Application of Universal Laboratory Test Code System in Hong Kong eHR Programme

Dr Clement McDonald spoke on adopting LOINC for semantic interoperability of laboratory data.

Dr Clement McDonald
Director of the Lister Hill National Centre for Biomedical Communications,
National Library of Medicine (NLM) of the National Institutes of Health (NIH)

LOINC is Essential for eHR

Logical Observation Identifier Names and Codes (LOINC) was initiated and developed in 1994 by Dr Clement McDonald while he was at the Regenstrief Institute. LOINC is a universal laboratory test code system used by electronic health records (eHR) around the world. It facilitates the exchange, pooling and processing of clinical data, which makes it essential for eHR. Hong Kong is one of the places in the world using LOINC for the development of its territory-wide Electronic Health Record Sharing System (eHRSS).

Dr Clement McDonald, who heads the Lister Hill National Center for Biomedical Communications in the NLM of the NIH, was invited to Hong Kong to present a keynote speech of “electronic Medical Records and Interoperability in the US – Hits and Misses …and New Work at NLM” in the eHealth in Action Seminar on 10 November 2015. The electronic Health Record Information Standards Office (eHRISO) has taken this opportunity to share with Dr McDonald our experience on the adaptation of LOINC in the eHR development.

Delivering Benefits with LOINC

Mr John Mok, Health Informatician at the Hospital Authority (HA) Information Technology and Health Informatics Division, shared the experience of adopting standard terminology in Hong Kong’s development of the eHRSS. Throughout the development process, LOINC was used as the groundwork of the eHR development for the sharing and enhancing interoperability of laboratory records.

Dr McDonald supported using LOINC as laboratory test standard in Hong Kong’s eHR, as he believes it provides universal codes and names that can facilitate information sharing, decision support and data analytics. At the same time, LOINC can assist data exchange to create a coherent and consistent record, facilitate better communication and add value to the eHR. As a result, quality of care can be improved and patients would benefit from the use of LOINC as it.

Hong Kong’s LOINC Strategy

The HA has been using LOINC as laboratory test standard for years and the eHRISO appreciates the benefits of using this universal code system for laboratory data sharing. Several LOINC workshops have been held locally since 2011 for the purpose of promoting the adoption of LOINC for clinical laboratories in Hong Kong. As most of the private laboratories are still beginners in using LOINC, they may not necessarily find it easy to adopt LOINC in view of the huge number of local test codes currently being used among them. Dr McDonald advised that those private laboratories could start using LOINC by focusing on common laboratory tests, and in general, prioritisation would help their planning on LOINC adoption for sharable laboratory records in eHR.

LOINC Development and Collaborative Work with SNOMED CT

LOINC and the Systematised Nomenclature of Medicine Clinical Terms (SNOMED CT) are being linked to develop a common terminology framework to create a synergising effect on the standardisation of clinical data. Both LOINC and SNOMED CT would be enriched by incorporating the codes from each other, which can bring about a more hierarchical, comprehensive and unified terminology for laboratories.

LOINC - SNOMED CT collaboration for standardisation of clinical data

Win-Win Situation

All parties believed that with the LOINC-enabled eHR and the popularity of using LOINC in private laboratories, health information could be exchanged safely, accurately and effectively. With the launch of the eHRSS early this year, the eHR would provide a world-class platform to demonstrate the benefits of LOINC, thereby improving the quality of patient care while creating a win-win situation for all parties including the eHRSS, LOINC and users of eHR.