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Wanchana Pontongmak M.Sc . Candidate.

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  1. Logical Observation Identifiers Names and Codes (LOINC) for Hematology Data Dictionary : Exemplified in Thai University Hospitals WanchanaPontongmak M.Sc. Candidate. PiangchanRojanavipart M.Sc., M.H.S. ChukiatViwatwongkasem PhD. BoonchaiKijsanayotin M.D., PhD.

  2. Outline • Background & Rationale • Objective • Materials and Methods • Results • Discussions & Conclusions

  3. Background & Rationale • Health information exchange (HIE) is the transmission of healthcare-related data electronically across organizations within a region, community or hospital system • Interoperability is a critical element in the future success of HIE at all level • To enable interoperability between systems, the health data standards are needed • Thailand has no standards for clinical laboratory test data at national level (Kijsanayotin B 2010)

  4. Background & Rational • Hematology test is an important laboratory test group used for testing the variety of blood • More than 20% of Thai Comptroller General Department (CGD) lab test listare hematology tests • The university hospitals lab test list is almost covered all lab tests in the country

  5. What is LOINC ? Logical Observation Identifiers names and codes (LOINC) is a unique identifier for medical laboratory and clinical observations LOINC • developed and maintained by the RegenstriefInstitute • contains more than 72,625 terms • broadly used in many countries • free of charge

  6. How does LOINC look like? • Serial code 1-5 characters and the check digit 1 character 20509-6 • The name consists of 6 axes <component>:<property>:<time>:<sample>:<scale>:<method> 20509-6 Hemoglobin : MCnc : Pt : Bld : Qn : Calculated 49498-9Leukocytes : NCnc : Pt : Bld : Qn : Estimate Hemoglobin [Mass/​volume] in Blood by Calculation Leukocytes [Number/volume] in Blood by Estimation Number concentration (10*3/uL) Result data type analyte that being measured concentration type When it is done Specimen type approach to do Mass concentration (g/dL) Point in time Blood Quantitative Running number Check digit number

  7. Objective • To construct a hematology data dictionary from the LOINC database based on hematology terms from 2 university hospitals in Thailand

  8. Materials & Methods • Local hematology test list (407 tests) • Ramathibodi hospital (198 tests) • Siriraj hospital (209 tests) • LOINC database and RELMA, (was released in 29 July 2013) • Available at www.loinc.org • Microsoft Excel

  9. Example of Data source Siriraj Ramathibodi

  10. RELMA

  11. Materials & Methods • Variable selection • Data cleansing and enhancing • Mapping • Hematology Data Dictionary

  12. 1. Variable selection • Selected local test variables • The selected variables: test names, unit, specimen, timing, data type and method • Other necessary variables: test code, short name, test group, and lab category

  13. 2. Data cleansing and enhancing Verifying model was adopted from the verification level flag (Verification Level Flag in HISPID (Conn 2000)) • Self determining • Expert determining • Cleansing local terms • Error types • Typographic errors • Non-generic names • Local test names • Duplicated terms

  14. 2. Data cleansing and enhancing • Enhancing local terms (Kim 2012) • online reference materials • hematology text books • Pooling local terms into one list • Removing duplicated terms

  15. 3. Mapping • Mapping • RELMA • Algorithm

  16. Results Two hundreds and forty two hematology test data were unique and used for mapping with LOINC codes More than 85% could be mapped to LOINC codes, of which 59.09% are 1-1, 27.27% are 1-Many, and 13.64 are unmapped

  17. Results • 209 Thai hematology terms were mapped to 315 LOINC terms • 66 LOINC terms for 1-1 • 179 LOINC terms for 1-Many

  18. Discussions & Conclusions • One to many results LOINC has high level of granularity than local tests • Multiple components • Multiple units • Multiple specimens • Multiple methods • The number of 1-Many mapping are 2.7 times of one to one mapping. This implies the high granularity of LOINC standard

  19. Discussions & Conclusions • Unmapped results • Local lab profile codes • No LOINC codes

  20. Discussions & Conclusions The high percentage of mapping indicates LOINC is appropriate for hematology lab test data in Thai healthcare services The hematology data dictionary has a potential to uses as a minimum codes list of LOINC standard in order to facilitate lab workers to standardize their local hematology tests The mapping processes for other type of laboratory tests should be continued in order to promote interoperability in HIS in Thailand

  21. Q&A

  22. Thank You