Two LOINC codes for one lab-item

Ian McNicoll ian at freshehr.com
Fri Feb 17 05:17:48 EST 2017


Thanks Grahame,

Very helpful.

Ian

Dr Ian McNicoll
mobile +44 (0)775 209 7859
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Co-Chair, openEHR Foundation ian.mcnicoll at openehr.org
Director, freshEHR Clinical Informatics Ltd.
Director, HANDIHealth CIC
Hon. Senior Research Associate, CHIME, UCL

On 17 February 2017 at 10:11, Grahame Grieve <
grahame at healthintersections.com.au> wrote:

> bit of both - there are some institutions running on a terminology server
> that can manage those kind of things, and others have to do manual
> conversion. But terminology servers are gradually becoming more commonly
> deployed (all the good ones I know of are free).
>
> Grahame
>
>
> On Fri, Feb 17, 2017 at 8:58 PM, Ian McNicoll <ian at freshehr.com> wrote:
>
>> Hi Robert,
>>
>> Thanks for the input.  This is going to be a universal issue, however and
>> wherever we are trying to aggregate bits of 'clinically identical' lab data
>> as-per your example.
>>
>> I am interested in how this is done now, as LOINC is not extensively used
>> in the UK outside individual institutions, and my understanding is that the
>> LOINC terminology carries enough relationship metadata to allow
>>
>> 2160-0 Creatinine [Mass/volume] in Serum or Plasma        Creatinine
>> Qn         mg/dL
>> 14682-9 Creatinine [Moles/volume] in Serum or Plasma      Creatinine
>> Qn         umol/L
>>
>> to be queried/inferenced as 'Creatinine Serum or Plasma' but this would
>> require a LOINC-aware terminology server.
>>
>> or do folk just manually document the sets of terms to be queried?
>>
>> Ian
>>
>> Dr Ian McNicoll
>> mobile +44 (0)775 209 7859 <+44%207752%20097859>
>> office +44 (0)1536 414994 <+44%201536%20414994>
>> skype: ianmcnicoll
>> email: ian at freshehr.com
>> twitter: @ianmcnicoll
>>
>>
>> Co-Chair, openEHR Foundation ian.mcnicoll at openehr.org
>> Director, freshEHR Clinical Informatics Ltd.
>> Director, HANDIHealth CIC
>> Hon. Senior Research Associate, CHIME, UCL
>>
>> On 16 February 2017 at 13:51, Robert Hausam <rrhausam at gmail.com> wrote:
>>
>>> In recent months I've had some discussions with Dan Vreeman at
>>> Regenstrief about the need to be able to group or aggregate "clinically
>>> equivalent" LOINC codes (however "clinically equivalent" is defined - mol
>>> and mass is one obvious case).  The original impetus for our discussion
>>> isn't being pursued on my end at the moment, but Dan did say that
>>> Regenstrief is embarking on an effort of their own to develop the
>>> capability for doing something like this.  I am sure that they would be
>>> interested in hearing about use cases that are being identified that need
>>> this capability (and also about anyone with an interest in helping them
>>> with getting the work done).
>>>
>>> Rob
>>>
>>> On Thu, Feb 16, 2017 at 6:23 AM, Wouter Zanen <
>>> w.zanen at eurotransplant.org> wrote:
>>>
>>>> The use case discussed was our use case. All that has been explained
>>>> makes perfect sense from a lab perspective (Mol and Mass are different
>>>> test), however in our use case we do need to aggregate them.
>>>>
>>>> In our case it is allowed to report have for example createnine in both
>>>> mg/dl and mmol/l, in the software application it will be one field with a
>>>> choice for the unit, we receive info from multiple labs in europe). We are
>>>> also looking for the possibility for electronic exchange of HL7v2 messages
>>>> in the future. We use the lab test observation (inlcuding specimem
>>>> details)  and lab test panel to record the test result. We try to bind with
>>>> both SNOMED and LOINC (being flexible), on a template level I see only two
>>>> solutions:
>>>>
>>>> I now see two options:
>>>>
>>>>    - Either we don't bind to LOINC and MAP Loinc codes in the mapping
>>>>    software we inevitable are going to need to process the HL7V2 message.
>>>>    Result is one archetype with both mol and mass units.
>>>>    - Or we invent a testfinding container archetype (Called Creatinine
>>>>    that binds to Snomed) and under that we have two test panel archetypes for
>>>>     Mol and Mass. This makes building the app more difficult but at least we
>>>>    know the composition is related to Createnine.
>>>>
>>>> Currently we prefer solution 1.
>>>>
>>>> Best regards,
>>>>
>>>> Wouter Zanen
>>>>
>>>>
>>>>
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>>>> >>> Ian McNicoll <ian at freshehr.com> 16/02/2017 11:04 >>>
>>>> Helpful but do rely on having some fairly sophisticated terminology
>>>> services and available mappings.
>>>>
>>>> We should keep this dialogue going as we will be working in a mixed
>>>> loinc snomed environment in a uk project.
>>>>
>>>> Ian
>>>> On Thu, 16 Feb 2017 at 09:38, Bert Verhees <bert.verhees at rosa.nl>
>>>> wrote:
>>>>
>>>>> Very well thought out guidelines in the second part. Will be helpful
>>>>> in the discussion
>>>>>
>>>>> Thanks
>>>>> Bert
>>>>>
>>>>> Op do 16 feb. 2017 om 10:07 schreef Ian McNicoll <ian at freshehr.com>:
>>>>>
>>>>> This was helpful but still implies that some sort of terminology
>>>>> service is required
>>>>>
>>>>> https://confluence.ihtsdotools.org/download/attachments/1278
>>>>> 1103/Expo_LOINC_SNOMED_EHR_October_2015_Final.pdf?version=1&
>>>>> modificationDate=1446571187000&api=v2
>>>>>
>>>>>
>>>>>
>>>>> _______________________________________________
>>>>> openEHR-clinical mailing list
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>>>>> ists.openehr.org
>>>>
>>>> --
>>>> Ian McNicoll
>>>>
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>>>
>>>
>>>
>>> --
>>> Robert Hausam, MD
>>> +1 (801) 949-1556 <+1%20801-949-1556>
>>> rrhausam at gmail.com
>>>
>>>
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>>
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>
>
>
> --
> -----
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