Happy 25th to LOINC!

April 1, 2019 / By Pam Banning

LOINC’s 25^th Anniversary was celebrated on February 16, 2019 with a social media blitz and many well wishes from around the world on Twitter and the LOINC Forum. Standing for Logical Observation Identifiers Names and Codes, LOINC is a standard terminology covering laboratory and clinical observations such as blood tests and vital signs, and numerous other data elements needed in health care.  

LOINC was established in 1994 by the Regenstrief Institute as a publicly available coding scheme for exchanging laboratory and clinical observations between computer systems. My employer at the time, ARUP Laboratories in Salt Lake City, asked me to attend the preliminary meetings in creating the first LOINC release. A contributory portion of the laboratory information system supporting the reference lab was turned over, along with data from Intermountain Health Care, local Indianapolis hospitals (Wishard and Riley Children’s), Mayo Medical Laboratories, and Corning MetPath (a reference laboratory later becoming part of Quest Diagnostics). Several in person meetings were held to analyze, compare, speculate and dispel tactics on what should be included. The first LOINC compendium consisted of 6,000 terms.

I became a founding member of the LOINC laboratory committee. The meetings were originally held in a 5^th floor conference room/library in Wishard Memorial Hospital, on the IUPUI campus (Indiana University-Purdue University Indiana). As we outgrew the conference room, the committee moved to various classrooms until an off-campus location near Clarian Health (now Indiana University Health) on the White River canal was available to house all of Regenstrief Institute’s staff and residents. Summer meetings usually ended with a comfortable one mile walk back to downtown hotels along the canal. Only recently did Regenstrief get their own building on 1101 W. 10^th Street. Across the parking lot are the only remaining pieces of Wishard’s original hospital: the smokestacks. Often on meeting breaks standing outside, I’d look over and envision the younger me, wet behind the ears, learning about LOINC.

It took several years for a browser/mapper utility to be created to help the user map a local lab catalog to LOINC. That meant the early users first had to comprehend the meanings behind the six-attribute coding scheme of LOINC. The learning curve was incredibly steep. Back at ARUP, my daily demands as clinical systems coordinator over multiple platforms and supervisor of database administrations clashed with the seemingly monumental task of getting the ARUP catalog fully mapped to LOINC. My normal daily routine was filled with interruptions and needs for the specialists to have their new tests designed, existing tests modified and special projects such as database content to drive a robotic track for delivering specimens to each laboratory workstation. In the end, I set up a separate, “hidden” cubicle in a quiet place, with no phone, so I could mentally shift gears and focus on learning LOINC.

Leaving ARUP in 1999 for 3M Health Information Systems Healthcare Data Dictionary (HDD) team gave me a unique opportunity not only to focus on LOINC, but also to help our customers with their LOINC mapping, and to expand my terminology horizons. In the U.S., we mapped the lab codes of the Department of Defense (DoD) medical facilities to LOINC. The HDD team also worked alongside some of the country’s prototype health information exchanges. International opportunities included consulting with Canada Health Infoway on adopting LOINC nationally through what became the panCanadian LOINC Observation Code Database (pCLOCD), and traveling to Singapore to assist the Ministry of Health in evaluating LOINC adoption through a prototype project involving nine hospitals. To this day, our team maintains client terminologies from projects that migrated to operational terminology management. We feel privileged to have worked closely with LOINC and the Regenstrief Institute all these years, and I’m especially honored to have received the LOINC Award for Distinguished Contributions in 2018.

The LOINC (rhymes with “oink”) mascot and logo are a pig; adding to the auspicious occasion, February 5 this year started the Chinese New Year of the Pig. Chinese horoscope claims that pigs are diligent, compassionate, generous and focused; however, “pigs never suspect trickery, so they are easily fooled.” As a “LOINCer,” I’d happily own to these traits. I remember working on LOINC release 2.63 and finding a “These Questions Three Panel.” Curious to identify the situation where this strange panel would be used, I looked further to find one of the three questions was to identify the airspeed of an unladen swallow. What? Turned out that the 3M team had the honor of finding a LOINC Easter Egg – a Monty Python one no less!

It’s been 25 great years working with LOINC contributors and users, collaborating from educational, technical and clinical perspectives to formulate a terminology assisting electronic collation of information for the benefit of patients and populations. Congratulations to LOINC and we look forward to many more years!

#LOINC25

Pam Banning, healthcare data analyst with 3M Health Information Systems.