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AOHC EMR Implementation Toolkit | LOINC Mapping Manual – Version 1.0
LOINC Mapping Manual AOHC EMR Implementation Toolkit
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LOINC Mapping Manual A Guide to assist in the LOINCing of electronic lab results in Nightingale on Demand
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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 [email protected]
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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.
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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, 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
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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
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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”. See results like: Hemoglobin
A1c ( . )
HEMOGLOBIN
A1C ( . )
Hemoglobin
A1C ( . )
Hemoglobin
A1c (
HEMOGLOBIN
A1C )
Hemoglobin
A1C (
HEMOGLOBIN
A1C )
HEMOGLOBIN
A1C ( Other )
Hemoglobin
A1C ( Other )
Hemoglobin
A1c ( Other )
Search “A1C”. See results like: HbA1C
HbA1C (
ROUTINE
CHEMISTAL )
HbA1C (
ROUTINE
CHEMISTRY I
)
HBA1C (
ROUTINE
CHEMISTRY I)
Search “A1C”. See results like: Hemoglobin
A1C
HEMOGLOBI
N A1C (
CHEMISTRY
)
Hemoglobin
A1c (
CHEMISTRY
)
Hemoglobin
A1C (
CHEMISTRY
)
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
CALCULATION (
MASTER LIST )
4243-BIOT_A1CHB
CALCULATION (
Master List )
4244-_A1CHB2
CALCULATION (
Master List )
4244-BIOT_A1CHB2
CALCULATION (
Master List )
GLYCOSYLATED
HEMOGLIB (HBA1C) (
CHEMISTRY )
GLYCOSYLATED
HEMOGLIB (HBA1C) (
Master List )
HBA1C ( Master List )
HEMOGLOBIN A1C (
Master List )
HEMOGLOBIN
A1C(CML) ( Master
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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”. See results like: LDL
CHOLESTEROL CALC.
LDL CHOLESTEROL CALC. (LDL CHOLESTEROL CALC.
LDL CHOLESTEROL CALC.( OTHER )
Search “LDL”. See results like: LDL
CHOLESTEROL (Calculated)
LDL CHOLESTEROL ( CALCULATED )
LDL CHOLESTEROL ( ROUTINE CHEMISTAL )
LDL CHOLESTEROL ( ROUTINE CHEMISTRY I )
LDL CHOLESTEROL ( CVD RISK )
LDL CHOLESTEROL ( CVD ORONTOHDL )
Search “LDL”. See results like: LDL
CHOLESTEROL
LDL Cholesterol ( CHEMISTRY)
LDL CHOLESTEROL ( CHEMISTRY )
LDL cholesterol ( CHEMISTRY )
Search “LDL”. See results like:
4102-_LDL
(RAND) ( Master
List )
4223-_LDL
(FAST) ( Master
List )
4224-BIOT_LDL
(FAST) ( Master
List )
4224-_LDL
(FASTING)
CALCULATION (
Master List )
4224-BIOT_LDL
(FASTING)
CALCULATION (
Master List )
4225-_LDL
(RANDOM)
CALCULATION (
Master List )
42748-MDS_LDL
CHOLESTEROL(C
ALCULATED) (
Master List )
LDL ( Master List
)
LDL
CHOLESTEROL (
Master List )
