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The potential adoption benefits and challenges of LOINC codes in a laboratory department: a case study

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Abstract

Background

Logical Observation Identifiers Names and Codes (LOINC) are a standard for identifying and reporting laboratory investigations that were developed and are maintained by the Regenstrief Institute. LOINC codes have been adopted globally by hospitals, government agencies, laboratories, and research institutions. There are still many healthcare organizations, however, that have not adopted LOINC codes, including rural hospitals in low- and middle- income countries. Hence, organizations in these areas do not receive the benefits that accrue with the adoption of LOINC codes.

Methods

We conducted a literature search by utilizing PubMed, CINAHL, Google Scholar, ACM Digital Library, and the Biomed Central database to look for existing publications on the benefits and challenges of adopting LOINC. We selected and reviewed 16 publications and then conducted a case study via the following steps: (1) we brainstormed, discussed, analyzed, created and revised iteratively the patient’s clinical encounter (outpatient or ambulatory settings) process within a laboratory department via utilizing a hypothetical patient; (2) we incorporated the work experience of one of the authors (CU) in a rural hospital laboratory department in Nigeria to break down the clinical encounter process into simpler and discrete steps and created a series of use cases for the process; (3) we then analyzed and summarized the potential usage of LOINC codes (clinically, administratively, and operationally) and the benefits and challenges of adopting LOINC codes in such settings by examining the use cases one by one.

Results

Based on the literature review, we noted that LOINC codes’ ability to improve laboratory results’ interoperability has been recognized broadly. LOINC-coded laboratory results can improve patients’ safety due to their consistent meaning as well as the related reduction of duplicate lab tests, easier assessment of workloads in the laboratory departments, and accurate auditing of laboratory accounts. Further, the adoption of LOINC codes may motivate government agencies to upgrade hospitals’ infrastructures, which could increase the possibility of international recognition of laboratory test results from those hospitals over the long term. Meanwhile, a lack of LOINC codes in paper format and a lack of LOINC codes experts are major challenges that may limit LOINC adoption.

Conclusion

In this paper, we intend to provide a snapshot of the possible usage of LOINC codes in rural hospitals in low- and middle-income countries via simpler and detailed use cases. Our analysis may aid policymakers to gain a deeper understanding of LOINC codes in regard to clinical, administrative, and operational aspect and to make better-informed decisions in regard to LOINC codes adoption. The use case analysis also can be used by information system designers and developers to reference workflow within a laboratory department. We recognize that this manuscript is only a case study and that the exact steps and workflows may vary in different laboratory departments; however, the core steps and main benefits should be consistent.

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References

  1. “LOINC from Regenstrief.” https://loinc.org/. Accessed 08 May 2017.

  2. McDonald C, Huff S, Suico J, Hill G, Leavelle D, Aller R, Forrey A, Mercer K, DeMoor G, Hook J, Williams W, Case J, Maloney P. LOINC, a universal standard for identifying laboratory observations: a 5-year update. Clin Chem. 2003;49(4):624–33.

    Article  CAS  PubMed  Google Scholar 

  3. S. H. P. ONC, State HIE bright spots synthesis lab exchange. https://www.healthit.gov/sites/default/files/lab_exchange_bright_spots_synthesis_final_09302013.pdf. 2013.

  4. ONC. Health IT dashboard. http://dashboard.healthit.gov/index.php. 2015.

  5. WHO. WHO forum on health data standardization and interoperability. WHO, Geneva, 2012.

  6. Kijsanayotin B, Thit WM. 12 Health Information Standards and Interoperability. Global health informatics: Principles of ehealth and mhealth to improve quality of care. Cambridge: Cambridge University Press; 2017. p. 149.

    Google Scholar 

  7. Wu L. Recommendations for a global framework to support health information exchange in low- and middle-income countries. 2016.

  8. Lin M, Vreeman D, McDonald C, Huff S. Auditing consistency and usefulness of LOINC use among three large institutions—Using version spaces for grouping LOINC codes. J Biomed Inf. 2012;45:658–66.

    Article  CAS  Google Scholar 

  9. Bodenreider O. Biomedical ontologies in action: role in knowledge management, data integration and decision support. Yearb Med Inform. 2008;47:67–79.

