2026-08-11 LIDR Meeting Notes

Hung Luu

Children’s

Riki Merrick

Vernetzt, APHL

Andrea Pitkus

University of Wisconsin

Pam Banning

3M - Solventum

Xavier Gansel

Biomerieux

Amy McCormick

Epic

Dan Rutz

Epic

Rob Rae

CAP

Rob Hausam

Hausam Consulting

Stan Huff

University of Utah

Ed Heierman

Abbott / IICC

Carmen Pugh

long term lab professional

Laurent Lardin

Biomerieux

Ralf Herzog

Roche

Christina Gallegos

APHL

Manjula Dharmawardhana

CDC

Jim Harrison

CAP

LOINC Changes for XXX Codes (Stan / Andrea)

In the recent LOINC webinar on Jul 21, 2026 (https://loinc.org/webinar ) Stan reported on a proposal to create valuesets for XXX LOINC codes - this proposal came from the Euorpean HL7 Semantic Working Group - they plan on using post-cooridnation to express system and method; this proposal affects codes (starting with molecular testing) that have system = XXX and are either methodless or have method = molgen

Open

Andrea review email:

1. For laboratory test orders or results, the System in LOINC combines two distinctly different items, Specimen Type and Specimen Source.  As such, SCT represents these in different hierarchies.  The 105887-4 Adenovirus DNA  example lists {specimen} but I don't see {source site}.  As you know many tests, especially those performed on tissue for cancer, swabs for culture/serologies/ID, STI testing may list the Source Site instead of the Specimen in the LOINC System.  Will Source Site also continue to be supported for the lab LOINCs so it can be accurately mapped to lab test orders and results?

As a note, if the expectation is SCT codes will be used in the SPM 4 and SPM 8 fields per the US HL7 v2 IGs, these would be mapped to SCT and not LOINC as indicated in the webinar, when used on the individual patient instance (which is different from the compendium/test build/current LOINC mapping on the test level).  

2. For the {molgen} changes I didn't see a LOINC with the methods mentioned like for {specimen}.  Will LOINC list the molgen methods across LOINCs that have been in use or also include other terms used for molecular genetics testing (as some have been LOINC specific terms/abbreviations)?    Where do you expect these methods to come from as not currently built in LIS, EHR, LIMS, PH and other systems (so not able to be implemented)?  If not implementable, suspect these details will be missing, especially in exchanges and downstream systems causing confusion.  They also won't be available for queries and tests currently separate would be comingled such as with FHIR queries downstream as IT won't know distinctions either.  Interfaces may have failures as well.

3. If current methods/LOINC details are replaced with {molgen} and the distinctions of the specific molgen are no longer visible in LOINC axes, Long and short names, etc., codes will appear to have the same details in searches and uses.  Consider the LOINCs highlighted in blue for Herpes XXX, both molgen.  

Will one be deprecated with a remap to the other?  If so, which one?  How many duplicate LOINCs will be created with this change?

Open

We found more just with the Herpes XXX search as below in blue

Open

and

Open

These are common PH reportables and would have widespread impact, not only nationally, but globally.

Several of these are listed as the most common LOINCs too.  Would rankings be updated and which would make the cut or would counts be combined and they would be even more common?

Before these proposed changes are made (and hopefully not in the August 2026 release), it would be good to get more data on the widespread change impacts and give implementers at least 6 months - 1 year heads up about forthcoming changes like this.  Vendors may need to update their functionality for supporting LOINC and roll those changes out to their customers.  Mappers may need to remap their LOINCs and update their customers.  Interfaces may need to be updated and tested (at a cost).  Automated rules in labs may need to be updated and tested and a number of changes not anticipated.  Countries may need to update their translations, etc.

LOINC used to provide at least 6-12 months about changes, but that doesn't appear to be happening.  It would not be good if this causes negative implications on LOINC too.

Have you considered piloting with LOINC Users to identify these and other issues before releasing to mitigate risks?

Other than the webinar do you have a webinar to address common questions such as above and others on using the codes with the proposed changes?  What is needed and what to do if it's unavailable?

We urge you to hold off on these changes until further work has been done.  There are more questions/needs, but pausing as these are some of the significant ones.

Discussion today:

The proposal is IN ADDITION to existing codes, that already have specific methods

Replacement would be for LOINCs with XXX → {specimen} and methodless or method = molgen, which is already broad - here is the list:

Why adding {molgen}, when it was methodless? there is a valueset for {molgen} but you don’t have to use it.

Pam thought we always wanted to have methods for DNA/RNA or other gene, they should NOT be blank - molgen was an umbrella term for any molecular testing

System in LOINC includes both sample types and source site - example swab from urethra is listed as Urethra in LOINC system - MUST ensure that if we call the attribute Specimentype, then we need to ensure that the components in the value set represent the type, not the source site - ideally we could utilize the Specimen CMT to populate the valueset for the LOINC system

User guide will be updated to explain how to use these LOINCs

Follow up on UDI representation

Adding Conclusion here: UDI Background = this page needs to get updated with the discussions from the last couple of LIDR WG notes!

Discussion today:

Vison 2030 work considerations

SHIELD focus should be for the top lab tests, even if some are not part of PT - see here for current thoughts:Common LOINCs for LIDRPreview

LIDR Patterns

• Biomerieux culture plates

• Toxicology screening vs confirmatory

• challenge tests

• urine dipstick variations

• required specimen pre-processing before running on instrument?

Action Item Follow up

• • Riki to draft the ask to get LIS vendor input on current state and preference of use of OBX-18 alone, PRT alone, or a mix of both = there is no forum to easily reach all LIS vendors, so look at last CAP LIS reviews for AP (Comparison Page Products - CAP TODAY ) and CP LIS vendor contacts (Comparison Page Products - CAP TODAY ) -

• Pull out the definitions from LIVD for test kit and equipment and put here: SHIELD Glossary

  • Review operational definition of “equivalence”

    • Will look for a CLSI defintion

    • also check IFCC definition

• Outreach to Dr. DeBaca

  • Hung will check for more info and maybe see, if she could participate in SHIELD

• Keep updating the googlesheet: Potassium LIVD data

• Shared Reportable Conditions LIVD google sheet for crowdsourcing with CSTE - added sign up sheet for PHAs to specific conditions and see how that develops

• Have LIVD File Repository Requirements

  Have draft budget (for setting up a web-based database and yearly maintenance): https://aphlinformatics.atlassian.net/wiki/download/attachments/915407143/LIDR - Budget.xlsx?api=v2

• Define next steps to migrate existing LIVD files into FHIR LIVD catalog format and find a FHIR server to host

Next call

Going to twice a month for meetings to allow for homework time, so next call Tuesday Aug 25, 2026 9 - 10 AM ET