LDL
CHOLESTEROL
CALC. ( Master
List )
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Name Gamma Dynacare
Life Labs(MDS)
CML Manual lab tests (ONLY for former Purkinje sites)
LDL
CHOLESTEROL(C
ML) ( Master List
)
We do NOT include:
SUBTITLE_HDL/
LDL(CML) (
Master List )
HDL
Search “HDL”. See results like: HDL
Cholesterol ( . )
HDL
cholesterol ( . )
HDL
CHOLESTEROL
( . )
HDL
CHOLESTEROL
( HDL
CHOLESTEROL
)
HDL
Cholesterol (
HDL
CHOLESTEROL
)
HDL
Cholesterol (
Other )
HDL
CHOLESTEROL
( OTHER )
Search “HDL”. See results like: HDL
cholesterol (
CVD
ORONTOHDL
)
HDL
CHOLESTERO
L ( CVD RISK )
HDL
cholesterol (
CVD RISK )
HDL
CHOLESTERO
L ( ROUTINE
CHEMISTAL )
HDL
cholesterol (
ROUTINE
CHEMISTAL )
HDL
cholesterol (
ROUTINE
CHEMISTRY I
)
HDL
CHOLESTERO
L ( ROUTINE
CHEMISTRY I
Search “HDL”. See results like: HDL
Cholesterol (
CHEMISTRY
)
HDL
CHOLESTER
OL (
CHEMISTRY
)
HDL CHOLIS
(
CHEMISTRY
)
HDL
CHOLESTTT
TTT<32010
9/L6 (
CHEMSITRY
)
Search “HDL”. See results like: 2023-_HDL (RAND) (
Master List )
4009-_HDL (FAST) (
Master List )
4009-BIOT_HDL
(FAST) ( Master List )
42769-MD_HDL
CHOLESTEROL (
Master List )
HDL ( Master List )
HDL CHOLESTEROL (
Master List )
HDL
CHOLESTEROL(CML)
( Master List )
Assume we don’t include:
SUBTITLE_HDL/LDL(
CML) ( Master List )
ACR
Search “MICROALB”
Search “ALBUMIN”,
Search “MICROALB
Search “microalb” See results like:
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Name Gamma Dynacare
Life Labs(MDS)
CML Manual lab tests (ONLY for former Purkinje sites)
See results like: MICROALB/CR
EAT RATIO (
MICROALBUMI
N 24h U)
MICROALB/CR
EAT RATIO (
MICROALBUMI
N R U)
MICROALBUMI
N (24H U) (
MICROALBUMI
N 24h U)
MICROALBUMI
N (RDM U) (
MICROALBUMI
N R U)
MICROALBUMI
N (24H U) (
OTHER )
MICROALBUMI
N R U (.)
MICROALBUMI
N R U
(MICROALBU
MIN R U)
MICROALBUMI
N R U ( OTHER
)
See results like: ALBUMIN
CREATINE
RATIO U (
CHEMISTRY
III )
ALBUMIN/GL
OBULIN
RATIO (
ROUTINE
CHEMISTRY II
)
MICROALBUM
IN ( AER )
MICROALBUM
IN (RANDOM)
( CHEMISTRY
III )
MICROALBUM
IN
EXCRETION
RATE ( AER )
See results like: MICROALB/
CREAT.
(CHEMISTR
Y)
ALBUMIN (
IMMUNOCH
EMISTRY )
Albumin (
IMMUNOCH
EMISTRY )
MICROALBU
MIN (RUR) (
CHEMISTRY
)
MICROALBU
MIN (UR) (
CHEMISTRY
)
Albumin;
Urine (
CHEMISTRY
)
8134-
_MICROALBUMIN/CR
EAT. RATIO (URINE) (
Master List )
8134-
BIOT_MICROALBUMI
N/CREAT. RATIO
(URINE) ( Master List)
MICROALB/CREATE
RATIO ( Master List )
MICROALB/CREAT.(C
ML) ( Master List )
MICROALBUMIN (
Master List )
MICROALBUMIN (24H
U) ( Master List )
MICROALBUMIN
(RDM U) ( Master List
)
MICROALBUMIN
(RUR)(CML) ( Master
List)
MICROALBUMIN
(UR)(CML) ( Master
List)
MICROALBUMIN 24H
U ( Master List )
MICROALBUMIN R U (
Maser List )
MICROALBUMINURIA
( Master List )
Fasting Glucose
Search “GLUCOSE SERUM FASTING” See results like: GLUCOSE
SERUM
FASTING (.)
