Meaningful use. Meaningful data. Meaningful care. The 3M Healthcare Data Dictionary: Standardizing lab data to LOINC for meaningful use

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1 Meaningful use. Meaningful data. Meaningful care. The 3M Healthcare Data Dictionary: Standardizing lab data to LOINC for meaningful use

2 Executive summary By using standard terminologies to report on core and menu-set objectives, meaningful use (MU) aims to establish a more effective means of capturing and using structured and computable healthcare data that is comparable across organizations and facilities. Stage 2 MU criteria emphasize information exchange between providers to improve care coordination. One of the biggest Stage 2 headaches is integrating and using laboratory data in electronic health records (EHR). Results must be coded in Logical Observation Identifiers Names and Codes (LOINC ). LOINC codes are used to: Incorporate lab orders and results into the EHR Submit lab results to public health agencies Transmit lab results to providers Report cancer cases to registries To meet MU requirements, a healthcare organization must be able to send, receive and store LOINC codes and report results to public health agencies.

3 Challenge: LOINC terminology compliance and MU Most electronic health records (EHRs) fail to meet provider expectations or needs. The EHR is designed to accept LOINC codes from an LIS, but not required to generate them. The EHR often contains empty fields where the LOINC codes should appear. The typical LIS database structure does not adhere to the LOINC format. Most EHRs do not have all the data necessary for LOINC. Less than 20% of the data can be mapped to LOINC. The result? Organizations must map laboratory information system (LIS) codes to LOINC on their own. Bottom line: Mapping laboratory data to LOINC codes requires significant expertise and effort. Integrating lab data into an EHR and leveraging it for reporting can be even more challenging.

4 Solution: 3M Healthcare Data Dictionary and 3M expertise With the 3M Healthcare Data Dictionary (3M HDD) and 3M s expert mapping services, providers can: Map all laboratory data accurately to LOINC Comply with Stage 2 requirements Manage all the standard and local terminologies required for MU Integrate disparate information systems to leverage all available data for an accurate and complete clinical picture Why 3M? Implementation experience and domain expertise The 3M HDD team is comprised of established subject matter experts in the laboratory domain with extensive experience in mapping local codes to LOINC. Many 3M HDD team members are active participants on LOINC and laboratory standards committees and are major contributors to the growth of LOINC content. To date, 3M has mapped more than a million legacy codes in the laboratory domain.

5 What is the 3M HDD? The 3M HDD is a terminology application that integrates a standard terminology like LOINC with local codes developed internally by an organization or inherited from legacy systems. All the concepts needed to describe medical care are identified in the 3M HDD by numeric concept identifiers, or NCIDs. Each LOINC code, name and the local LIS code (and name) are normalized by an NCID in the 3M HDD, as shown in this diagram: LOINC code 3M HDD Glucose, Serum or Plasma Quantitative NCID Glucose: MCNC:PT: Serum / Plasma: QN GLU LOINC name LIS #1 code R1234 LIS #2 code The 3M HDD concept mapping approach achieves semantic interoperability and lets the LIS and EHR continue to use local codes and maintain links to standard terminologies thanks to the 3M HDD.

6 Why use the 3M HDD solution? Because such a large percentage of data in an LIS never leaves it, the data does not have standard codes and is not usable in an EHR. However, approximately 70 percent of LIS data can be mapped to LOINC by using the 3M HDD and 3M mapping services. More importantly, clinical data and terminologies like LOINC are dynamic entities. LOINC is updated semi-annually, with new codes added and old ones removed. LOINC grows through submissions from laboratories and implementers like 3M. But when an organization uses the 3M HDD and 3M mapping services: If a lab test is not currently included in LOINC, the local code can be mapped to a 3M HDD concept and 3M will submit an update request to LOINC on behalf of the customer. If a LOINC code is assigned in a future release, it can be added to the 3M HDD to the same NCID to which the local code is already assigned and made available to the client seamlessly. Healthcare organizations count on 3M to assist with the integration of new LIS and other ancillary information systems, so they can continue to populate their EHR with data that can be compared and analyzed across the enterprise and continue to meet MU standards.

