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Hi, I’m Dan
I’m a physical therapist and medical informatician
Unusual, I know.
I’m PI on contracts from bioMérieux and BD for LOINC content development (and
many federal and non-profit funding sources for LOINC).
This material contains content from LOINC® (http://loinc.org). The LOINC Table, LOINC Table Core, LOINC Panels and Forms File, LOINC
Answer File, LOINC Part File, LOINC Group File, LOINC Document Ontology File, LOINC Hierarchies, LOINC Linguistic Variants File, LOINC/
RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright © 1995-2018, Regenstrief Institute, Inc. and the
Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/
license.
FHIR and LOINC go together
like chips and salsa
1. Introduction to LOINC
2. LOINC in the FHIR jungle
3. LOINC specific features in the FHIR
terminology services
📷 Verino77 | cc-by-sa
Session Exercise
Terminology Track
https://danielvreeman.com/fhir/
Let’s get a sense of who’s here
📷 CaptionTime
LOINC is a freely available global standard
8462-4 Diastolic blood pressure 63736-3 Materials to which you were exposed in your
work or daily life
24725-4 Head CT
63805-6 How long did you handle paints or solvents
57021-8 CBC W Auto Differential panel - Blood yourself?
📷 glasgowamateur | cc-by-sa
📷 unamid-photo | cc-by-nd
Today, there are hundreds of
millions of patients with billions
of discrete results stored in
systems around the world that
are coded with LOINC.
Taking a little deeper
LOINC dive
Anatomy of a LOINC Term
4544-3 Hematocrit:VFr:Pt:Bld:Qn:Automated count
Component Hematocrit
Property VFr
Timing Pt
System Bld
Scale Qn
Timing Pt LP6960-1
Scale Qn LP7753-9
Component Hematocrit
Property VFr
Timing Pt
System Bld
Scale Qn
[base]/Observation?patient=f001&code=718-7
Return patients with a
hemoglobin Observation
[base]/Patient?_has:Observation:patient:code=718-7
Reverse chaining
Observation
Works great for coded answers too
Extension AminoAcidChangeType =
LOINC:48006-1
Diagnostic Report and
Imaging Study
For lab, pathology, radiology, and other
diagnostic services (cardiology, etc)
https://www.apple.com/healthcare/health-records/
https://support.apple.com/en-us/HT208647
LOINC-specific FHIR Services
Cool tricks with LOINC via FHIR’s Terminology Services
https://danielvreeman.com/fhir/
powered by HAPI FHIR via SmileCDR
A LOINC API via FHIR
Terminology Services enables
capabilities that were much
harder before!
https://loinc.org/fhir
LOINC as a CodeSystem
Resource
LOINC as a CodeSystem
https://www.hl7.org/fhir/loinc.html
Codes
LOINC Codes 21176-3
LOINC Parts LP31755-9
LOINC Answer Lists LL715-4
LOINC Answer Codes LA11165-0
STATUS
CLASS
CLASSTYPE 1=Lab; 2=Clinical; 3=Claims Attachments; 4=Surveys
Radiology Properties
rad-modality-modality-type
rad-anatomic-location-region-imaged
…
[base]/ValueSet/LL1162-8/$expand
{
"resourceType": "ValueSet",
"status": "active",
"compose": {
"include": [
{
"valueSet": [
"http://loinc.org/vs/LL1162-8"
]
}
]
},
"expansion": {
"identifier": "urn:uuid:18e39118-b23c-42a4-ac01-a4156248f91c",
"timestamp": "2018-06-05T16:35:35+00:00",
"total": 5,
"parameter": [
{
"name": "version",
"valueUri": "http://loinc.org/vs/LL1162-8|Beta.1"
}
],
"contains": [
{
"system": "http://loinc.org",
"code": "LA137-2",
"display": "None"
},
{
"system": "http://loinc.org",
Some key LOINC subsets
available as ValueSets
Get the LOINC/RSNA Radiology Playbook
