LOINC Mapping Manual A Guide to assist in the LOINCing of electronic lab results in Nightingale on Demand LOINC Mapping Manual Version 1.0 1
Contents 1.0 Introduction... 3 1.1 LOINC Mapping... 3 1.2 Before you Begin LOINC Mapping... 3 1.3 How to LOINC an Electronic Lab Result... 4 1.4 LOINC Mapping Reminders... 5 1.5 Common lab names for the CDM Diabetes Flowsheet... 5 1.6 Common lab names for an INR Flowsheet... 11 1.7 LOINC Names in NOD... 11 For questions or comments, please contact: AOHC EMR Project Association of Ontario Health Centres emr@aohc.org LOINC Mapping Manual Version 1.0 2
1.0 Introduction LOINC Mapping in Nightingale on Demand (NOD is conducted at an enterprise level, and ensures that the electronic lab results contained in client charts can be viewed/presented to users in a consolidated manner. LOINC stands for Logical Observation Identifiers Names and Codes which is a universal code system for identifying laboratory and clinical observations. http://loinc.org It is recommended that a clinical super user complete LOINC mapping in the production environment during Go Live week. LOINC mapping requires that the user has basic knowledge of lab test language and clinical acronyms. 1.1 LOINC Mapping You can associate lab results from different lab facilities with a common LOINC lab name so all results for the same or similar tests can be included on the same graph, table or flowsheet (including CDM Flowsheets regardless of the lab facility that performed the test. This is done by including tests from all labs to the single applicable LOINC code name. LOINCing also associates electronic lab results with lab results that have been manually entered into NOD. Instructions for the completion of LOINC mapping, a partial list of commonly used codes, and NOD LOINC names is included in this manual. 1.2 Before you Begin LOINC Mapping Ensure you have identified the commercial labs that you will be receiving electronic results from e.g. Lifelabs (MDS, CML, Gamma-Dynacare, Alpha. If you would like to include lab results from local hospitals, contact Nightingale helpdesk to ensure the setup of the hospital in the Lab Sites listing for inclusion in your LOINC mapping. If you are migrating lab data from Purkinje to NOD, the Purkinje lab results should also be LOINC mapped. If your providers conduct queries in Ontario Lab Information System (OLIS, any results filed to your patient charts can also be mapped. Ensure you complete LOINC mapping for all lab results used in the NOD supplied CDM Flowsheets for Diabetes, Hypertension, Asthma, COPD and Heart Failure. Identify and prioritize additional lab results that your providers want LOINCed, to ensure complete graph/chart displays regardless of the source lab. LOINC Mapping Manual Version 1.0 3
1.3 How to LOINC an Electronic Lab Result LOINC Mapping is performed in the Enterprise module and therefore applicable to all providers / locations within the enterprise. 1. In the Enterprise module, click the Mapping then the LOINC menu. The Lab Mapping screen displays. 2. In the Lab Name field, select the laboratory from the list. Use the first entry in the list displayed for CML, Gamma-Dynacare, and MDS (these are the Ontario based providers 3. In the Test Name field, type the name of the test that you wish to map. Search using contains the word if unsure of the lab test name. The matching results display in the list in the Available Tests field. 4. In the Available Tests field, select the test that you want to map from the list and click Add. The test displays in the Selected Tests list box. Select one of each spelling variation/categorization of the desired lab result. Ex: Glucose,, glucose, (Routine Chemistry, (Chemistry II, (Chemistral 5. In the Lab Name field, select another laboratory from the list. If the search criteria is unchanged in the Test Name field, all matching results for the newly selected lab display. 6. In the Available Tests field, select the test and click Add. 7. Repeat the steps above until you have selected the same test from all labs that you receive results from. 8. In the Loinc field, type the equivalent test name. The search results display in the list LOINC Results field. 9. In the LOINC Results field, select the required LOINC test name. 10. Select Map All LOINC Mapping Manual Version 1.0 4
