The Regenstrief Institute released version 2.66 of the Logical Observation Identifiers Names and Codes (LOINC) on June 21st this year. The release has a total of 91,388 terms. There were 4155 existing LOINC terms edited in this release. and over 2,000 new terms with more than half in the survey space. They included the work of National Community of Health Centers PRAPARE (Protocol for Responding to and Assessing Patients’ Assets, Risks and Experiences); a broad collection of Social Determinants of Health (SDH). Having these in place for coding within electronic health record helps clinicians identify SDH risks which indicate potential for poorer outcomes and higher costs. Subsets of PRAPARE include Personal Characteristics, Family & Home, Money & Resources, Social & Emotional Health, and some optional Questions. It is interesting that existing LOINC terms are able to be tied into the collation (Housing status, Race, Current Work Status, etc.). Other assessments may carry copyrights, which require unique LOINCs to be created.
In this release the laboratory Drug/Tox category has LOINC Long Common display names updated to Tall Man practices as described by the Institute for Safe Medication Practices. There are many instances where adoptees use a LOINC display in their health information exchange, so this safety practice can be implemented by a simple load of the 2.66 file.
Regenstrief is starting to loosen the reigns on LOINC Order Panels by removing some previously required components. For example, it took the longest time to get the Hemoglobin as a Required element out of the Blood Gas Panels. While Hemoglobin is used in blood gas calculations, it is not reported to the clinicians from this instrument. In another situation, there may have been a serology panel issued with a Scale set to Quantitative, but the lab uses a semiquantitative scale, meaning the lab couldn’t use that serology panel LOINC to identify its lab order. For example, in LOINC 2.66, 33563-6 Rickettsia rickettsia Ab.IgG & IgM panel is adjusted to scale of “–” (like a wild card), allowing ordinal terms to be included alongside quantitative terms. This allows for multiple testing forms/algorithms to use the same LOINC term and receive whichever results the local laboratory offers. We also see the Short Blood Count Panel 55439-5 has a comment entered that the methodless Leukocyte count component 26464-8 may be substituted by an automated method 6690-2. This can be interpreted as ground breaking news, as in prior years substitution was not allowed. We are constantly providing feedback to Regenstrief when clients’ laboratory panels land outside of mapping criteria to LOINC order codes and currently await changes to bilirubin and thromboelastography panels for our clients.
The update work has wrapped up for this LOINC version. Onto the next terminology release! If you have other terminology topics that you’d like us to discuss, please contact us.