[base]/ValueSet/?url=http://loinc.org/vs/loinc-
rsna-radiology-playbook
"resourceType": "ValueSet",
"id": "loinc-rsna-radiology-playbook",
"meta": {
"versionId": "2",
"lastUpdated": "2018-12-14T22:36:16.510+00:00"
},
"url": "http://loinc.org/vs/loinc-rsna-radiology-playbook",
"name": "LOINC/RSNA Radiology Playbook",
"status": "active",
"compose": {
"include": [
{
"system": "http://loinc.org",
"concept": [
{
"code": "24531-6",
"display": "US Retroperitoneum"
},
{
"code": "24532-4",
"display": "US Abdomen RUQ"
},
{
"code": "24533-2",
"display": "MRA Abdominal vessels W contrast IV"
},
{
"code": "24534-0",
"display": "US.doppler Abdominal vessels"
},
Building ValueSets based on
LOINC Properties
"compose": {
"inactive": false,
"include": [
{
"system": "http://loinc.org",
Exclude:
{
"system": "http://loinc.org",
"version": "2.64",
"filter": [
Super System of Fetus, Donor, BPU {
"property": "SYSTEM",
"op": "regex",
"value": "\\^Fetus$"
Can also use LOINC Part codes in Compose },
{…}
]
[base]/ValueSet/test-west-nile/$expand
"expansion": {
"identifier": "urn:uuid:3eb88c25-061e-4479-9aed-cf64a012051c",
"timestamp": "2018-06-19T14:33:59+00:00",
"total": 67,
"parameter": [
{…}
],
"contains": [
{
"system": "http://loinc.org",
"code": "31701-6",
"display": "West Nile virus IgG Ab [Presence] in Serum"
},
{
"system": "http://loinc.org",
"code": "33329-4",
"display": "West Nile virus IgG Ab [Titer] in Serum"
},
{
"system": "http://loinc.org",
"code": "39555-8",
"display": "West Nile virus Ab [Units/volume] in Serum"
},
{
"system": "http://loinc.org",
"code": "41232-0",
New LOINC Groups also available!
Read more at: loinc.org/groups
[base]/ValueSet/$expand?url=http://loinc.org/vs/
LG34372-9
"expansion": {
"identifier": "urn:uuid:23c8b092-72a7-424b-a1c0-bee0985a106b",
"timestamp": "2019-06-11T16:24:17+00:00",
"total": 7,
"parameter": [
{
"name": "version",
"valueUri": ""http://loinc.org/vs/LG34372-9|2.65-Beta.2"
}
],
"contains": [
{
"system": "http://loinc.org",
"code": “3142-7",
"display": "Body weight Stated"
},
{
"system": "http://loinc.org",
"code": "3141-9",
"display": "Body weight Measured"
},
{
"system": "http://loinc.org",
"code": "29463-7",
"display": "Body weight"
},
{
"system": "http://loinc.org",
LOINC ConceptMap
Resources
LOINC content in ConceptMap
LOINC publishes several kinds of mappings to external
terminologies
LOINC Terms
IEEE codes
RadLex RPID codes
LOINC Parts
PubChem
RadLex RIDs
RxNorm
Get the LOINC to IEEE
Mapping
[base]/ConceptMap/?url=http://loinc.org/cm/loinc-
to-ieee-device-codes
{
"resourceType": "ConceptMap",
"id": "LOINC-IEEE-MEDICAL-DEVICE-CM",
"meta": {
"versionId": "1",
"lastUpdated": "2018-05-04T01:10:54.569+00:00"
},
"url": "http://loinc.org/cm/loinc-to-ieee-device-codes",
"version": "Loinc_2.65",
"name": "LOINC/IEEE Device Code Mappings",
"publisher": "Regenstrief Institute, Inc.",
"contact": [
{
"name": "Regenstrief Institute, Inc.",
"telecom": [
{
"system": "url",
"value": "https://loinc.org"
}
]
}
],
"group": [
{
"source": "http://loinc.org",
"target": "urn:iso:std:iso:11073:10101",
"element": [
{
"code": "11556-8",
"display": "Oxygen [Partial pressure] in Blood",
"target": [
{
"code": "160116",
"display": "MDC_CONC_PO2_GEN",
"equivalence": "equal"
}
]
Take home lesson:
When clinical data is coded with LOINC
codes and made accessible by FHIR,
diverse IT applications can understand
and interact with it for the benefit of
many in the health ecosystem.
Happy LOINCing!