1.4 LOINC Mapping Reminders Keep track of the test results that you have LOINC mapped and monitor flowsheets, graphs and charts to ensure results are flowing and displaying as expected. The application does not display LOINC mapped results to users. PLEASE NOTE: If your lab results are not working as expected or LOINC mapping needs to be edited, the LOINC mapping process must be redone. Ensure that all available tests have been included and the same LOINC name is selected. Each subsequent mapping will replace the prior entered mapping. For example, if Nightingale advises that new lab interfaces are available you will have to repeat the LOINC mapping process if you want these results to be included in the flowsheets, graphs and chart displays including all prior labs sites and the new lab site in the mapping. If you create CDM Flowsheets, ensure you use the appropriate LOINC name for the lab results that you expect to flow into the flowsheet. If you need assistance to identify an appropriate LOINC name, contact the helpdesk to assist in the identification of the appropriate/available names in the system. 1.5 Common lab names for the CDM Diabetes Flowsheet The following tables provide a list of lab test names frequently used by laboratories and utilized in the NOD supplied CDM Flowsheet for Diabetes. This list is not 100% complete and includes examples of available tests that you may see when you conduct LOINC mapping for commercial labs and LOINC Mapping Manual Version 1.0 5
migrated Purkinje lab results. Hospital test names have not been included in the listing. Name Gamma Dynacare Life Labs(MDS CML Manual lab tests (ONLY for former Purkinje sites HbA1C Search A1C. A1c (. HEMOGLOBIN A1C (. A1C (. A1c ( HEMOGLOBIN A1C A1C ( HEMOGLOBIN A1C HEMOGLOBIN Search A1C. HbA1C HbA1C ( CHEMISTAL HbA1C ( I HBA1C ( I Search A1C. See results like: A1C HEMOGLOBI N A1C ( A1c ( A1C ( Search A1C. See results like: 42302-MDS_HBA1C ( MASTER LIST 4240-_A1C ( MASTER LIST 4240-BIOT_A1C ( Master List 4241-_HEMOGLOBIN A1C ( MASTER LIST 4241- BIOT_HEMOGLOBIN A1C ( Master List 4243-_A1CHB MASTER LIST 4243-BIOT_A1CHB A1C ( Other Master List A1C ( Other 4244-_A1CHB2 A1c ( Other Master List 4244-BIOT_A1CHB2 Master List GLYCOSYLATED HEMOGLIB (HBA1C ( GLYCOSYLATED HEMOGLIB (HBA1C ( Master List HBA1C ( Master List HEMOGLOBIN A1C ( Master List HEMOGLOBIN A1C(CML ( Master LOINC Mapping Manual Version 1.0 6
Name Gamma Dynacare Life Labs(MDS CML Manual lab tests (ONLY for former Purkinje sites List SUBTITLE_HEMOGLO BIN A1C(CML ( Master List LDL Search LDL. LDL CALC. LDL CALC. (LDL CALC. LDL CALC.( OTHER Search LDL. LDL L (Calculated LDL L ( CALCULATED LDL L ( CHEMISTAL LDL L ( I LDL L ( CVD RISK LDL L ( CVD ORONTO Search LDL. See results like: LDL CHOLESTER OL LDL Cholesterol ( LDL CHOLESTER OL ( LDL cholesterol ( Search LDL. See results like: 4102-_LDL (RAND ( Master List 4223-_LDL (FAST ( Master List 4224-BIOT_LDL (FAST ( Master List 4224-_LDL (FASTING Master List 4224-BIOT_LDL (FASTING Master List 4225-_LDL (RANDOM Master List 42748-MDS_LDL (C ALCULATED ( Master List LDL ( Master List LDL ( Master List LDL CALC. ( Master List LOINC Mapping Manual Version 1.0 7
Name Gamma Dynacare Life Labs(MDS CML Manual lab tests (ONLY for former Purkinje sites LDL (C ML ( Master List We do NOT include: SUBTITLE_/ LDL(CML ( Master List Search. Cholesterol (. cholesterol (. (. ( Cholesterol ( Cholesterol ( Other Search. cholesterol ( CVD ORONTO L ( CVD RISK cholesterol ( CVD RISK L ( CHEMISTAL cholesterol ( CHEMISTAL Search. See results like: Cholesterol ( CHOLESTER OL ( CHOLIS ( CHOLESTTT TTT<32010 9/L6 ( CHEMSITRY Search. See results like: 2023-_ (RAND ( Master List 4009-_ (FAST ( Master List 4009-BIOT_ (FAST ( Master List 42769-MD_ ( Master List ( Master List ( Master List (CML ( Master List Assume we don t include: SUBTITLE_/LDL( CML ( Master List cholesterol ( ( OTHER I L ( I ACR Search MICROALB Search ALBUMIN, Search MICROALB Search microalb LOINC Mapping Manual Version 1.0 8
