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An Introduction to  Clinical LOINC Stanley M. Huff, M.D. Intermountain Healthcare [email_address]
Outline for All Tutorials ,[object Object],[object Object],[object Object],[object Object]
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Important facts ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Coverage ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Messaging Paradigm System A System B Trigger Event Network Order Result
HL7 Result Message (ORU) Segment Data Field MSH|^~amp;|||||19981105131523||ORU^R01| PID|||100928782^9^M11||Smith^John^J| OBR||||Z0063-0^BP^LN| OBX||CE|8361-4^POSITION^LN||SIT^Sitting| OBX||NM|8479-8^SBP^LN||138|mmHg| Component
OBX: a name-value pair approach A code that identifies the data in OBX-5 (Temp Reading) OBX||NM|11289-6^^LN||38|C^^ISO+|||||F Other data fields include: date of observation, identity of provider giving observation, normal ranges, abnormal flags Status A code that  identifies the units of numerical data in OBX-5 A code that identifies the  datatype of OBX-5 OBX-5: Data
OBX: with a coded value OBX||CE|883-9^ Blood Group ^LN||58460004^ Group O ^SCT| The code is from SNOMED The code is from LOINC OBX-5: Data A code for Group O A code that identifies the  datatype as a coded element A code that identifies the data in OBX-5 (ABO Blood Group)
So we are all using HL7, what is the problem? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],You and I may know that these are similar results, but our computers will not.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],The Goal Agree on a universal coding system for clinical observations.
How terminologies fit into the model ,[object Object],[object Object],[object Object],[object Object]
Focus of LOINC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Brief History of LOINC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Approach ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LOINC makes names for things in use  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Two LOINC committees ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Current and Former Clinical LOINC Members ,[object Object]
Clinical LOINC Subject Areas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LOINC Mascot
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],General Form of Clinical LOINC Names <component> : <property> : <timing> : <system> : <scale> :  <method> The first 5 parts are mandatory, but  method  is optional. Subparts of the six axes are created as needed in specific subject areas. 8331-1  Body Temperature  :TEMP  :PT  :MOUTH  :QN
Summary of the six primary axes (clinical) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Component ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Subtypes – period as a separator ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Challenge/Pre condition - ^ as a separator ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Adjustments - ^ ^ as a separator ,[object Object],[object Object]
Kind of Property ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],The characteristic or attribute of the component that is measured, evaluated, or observed.
Timing ,[object Object],[object Object],[object Object],[object Object],[object Object],The interval of time over which the observation or measurement was made.
System ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],The system (context) or body part about which the observation was made.
Patient, Control, or Donor (as part of system) ,[object Object],[object Object],[object Object],[object Object],[object Object],Non-patient values for this axis should be used with care, or combinatorial explosion could result
Scale ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Method ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Procedure used to make the measurement or  observation.  Only used when it makes an  important distinction in sensitivity or specificity.
Putting it all together ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
More complex examples ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HL7 & the Claims Attachment Recommendation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Unsolicited Attachment
Request for Additional Information
Organizations & Documents X12 277 Transaction 12748-1 9832-1 X12 275 Transaction HL7 CDA R1 15748-3 7832-8 20118-5 4332-7 12748-1 9832-1 ASC X12 & Subcommittee  X12N X12  Trans. Sets  277,  275 TG2 Impl. Guides  277, 275 Health Level  Seven HL7  CDA R 1 HL7  Claims  Attachments Impl.  Guide LOINC Consortium LOINC Codes LOINC Attachment Booklets
Attachment Types Selected for HIPAA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CDA: Semi- or fully-structured HIPAA  Claims Attachments Autoadjudicate Provider Payer Transcription * Scanned Paper or Document Imaging * Level 3 CPR Image + XML Semistructured Structured and coded Specific XML forms *
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Use cases for Context Specific Hierarchies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Consultation Note Example ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Issues related to “collections” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Proposed stragegy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Literature References ,[object Object],[object Object],[object Object],[object Object]

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2009 08 13 - Clinical LOINC Tutorial - Introductions and Foundations

  • 1. An Introduction to Clinical LOINC Stanley M. Huff, M.D. Intermountain Healthcare [email_address]
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  • 6. The Messaging Paradigm System A System B Trigger Event Network Order Result
  • 7. HL7 Result Message (ORU) Segment Data Field MSH|^~amp;|||||19981105131523||ORU^R01| PID|||100928782^9^M11||Smith^John^J| OBR||||Z0063-0^BP^LN| OBX||CE|8361-4^POSITION^LN||SIT^Sitting| OBX||NM|8479-8^SBP^LN||138|mmHg| Component
  • 8. OBX: a name-value pair approach A code that identifies the data in OBX-5 (Temp Reading) OBX||NM|11289-6^^LN||38|C^^ISO+|||||F Other data fields include: date of observation, identity of provider giving observation, normal ranges, abnormal flags Status A code that identifies the units of numerical data in OBX-5 A code that identifies the datatype of OBX-5 OBX-5: Data
  • 9. OBX: with a coded value OBX||CE|883-9^ Blood Group ^LN||58460004^ Group O ^SCT| The code is from SNOMED The code is from LOINC OBX-5: Data A code for Group O A code that identifies the datatype as a coded element A code that identifies the data in OBX-5 (ABO Blood Group)
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  • 39. Request for Additional Information
  • 40. Organizations & Documents X12 277 Transaction 12748-1 9832-1 X12 275 Transaction HL7 CDA R1 15748-3 7832-8 20118-5 4332-7 12748-1 9832-1 ASC X12 & Subcommittee X12N X12 Trans. Sets 277, 275 TG2 Impl. Guides 277, 275 Health Level Seven HL7 CDA R 1 HL7 Claims Attachments Impl. Guide LOINC Consortium LOINC Codes LOINC Attachment Booklets
  • 41.
  • 42. CDA: Semi- or fully-structured HIPAA Claims Attachments Autoadjudicate Provider Payer Transcription * Scanned Paper or Document Imaging * Level 3 CPR Image + XML Semistructured Structured and coded Specific XML forms *
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Editor's Notes

  1. 08/17/09
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  4. The pig picture was on an old t-shirt that was found stuffed under something when we moved offices. I cut the pig out and put it in an 8 x 10 frame that we had. I took a picture of it with my cell phone and emailed it to myself. Then I inserted the picture into a blank powerpoint and VOILA - The French Pig. (Sandy Poremba) Do we know who the original artist was?  (Stan) I think it was Jill Warvel - a programmer from here. (Sandy Poremba)
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