Logical Observation Identifiers Names And Codes
LOINC® (Logical Observation Identifier Names And Codes) is a U. S. Federal Government designated standard for use in the electronic exchange of clinical health information. The purpose of LOINC® is to provide a universal, standardized coding system for laboratory tests and other clinical observations. 1 It is the other clinical observations that are of interest to nursing, especially for assessment. 2 Data elements from the Nursing Management Minimum Nursing Data Set (NMMDS) have been incorporated into LOINC®. 3 Also the Clinical Care Classification nursing diagnoses/outcomes have been integrated into the clinical LOINC application. 4 Additionally, there is ongoing work between LOINC and SNOMED to link their terminologies to improve safety, and provide functionality and interoperability for health data exchange with electronic medical records. 5
LOINC® allows “hospitals, health maintenance organizations, pharmaceutical manufacturers, researchers, and public health departments who receive… messages from multiple sources, to automatically file the results in the correct location in their medical records, research, and/or public health records.” 1 p 624 each observation has six characteristics: the name of the observation (the component); the property (substance concentration, mass, volume); timing of the measurement; the type of system or sample such as serum, urine, patient, or family; scale and the method used to make the observation, a property that is optional. 6 Each of these observation have a code, a long formal name, a “short” 30-character name, and synonyms. Developed by the Regenstrief Institute in 1994, LOINC is freely available from http://www.regenstrief.org/loinc/. The Regenstrief LOINC® Mapping Assistant (RELMATM), which aids in the mapping of local test codes LOINC codes as well as browsing LOINC® results, is also freely available. LOINC is updated twice a year in June and December and is available as a Microsoft Access (.mdb) database file, a tab-delimited text file (.txt), and a comma delimited text file (.csv). 7
The LOINC® Committee in cooperation with the Regenstrief Institute and other stakeholders “helps set priorities for new content.” 8 The development of naming rules and names for new subject matter are often instigated by individual members who also serve as content experts to answer questions that may arise with new submissions. There are two primary divisions of The LOINC® Committee: “the Laboratory LOINC® Committee which deals with observations made on specimens, and the Clinical LOINC® Committee which deals with observations made on patients.”
As of 2013 LOINC® contained over 71,000 terms. 6 These codes are being used by “large reference laboratories and federal agencies, e.g., the CDC and the Department of Veterans Affairs, and are part of the Health Insurance Portability and Accountability Act (HIPAA) attachment proposal. It is one of the external vocabularies used by the Digital Imaging and Communications in Medicine (DICOM). 7 Internationally, LOINC codes “have been adopted in Switzerland, Hong Kong, Australia, and Canada, and by the German national standards organization, the Deutsches Instituts für Normung.” 1p. 624 The HL7 Standards Development Organization in 1999 identified LOINC as “a preferred code set for laboratory test names in transactions between healthcare facilities, laboratories, laboratory testing devices, and public health authorities.” 9
An National Institute of Health page with much information about both SNOMED and LOINC.
References
1. McDonald CJ, Huff SM, Suico JG, et al. LOINC, a Universal Standard for Identifying Laboratory Observations: A 5-Year Update. Clinical Chemistry. April 1, 2003 2003;49(4):624-633 [Electronic Version at http://www.clinchem.org/content/649/624/624.long] .
2. Matney S. Using Information and Terminology Standards to Improve Care. Vol 2014: 3M Health Information Systems; 2013.
3. Kunkel DE, Westra BL, Hart CM, Subramanian A, Kenny S, Delaney CW. Updating and normalization of the Nursing Management Minimum Data Set element 6: patient/client accessibility. Comput Inform Nurs. Mar 2012;30(3):134-141.
4. Saba VK. About CCC. 2012; http://www.sabacare.com/About/?PHPSESSID=
b9e97459af41b2c80d194d7434aa7800 .
5. SNOMED CT and LOINC to be linked by cooperative work. 2013; http://www.ihtsdo.org/about-ihtsdo/governance-and-advisory/harmonization/loinc .
6. Kim TY, Matney SA. Standards. In: Nelson R, & Staggers, N., eds. Health Informatics: An Interprofessional Approach. St. Louis, MO: Elseiver; 2014:351-369.
7. Vreeman D. LOINC Overview. 2010; http://loinc.org/faq/getting-started/getting-started/#how-are-loinc-and-relma-distributed . Accessed October 1, 2014.
8. LOINC Development. 2014; https://loinc.org/background/loinc-development. Accessed September 30, 2014.
9. Logical Observation Identifiers Names and Codes (LOINC®). 2013; http://www.nlm.nih.gov/research/umls/loinc_main.html . Accessed September 30, 2014.
Additional Resources for the CCC
NEW: Vreeman, D. New Universal Nursing Management Codes Can Enlighten Staffing and Environmental Decisions. July 17, 2015.
A new standardized data set of more than 100 coded and measurable terms is now available that enables health care systems to objectively evaluate and compare the effectiveness of their nursing care, staffing and facilities – unit-by-unit and shift-by-shift.
Harman TL, Seeley RA, Oliveira IM, et al. Standardized mapping of nursing assessments across 59 U.S. military treatment facilities. Paper presented at: AMIA Annu Symp Proc2012; Washington, DC.
Article reporting that nursing flowsheet data can be mapped to standard terminologies, but there is a lack of coverage necessary to represent nursing assessments.
Choi J, Jenkins ML, Cimino JJ, White TM, Bakken S. Toward Semantic Interoperability in Home Health Care: Formally Representing OASIS Items for Integration into a Concept-oriented Terminology. J Am Med Inform Assoc. Jul-Aug 2005;12(4):410-417.
Report of attempt to formally represent OASIS-B1 concepts using the LOINC.)
Hyun S, Bakken S. Toward the creation of an ontology for nursing document sections: mapping section names to the LOINC semantic model. AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium. 2006:364-368.
A study that aimed to identify the components of existing electronic nursing documents, and to represent them with Logical Observation Identifiers, Names, and Codes (LOINC) to assess the sufficiency of LOINC for non-ambiguously defining nursing document components.
A Wikipedia description of LOINC with some interesting facts.
Currie LM, Mellino LV, Cimino JJ, Bakken S. Development and representation of a fall-injury risk assessment instrument in a clinical information system. Stud. Health Technol. Inform. 2004;107(Pt 1):721-725
As part of a larger project aimed at identifying and addressing the information needs of clinicians while using a clinical information system, an electronic fall and injury risk assessment instrument is in development to address a hospital-based fall and injury prevention initiative.
Scichilone RA. The benefits of using SNOMED CT and LOINC in assessment instruments. Journal of AHIMA / American Health Information Management Association. Jul 2008;79(7):56-57.
Sheide A, Wilson PS. Reading up on LOINC. Journal of AHIMA / American Health Information Management Association. Apr 2013;84(4):58-60
Westra BL, Subramanian A, Hart CM, et al. Achieving "meaningful use" of electronic health records through the integration of the Nursing Management Minimum Data Set. Journal of Nursing Administration. Jul-Aug 2010;40(7-8):336-343
Article about the use of the National Management Mminimum Data Set to reduce administrative burden and enhance the meaningful use of healthcare data so that nursing relevant contextual data are available to improve outcomes and safety measurement for research and quality improvement in and across healthcare organizations.
Created October 1, 2014
