A dedication to data interoperability

I recently attended the June 2018 Laboratory LOINC Conference in Indianapolis to get the latest LOINC updates. I have attended many previous meetings, but this time was special. My colleague Pam Banning received this year’s LOINC Award for Distinguished Contributions!

Pam is only the fourth person to be so honored, in the award’s third year. She has dedicated a majority of her professional career to data interoperability. With the 3M Healthcare Data Dictionary (HDD) team, Pam has helped our customers, ranging from independent and reference laboratories, to hospitals and clinics big and small, to national and international organizations like the U.S. Department of Defense (DoD), Canada Health Infoway and Singapore’s Ministry of Health, to map and use standards like LOINC. For the U.S. DoD alone, we have mapped over 6 million DoD specific codes, to LOINC and other standard terminologies, in two decades. Everyone shares the vision of interoperability, but their immediate concern is – and correctly should be---patient care and efficient operation of the care delivery and support process. 

Standards like LOINC grow through user submission of terms needed for their operation, with new releases at predetermined frequencies (e.g., twice a year for LOINC). For instance, the current LOINC, version 2.64 released June 15, 2018, added 1,335 new codes: 525 laboratory, 321 clinical and 489 survey terms. That is why LOINC is supportive of laboratories and other health care information systems continuing to use local codes so they can implement and report on a needed lab tests and results immediately---it is not practical to delay up to 6 months! LOINC’s purpose, like that of other standards, is to support data interoperability, for example in exchanging data with external organizations, by providing a standard to map to; this approach is a win-win for all.

As LOINC increases both in content and number of users---currently the database has 87,863 terms and there are nearly 65,000 registered users from 172 countries---growing pains are inevitable. There is a constant tension between developing new LOINC terms by following a robust, well defined design structure according to terminology principles and accommodating operational needs that do not fit the use case for which these principles were instituted. For example, during the meeting one user requested LOINC codes for laboratory message fields that are outside the scope and purpose of LOINC, for data that are used for internal processing and unlikely ever to be exchanged externally, such as “centrifuge status.” A suggestion was even made to have a “generic” LOINC code for “no LOINC required” just to “fill in” the data fields. The interesting discussion that ensued highlighted the need for continuing education regarding standard terminologies as well as the need to promote the vision of interoperable data, outside the standard and terminology world, to all healthcare applications and systems.

Tirelessly dedicating her career to education and advocacy for interoperability is one of the reasons Pam received the award. It has been an honor for me to witness part of this LOINC journey and learn from the best. The 3M HDD team congratulates and thanks Pam for all her contributions and leadership, and we looks forward to continuing to grow together.

Chris Gordon is an analyst for the 3M Healthcare Data Dictionary team.