    Google Scholar 

  10. Scichilone R. The Benefits of Using SNOMED CT and LOINC in Assessment Instruments. J AHIMA. 2008;79(9):56–7.

    PubMed  Google Scholar 

  11. Wu J, Finnell J, Vreeman D. Evaluating congruence between laboratory LOINC value sets for quality measures, public health reporting, and mapping common tests. In: AMIA Annual Symposium Proceedings, pp. 1525–1532. 2013.

  12. FDA Adopts LOINC Standard. J AHIMA. 2015;86(7):13. http://connection.ebscohost.com/c/articles/103422821/fda-adopts-loinc-standard

  13. Vreeman D, Chiaravalloti M, Hook J, McDonald CJ. Enabling international adoption of LOINC through translation. J Biomed Inf. 2012;45:667–73.

    Article  Google Scholar 

  14. Deckard J, McDonald C, Vreeman D. Supporting interoperability of genetic data with LOINC. J Am Med Inf Assoc. 2015;22:621–7.

    Article  Google Scholar 

  15. Beitia A, Kuperman G, Delman B, Shapiro J. Assessing the performance of LOINC® and RadLex for coverage of CT scans across three sites in a health information exchange. In: AMIA Annual Symposium Proceedings, pp. 94–102. 2013.

  16. Wilson P, Scichilone R. LOINC as a data standard. J AHIMA 2011;82:44–47.

  17. Abhyankar S, Goodwin R, Sontag M, Yusuf C, Ojodu J, McDonald C. An updateontheuseofhealthinformation technology innewbornscreening. Semin Perinatol. 2015;39:188–93.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Sheide A, Wilson P. Reading Up on LOINC. J AHIMA. 2013;84(4):58–60.

    PubMed  Google Scholar 

  19. Aller R. For vendors, LOINC a fast track to the future. CAP Today. 2003;17(11):34.

    PubMed  Google Scholar 

  20. Lin M, Vreeman D, McDonald C, Huff S. Correctness of voluntary LOINC mapping for laboratory tests in three large institutions. In: AMIA 2010 Symposium Proceedings, pp. 447–451. 2010.

  21. Baorto D, Cimino J, Parvin C, Kahn M. Combining laboratory data sets from multiple institutions using. Int J Med Inf. 1998;51:29–37.

    Article  CAS  Google Scholar 

  22. Lab Interoperability Cooperative. How to conquer the top 10 challenges/tricks of the trade and straightforward advice. http://www.cybermanual.com/how-to-conquer-the-top-10-challenges_tricks-of-the-trade.html.

  23. Lessons learned from a journey to EMR. Health Manag Technol. 2009;30(11):24–7.

  24. Oak M. A review on barriers to implementing health informatics in developing countries. J Heal Informatics Dev Ctries. 2007;1(1):19–22.

    Google Scholar 

  25. Korganonkar R. Adoption of information system by Indian hospitals: challenges and roadmap. Int J Sci Eng Res. 2014;5(2):473–9.

    Google Scholar 

  26. Moodley D, Seebregts C, Pillay A, Meyer T. An ontology for regulating eHealth interoperability in developing African countries. In: International Symposium on Foundations of Health Informatics Engineering and Systems, pp. 107–124. 2013

  27. Patterson M, Bond R, Mulvenna M, Reid C, McMahon F, McGowan P, Cormican H. The design of a computer simulator to emulate pathology laboratory workflows. In: Proceedings of the European Conference on Cognitive Ergonomics, p. 25. 2016.

  28. Muirhead D, Aoun P, Powell M, Juncker F, Mollerup J. Pathology economic model tool: a novel approach to workflow and budget cost analysis in an anatomic pathology laboratory. Arch Pathol Lab Med. 2010;134(8):1164–9.

    PubMed  Google Scholar 

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Acknowledgement

Authors would like to thank Dr. Clem McDonald for his constructive suggestions sincerely. This study is supported by Ohio University College of Health Sciences and Professions start-up funds and Department of Social and Public Health.

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Authors and Affiliations

  1. Department of Social and Public Health, College of Health Sciences and Professions, Ohio University, Athens, OH, 45701, USA

    Chukwuemeka Uchegbu & Xia Jing

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  1. Chukwuemeka Uchegbu
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  2. Xia Jing
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Correspondence to Xia Jing.

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Uchegbu, C., Jing, X. The potential adoption benefits and challenges of LOINC codes in a laboratory department: a case study. Health Inf Sci Syst 5, 6 (2017). https://doi.org/10.1007/s13755-017-0027-8

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