7 3M HDD: Concept relationships to power data analytics More than just mapping The 3M HDD defines relationships among concepts that enable data grouping and comparison. These relationships are derived from industry standards or can be custom-built to meet specific user requirements. For example, if you search LOINC for glucose, you will get back around 800 LOINC codes. Not very helpful when you want to analyze data. However, when you use the 3M HDD for your glucose search, it s easy to identify which lab tests measure glucose instead of just contain glucose in their names. As the diagram below shows, additional relationships (e.g., Has Specimen or Has Analyte ) can further filter a search. Glucose, Serum or Plasma Quantitative NCID LOINC Glucose^Post Calorie Fast, Serum or Plasma Quantitative NCID LOINC Somatotropin^Pre/Post Dose Glucose, Serum or Plasma Quantitative NCID LOINC Select all lab tests related to this analyte Glucose NCID RxNorm 4850 SNOMED CT Has Analyte Relationship (NCID 76770) Human Growth Hormone NCID RxNorm SNOMED CT Has Analyte Relationship (NCID 76770)

8 3M HDD: Leverage integrated clinical data The 3M HDD integrates and manages major terminologies, standard or local, required by an organization, including SNOMED CT (Systematized Nomenclature of Medicine Clinical Terms), the RxNorm clinical drug standard, and ICD-9-CM and ICD-10-CM. Local codes are mapped to standards, and standard codes relate to one another. The diagram below shows how the 3M HDD expresses the concepts and relationships: Problems Acromegaly NCID SNOMED CT Has Diagnostic Lab Test (NCID ) Labs Somatotropin^Pre/Post Dose Glucose, Serum or Plasma Quantitative NCID LOINC Has Analyte Relationship (NCID 76770) Meds Human Growth Hormone NCID RxNorm SNOMED CT

9 The 3M advantage What does mapping and terminology content in the 3M HDD mean to a healthcare organization? For starters: Ability to address limitations encountered when trying to meet MU vocabulary standards criteria Availability of support, guidance and expertise in adopting, implementing and maintaining standard terminologies Access to a rich knowledge base that enables MU, decision support and analytics Data integration and translation across disparate vendor platforms Ability to improve operational efficiency and achieve semantic interoperability across the enterprise As the need for structured data capture and data exchange increases, the 3M HDD is the metadata management tool that combines comprehensive terminology content and an expert community to help your organization achieve the accurate, consistent vocabulary standardization essential to meeting MU measures today and tomorrow.

10 About 3M Health Information Systems Best known for our market-leading coding system and ICD-10 expertise, 3M Health Information Systems delivers innovative software and consulting services designed to raise the bar for clinical documentation improvement, computer-assisted coding, case mix and quality outcomes reporting, and document management. Our robust healthcare data dictionary and terminology services also support the expansion and accuracy of your electronic health record (EHR) system. With 30 years of healthcare industry experience and the know-how of more than 100 credentialed 3M coding experts, 3M Health Information Systems is the go-to choice for 5,000+ hospitals worldwide that want to improve quality and financial performance. For more information on how the 3M Healthcare Data Dictionary can assist your organization with standardizing to LOINC for your laboratories, contact your 3M sales representative, call us toll-free at , or visit us online at Health Information Systems 575 West Murray Boulevard Salt Lake City, UT U.S.A M is a trademark of 3M Company. LOINC is a registered U.S. trademark of Regenstrief Institute, Inc. SNOMED and SNOMED CT are registered trademarks of the International Health Terminology Standards Development Organisation. The International Statistical Classification of Diseases and Related Health Problems Tenth Revision (ICD-10) is copyrighted by the World Health Organization, Geneva, Switzerland M All rights reserved. Published 02/

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