LOINC Facilitates Exchange of MY Data!

July 10, 2015 / By Susan Matney, PhD, RN

A few months ago I wrote a personal blog detailing the lack of interoperability for my data after a knee replacement. The most important observations that are measured after knee replacement are pain intensity and knee flexion angle. I would have loved to see my pain levels graphed out over time as it decreased while my knee flexion graph showed an increase. This meant that my measurements from hospital, home, physical therapy and the physician’s office all needed to be in the same system. So…what needs to be done to have my data where it needs to be to track my progress?

The problem is lack of interoperability between settings. In my situation, each system spoke a different language so they could not communicate with each other. Interoperability occurs when each system speaks the same language. Logical Observation Identifiers Names and Codes (LOINC) apply universal code names and identifiers to medical terminology related to electronic health records. The purpose is to assist in the electronic exchange and gathering of clinical results (such as my pain scale and knee flexion angle). LOINC has two main parts: laboratory LOINC and clinical LOINC.

The use of LOINC enables the exchange and examination of measurement data from healthcare providers for use in clinical care and research. With appropriate implementation, there will be one specific LOINC code for the “knee flexion” (like mine) used when the measurement is performed in any setting across the country. The key here is specificity, so that patients like me can be assured that their data is available across the continuum of care.

Adoption of LOINC codes by healthcare providers alone does not solve the problem. Many systems include their own institutional codes that require a “mapping” to the LOINC codes for that same concept. The healthcare data dictionary (HDD) allows users to load their own local codes. The HDD also houses all the standard terminologies required for interoperability between systems, including LOINC. Even though LOINC is freely available, there are not application program interfaces (APIs) or services associated with it for implementation into the electronic health record (EHR) and translation from local codes to LOINC codes. Hence, my big announcement: 3M has worked out an agreement with Regenstrief to release the LOINC codes within HDDAccess (www.HDDAccess.com).

HDD Access contains terminology content and is freely available; however, it has limited capabilities because the database holds a third of all the codes contained in the commercial version of HDD. Alternatively, there is a commercial version of the HDD, mapping tools and informatics services. A robust set of terminology solutions empowers clients to solve challenges with semantic interoperability, meaningful use attestation, pre-scrub data for analytics and other challenges with disparate clinical data.

I would have had much better care if my knee flexion measurement had been shared between care providers. LOINC is the answer for encoding the measurement.

Susan Matney, RN, MSN, FAAN, is a medical informaticist with 3M Health Information Systems, Healthcare Data Dictionary (HDD) Team.