2024-02-13 SHIELD Topic#2

Date

Feb 13, 2024

Attendees

Open

Slides

Open

Recording:

https://drive.google.com/file/d/1q65A6JjSkuY0MMrlUqd3P_y_VYU0GUeD/view?usp=drive_link

From Chat

Riki Merrick 12:41 PM

Should titers really be "alpha" results?

Riki Merrick 12:49 PM

in HL7 we would expect those in the SN datatype: Comparator^numeric^separator^numeric

Andrea Pitkus 12:51 PM

This is a great example in how many developers/implementers may interpret things differently and implement differently, sometimes not in accord with Best Practice or in ways a standard is not intended to be used.  Another example Pam mentioned is using LOINC names for lab test names, especially since it may not meet newer accreditation requirements for the scope of tests on a lab's menu/CLIA specimen collection manual

CALLAHANL 12:55 PM

Is there a need for more precise definition of the parts of a test particularly what is being actually measured

Andrea Pitkus  to  Everyone 12:42 PM

PGHD FHIR discussions on HL7 Zulip chats have had some folks wanting to use the capillary glucose by glucometer (fingerstick glucose) LOINC for Continuous Glucose monitors whether implantable insulin device "glucose levels" or Continuous Glucose Monitor (CGM) patches.  Really these are not performed on capillary blood but interstitial fluid so another LOINC is needed to distinguish these values for whatever use. (Nice recording of discussion from recent LOINC meeting as this may apply to  devices emerging in the consumer market whether lab or fitness/health measures)

Thank you for a great overview, Pam!

Right as titers can't be used in calculations.  However, when in quality measures some have tried to conver to decimal to report using structured query language (SQL)

Dirk Bakkeren  to  Everyone 12:47 PM

In the Netherland our scientific society NVKC selected LOINC codes to reused in the Netherland. We agree we need Display Names and Consumer Name in the Future. Regretfully the samples shown are English oriented so we need some sort of translation of these terms.

Andrea Pitkus  to  Everyone 12:48 PM

Thanks for mentioning your experience, Dr. Bakkeren.  Some of the names are not available in all languages

ana szarfman  to  Everyone 12:49 PM

Do you have a software that can handle all these different features

Andrea Pitkus 12:49 PM

Who is this question directed to, Ana?  The LOINC team or Dirk?

John Snyder (NLM) 12:50 PM

In 2017, LOINC introduced the LOINCTableCore file as a subset of all the columns in the main LOINC file. LOINCTableCore does not contain the LOINC display name, so user will need to use the entire LOINC.csv file to obtain this information. We may need consider a proposal to enhance the LOINCtableCore file to include the display name?

Andrea Pitkus 12:54 PM

Different Health IT exists for different purposes, but ONC certification helps ensure certified functionality for items/data elements, etc.  However, not all Health IT software is certified too

Some Call Notes:

In Netherlands they are working on the LOINC to use for data exchange and working on a flag that indicates not sharing results for specific codes – using SCT for that

Ana’s question:

Ana has been using a software that can pinpoint the rules needed for mapping

Many to many mapping is a problem

Often the software is directed towards a ???

We need users to interpret the different results

Often folks do not read the implementation guides that are available

Folks were asking about the LOINC police?

Patient generated health data

Consumer performed lab testing

Health apps on watches

Insulin pumps monitoring glucose level

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