GLUCOSE
Search “GLUCOSE-FASTING” and “FASTING GLUCOSE” See results like: FASTING
GLUCOSE (
SPECIAL /
Search GLUCOSE FASTING-SER See results like: Glucose
Fasting (
CHEMISTRY
)
See results like:
42011-
MDS_GLUCOSE-
FASTING ( Master List
)
42115-
MDS_GLUCOSE-
FASTING ( Master List
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Name Gamma Dynacare
Life Labs(MDS)
CML Manual lab tests (ONLY for former Purkinje sites)
SERUM
FASTING
(OTHER)
GLUCOSE
SERUM
FASTING
(GLUCOSE
SERUM
FASTING)
ROUTINE II )
GLUCOSE-
FASTING (
ROUTINE
CHEMISTRY )
GLUCOSE-
FASTING (
ROUTINE
CHEMISTRY I
)
GLUCOSE-
FASTING (
ROUTINE
CHEMISTRAL
)
GLUCOSE-
FASTING (
ROUTINE
CHEMISTRY-
GTT )
GLUCOSE
FASTING (
CHEMISTRY
)
Glucose
Fasting (
GLUCOSE
CHALLENGE
75mg)
Glucose
Fasting (
GLUCOSE
TOLERANCE
75G: )
Glucose
Fasting (
GTT-
GESTATION
AL 100G: )
GLUCOSE
FASTING (
LACTOSE
TOLERANCE
TEST: )
GLUCOSE
FASTING-SE
(
CHEMISTRY
)
GLUCOSE
FASTING-
SER (
CHEMISTRY
)
)
42210-
MDS_GLUCOSE-
FASTING ( Master List
)
Glucose Fasting
(Master List)
Glucose Fasting(CML)
( Master List)
GLUCOSE FASTING-
SER(CML) ( Master
List )
SUBTITLE_GLUCOSE
FASTING(CML) (
Master List )
Glucose Serum Fasting
( Master List )
GLUCOMETER –
FASTING GLUCOSE (
Master List )
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.
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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 Gamma
Dynacare Life Labs(MDS)
CML Manual lab tests (ONLY for former Purkinje sites)
INR Search “INR”. See results like: INR ( . )
inr ( . )
INR ( INR )
INR ( Other)
Inr ( Other)
Search “INR”. See results like: inr (
HEMATOLOG
Y IV)
INR (
HEMATOLOG
Y IV )
Search “I.N.R.”. See results like: I.N.R. (
HEMATOLOG
Y IV )
Search “INR” and “I.N.R.”. See results like: 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.
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CDM Flowsheet: Diabetes: Lab Test Name NOD LOINC Name: HbA1C HEMOGLOBIN A1C/HEMOGLOBIN.TOTAL Fasting Glucose GLUCOSE CSF/GLUCOSE PLAS Blood Gas Studies BLOOD GAS STUDIES LDL Cholesterol CHOLESTEROL.IN LDL HDL Cholesterol CHOLESTEROL.IN HDL TC:HDL-C Ratio CHOLESTEROL.IN HDL /CHOLESTEROL.TOTAL
NOTE: This LOINC name is being investigated for accuracy by NIC Support
Triglycerides TRIGLYCERIDE ACR ALBUMIN/CREATININE eGRF GLOMERULAR FILTRATION RATE CDM Flowsheet: Heart Failure: Lab Test Name NOD LOINC Name: Sodium SODIUM Potassium POTASSIUM Creatinine CREATININE eGRF GLOMERULAR FILTRATION RATE CDM Flowsheet: Hypertension: Lab Test Name NOD LOINC Name: Fasting Glucose GLUCOSE CSF/GLUCOSE PLAS ACR ALBUMIN/CREATININE eGFR GLOMERULAR FILTRATION RATE TC:HDL-C Ratio CHOLESTEROL.TOTAL/CHOLESTEROL.IN HDL
LDLC CHOLESTEROL.IN LDL Triglycerides TRIGLYCERIDE CDM Flowsheet: Asthma: Lab Test Name NOD LOINC Name: PEFR EXPIRATORY VOLUME.FORCED AT 1.0 S/VITAL
CAPACITY.FORCED CDM Flowsheet: COPD: Lab Test Name NOD LOINC Name: Oxygen Saturation % OXYGEN SATURATION