The bulk of the recent media attention directed at clinical terminology standards has, for quite obvious reasons, been focused on the the impending October 1, 2015 deadline for ICD-10 conversion. SNOMED, the terminology meant to standardize the way interactions between patients and clinicians are recorded in EHRs, also often gets mentioned in the context of their relative relationship to the ICD-10 overhaul. But despite all the buzz surrounding these high-profile terminologies and their impact on the future of health care, it’s important for providers to remember that Meaningful Use standards apply to more than just attestation these days.
That is why it is important for facilities undertaking laboratory work to get up to speed on LOINC.
Preventing Mistakes Between the Lab and the Clinic
While the LOINC standard has indeed recently been recommended by the FDA, one does not need to be overly familiar with the legislation surrounding LOINC to see its importance. Obviously a great deal of what constitutes effective patient care happens in the clinic, but there is another side to it as well. Much what makes a visit to a health care provider valuable goes on behind the closed doors of the laboratory, and that is where LOINC terminology applies.
Just as the implementation of SNOMED seeks to standardize how problems are documented within the EHR, the implementation of LOINC seeks to standardize the terminology used in lab results.
The effective and correct processing of lab work is critical to establishing diagnoses, informing courses of treatment, and ensuring a patient’s well-being. If local laboratories are not set up to communicate effectively and in the same language with clinic EHRs or with each other, interoperability issues can easily arise.
What Could Go Wrong Without LOINC?
The potential problems that can arise without a standard vocabulary for discussing results are easy to see. For instance, a patient gets bloodwork done at a local lab and the results are sent to an enterprise data warehouse for reporting and analytics, to a facility on an HIE platform, or to a hospital that is part of an ACO. If the EHR cannot understand the laboratory’s localized terminology, the results become un-usable.
On the provider side, the Meaningful Use program has established a new generation of certified EHRs that come packaged with support for SNOMED, RxNorm, and LOINC. But the burden is on the provider to ensure that their local lab systems can properly communicate with their EHR in order to attest for Meaningful Use dollars. This quickly becomes an interoperability obstacle especially if the EHR doesn’t come packaged with mapping or data normalization capabilities.
LOINC Beyond the Lab - Closing the Gap Between Orders and Results
Effective patient care is not the only reason interoperability is important. Laboratory test results are used in a variety of different scenarios. The data that LOINC terminology describes can be used within quality measures where health plans need to have visibility between what was ordered and what was actually completed by the lab. For instance, through the application of a map between CPT and LOINC, an organization may want to answer critical business questions like - was the lab test actually completed? Was the right test performed? Are all the test results accounted for based on the corresponding claim? Are any follow-up activities required with a particular patient cohort? .
Above and beyond attesting for Meaningful Use and utilizing LOINC for quality measures, the advantages of the LOINC terminology are clear. Facilitating an environment in which lab results are standardized, inside the lab and out, makes encoding lab results in LOINC a must for institutions concerned with accuracy, interoperability, and enabling reporting and population health initiatives..
Is your local lab results encoded in LOINC? If not, how are you addressing your interoperability challenges? Leave your comments below.