistry.

[9]  Clement J. McDonald,et al.  Development of the Logical Observation Identifier Names and Codes (LOINC) vocabulary. , 1998, Journal of the American Medical Informatics Association : JAMIA.

[10]  Perry L. Miller,et al.  Application of Information Technology: Organization of Heterogeneous Scientific Data Using the EAV/CR Representation , 1999, J. Am. Medical Informatics Assoc..

[11]  Clement J. McDonald,et al.  Model Formulation: Units of Measure in Clinical Information Systems , 1999, J. Am. Medical Informatics Assoc..

[12]  J. Cimino.  Desiderata for Controlled Medical Vocabularies in the Twenty-First Century , 1998, Methods of Information in Medicine.

[13]  Sylvia Thun,et al.  Case Report: LOINC® Codes for Hospital Information Systems Documents: A Case Study , 2009, J. Am. Medical Informatics Assoc..

[14]  Lonnie Blevins,et al.  The Indiana network for patient care: a working local health information infrastructure. An example of a working infrastructure collaboration that links data from five health systems and hundreds of millions of entries. , 2005, Health affairs.

[15]  S M Huff,et al.  A Characterization of Local LOINC Mapping for Laboratory Tests in Three Large Institutions , 2010, Methods of Information in Medicine.

[16]  James J. Cimino,et al.  Combining laboratory data sets from multiple institutions using the logical observation identifier names and codes (LOINC) , 1998, Int. J. Medical Informatics.

[17]  C. McDonald,et al.  LOINC, a universal standard for identifying laboratory observations: a 5-year update. , 2003, Clinical chemistry.

[18]  Ming-Chin Lin,et al.  Correctness of Voluntary LOINC Mapping for Laboratory Tests in Three Large Institutions. , 2010, AMIA ... Annual Symposium proceedings. AMIA Symposium.

[19]  Olivier Bodenreider,et al.  Evaluation of the UMLS as a terminology and knowledge resource for biomedical informatics , 2002, AMIA.

[20]  Cynthia Brandt,et al.  Automating Identification of Adverse Events Related to Abnormal Lab Results Using Standard Vocabularies , 2005, AMIA.

[21]  G. Pezzino.  A Guide to the implementation of the National Electronic Disease Surveillance System (NEDSS) in state public health , 2001 .