Name Gamma Dynacare Life Labs(MDS CML Manual lab tests (ONLY for former Purkinje sites MICROALB/CR EAT RATIO ( N 24h U MICROALB/CR EAT RATIO ( N R U N (24H U ( N 24h U N (RDM U ( N R U N (24H U ( OTHER N R U (. N R U (MICROALBU MIN R U N R U ( OTHER ALBUMIN CREATINE RATIO U ( III ALBUMIN/GL OBULIN RATIO ( II MICROALBUM IN ( AER MICROALBUM IN (RANDOM ( III MICROALBUM IN EXCRETION RATE ( AER See results like: MICROALB/ CREAT. (CHEMISTR Y ALBUMIN ( IMMUNOCH EMISTRY Albumin ( IMMUNOCH EMISTRY MICROALBU MIN (RUR ( MICROALBU MIN (UR ( Albumin; Urine ( 8134- _N/CR EAT. RATIO (URINE ( Master List 8134- BIOT_ N/CREAT. RATIO (URINE ( Master List MICROALB/CREATE RATIO ( Master List MICROALB/CREAT.(C ML ( Master List N ( Master List N (24H U ( Master List N (RDM U ( Master List N (RUR(CML ( Master List N (UR(CML ( Master List N 24H U ( Master List N R U ( Maser List NURIA ( Master List Fasting Glucose Search SERUM FASTING SERUM FASTING (. Search - FASTING and FASTING FASTING ( SPECIAL / Search FASTING-SER See results like: Glucose Fasting ( 42011- MDS_- FASTING ( Master List 42115- MDS_- FASTING ( Master List LOINC Mapping Manual Version 1.0 9
Name Gamma Dynacare Life Labs(MDS CML Manual lab tests (ONLY for former Purkinje sites SERUM II FASTING - FASTING ( 42210- (OTHER FASTING ( MDS_- FASTING ( Master List SERUM Glucose FASTING - Fasting ( Glucose Fasting ( FASTING ( (Master List SERUM CHALLENGE Glucose Fasting(CML FASTING I 75mg ( Master List Glucose FASTING- - Fasting ( SER(CML ( Master FASTING ( List CHEMISTRAL TOLERANCE 75G: Glucose SUBTITLE_ FASTING(CML ( Master List - Fasting ( Glucose Serum Fasting FASTING ( - GTT GTT- GESTATION AL 100G: FASTING ( ( Master List GLUCOMETER FASTING ( Master List LACTOSE TOLERANCE TEST: FASTING-SE ( FASTING- SER ( Some of the same lab tests will appear within NOD supplied CDM flowsheets. Once the LOINC mapping is completed once for the specific test, the lab results with flow into all associated flowsheets which contain that lab test. LOINC Mapping Manual Version 1.0 10
1.6 Common lab names for an INR Flowsheet An INR flowsheet may be developed by your Centre if desired, as there is no pre-developed INR flowsheet available in NOD. It is not recommended to LOINC prothrombin time into your INR tests. Although they measure the same thing, they are on different scales. Combining prothrombin time results alongside INR results will make your flowsheet very difficult to interpret. Name INR Gamma Dynacare Search INR. INR (. inr (. INR ( INR INR ( Other Inr ( Other Life Labs(MDS Search INR. inr ( HEMATOLOG Y IV INR ( HEMATOLOG Y IV CML Search I.N.R.. I.N.R. ( HEMATOLOG Y IV Manual lab tests (ONLY for former Purkinje sites Search INR and I.N.R.. I.N.R.(CML ( Master List 1069-_INR ( Master List 1069-BIOT_INR ( Master List 18402- MDS_INR ( Master List 18414- MDS_INR ( Master List INR ( Master List 1.7 LOINC Names in NOD The following chart provides the LOINC names you will require for all NOD supplied CDM Flowsheets and your custom developed INR Flowsheet. Once a LOINC name is entered, the LOINC results pick list will be generated, and the appropriate name must be selected before the Map All button is clicked to complete the mapping process. LOINC Mapping Manual Version 1.0 11
CDM Flowsheet: Diabetes: Lab Test Name HbA1C Fasting Glucose Blood Gas Studies LDL Cholesterol Cholesterol TC:-C Ratio Triglycerides ACR egrf NOD LOINC Name: HEMOGLOBIN A1C/HEMOGLOBIN.TOTAL CSF/ PLAS BLOOD GAS STUDIES.IN LDL.IN.IN /.TOTAL NOTE: This LOINC name is being investigated for accuracy by NIC Support TRIGLYCERIDE ALBUMIN/CREATININE GLOMERULAR FILTRATION RATE CDM Flowsheet: Heart Failure: Lab Test Name Sodium Potassium Creatinine egrf NOD LOINC Name: SODIUM POTASSIUM CREATININE GLOMERULAR FILTRATION RATE CDM Flowsheet: Hypertension: Lab Test Name Fasting Glucose ACR egfr TC:-C Ratio LDLC Triglycerides NOD LOINC Name: CSF/ PLAS ALBUMIN/CREATININE GLOMERULAR FILTRATION RATE.TOTAL/.IN.IN LDL TRIGLYCERIDE CDM Flowsheet: Asthma: Lab Test Name PEFR NOD LOINC Name: EXPIRATORY VOLUME.FORCED AT 1.0 S/VITAL CAPACITY.FORCED CDM Flowsheet: COPD: Lab Test Name Oxygen Saturation % NOD LOINC Name: OXYGEN SATURATION LOINC Mapping Manual Version 1.0 12
Centre-developed Flowsheet: INR Lab Test Name INR NOD LOINC Name: COAGULATION TISSUE FACTOR INDUCED.INR LOINC Mapping Manual Version 1.0 13