PubMed · 7804634
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L Augsburg, J Haw, P Hernan-Miller, J Vincent, L Whitaker. 1994. Computer validation life cycle.. https://pubmed.ncbi.nlm.nih.gov/7804634/
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Many laboratories use electronic message standards to transmit results to their clients. If all laboratories used the same "universal" set of test identifiers, electronic transmission of results would be greatly simplified. The Logical Observation Identifier Names and Codes (LOINC) database aims to be such a code system, covering at least 98% of the average laboratory's tests. The LOINC database should be of interest to hospitals, clinical laboratories, doctors' offices, state health departments, governmental healthcare providers, third-party payors, organizations involved in clinical trials, and quality assurance and utilization reviewers. The fifth release of the LOINC database, containing codes, names, and synonyms for approximately 6300 test observations, is now available on the Internet for public use. Here we describe the LOINC database, the methods used to produce it, and how it may be obtained.
Information technology can enhance the effectiveness of the part of the laboratory testing loop that occurs outside of the clinical laboratory. That external component involves the presentation of laboratory results and related information to physicians and the reception of physician requests for follow-up testing. Improvements made in the clinician-computer interface can conceivably enhance the quality of information transfer of this part of the testing loop and thereby improve the effectiveness of the entire loop. Our experience has been that results presentation is easier to address than order reception and that the economic benefits from improved result presentation can be substantial. Improving order reception requires more finesse, especially with the limitations of today's health systems and their information systems in mind. For instance, effective computer-based management of prospectively developed orders (eg, clinical protocols) not only can have a substantial positive impact on test use, but is actually welcomed by clinicians. Application of information technology at the clinician-computer interface has good potential to foster more appropriate use of clinical laboratory resources.
Software standards simplify communication and cooperation between applications provided by different software vendors. However, adherence to a rigid standard can stifle innovation. Open standards, which are not proprietary to any particular vendor, are particularly useful. Many standard-setting organizations have provided useful tools for laboratory informatics, including the American Society for Testing and Materials (ASTM), Institute of Electrical and Electronics Engineers, National Committee for Clinical Laboratory Standards, and the College of American Pathologists. Data communication standards, such as ASTM 1238, HL7, and Digital Image Communication of Medicine, have reduced the cost and improved the timeliness of interfaces. Nomenclatures, particularly the Systematized Nomenclature of Medicine (SNOMED), have facilitated the structuring of medical information, and decision rules can be communicated with ASTM E1460. Laboratory Observation Identifier Names and Codes has eased the problem of identifying tests during interchange of laboratory data. Implementation standards are useful references for those deploying information systems. Standards have provided multiple benefits to laboratories and to the health care organizations of which they are a component.