5-張林 HL7Asia2017-英文版-170815-13015-張林 HL7Asia2017-英文版-170815-1301

jingALOINCmappingstudyinChinaResearchonStandardsandSpecificationsRelatedtoRegionalExchangeandSharingofCLinicalLaboratoryInformationsponsoredbytheNationalHealthandFamilyPlanningCommission(NHFPC)WhoamI??Name:LinZhang?ALOINCVolunteer?HonoraryLifetimeLOINCPremiumMembership?StandingmemberofCHISS?MainlyinterestedinHITstandards,esp.inologies?Andanactivevolunteerinopensourcedomain,chasWikipediaMediawikianditsSMWExtensionetc.?LaboratoryMedicinePractitioner?NuclearMedcineRadiochemistAugust19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing2?Background?LOINCMapping?80/20Rule?AMappingStudyofCommonLabTestsina?Summary?AcknowledgementAugust19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing3?LOINCistheinternationalstandardforidentifyinghmeasurementsobservationsand?Itisdesignedtofacilitateexchangeandsharingofthesehealthdata,includinglabdata?LabLOINCisonemajorpartofthewholeterminology?Tothisend,weneedtomapourlocaltestcodestoLOINCasauniversalstandardthateverysystemcanunderstand.?However,mappingissohardasaresourceintensiveeffort.?Soitneedsguidance,includingrank/frequencyinformationbasedonroutineusagepatternsinalocalcontext.August19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing480/20Rule:ParsimoniousMapping?KeyReferences:?VreemanDJ,FinnellJT,OverhageJM.Arationaleforparsimoniouslaboratorytermmappingbyfrequency.AMIAAnnuSympProc.2007Oct11:771-5./pmc/articles/PMC2655785/?Top2000+SI/USVersions(December2016).CommonLOINCbsLaboratorybslaboratoryilizationintheintensivecareanditsimplicationsforlargelectioneffortsJAmMedInformAssoc(2):229-August19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing5AMappingStudysinChina?Project:ResearchonStandardsandSpecificationsionalHealthandFamilyPlanningCommissionigatorBaoluoLi?WG6–LOINCWorkingGroup?Subset:LOINCcodesofCommonlabtestsinChina?ToprovidemappingguideandstatisticalevidenceonsuitabilityofLOINCtonationalstakeholders,suchashealthcareorganizations,governmentagenciesandvendors.?Mappinglocalobservations(reportitems)otherthanlocalpanelstoAugust19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing6?Sampledatawereprovidedbyarangeofrepresentativehealthcareorganizationswithinseveralregions/citiesinthiscountry.?Sampledataincludeslocalobservationsandfrequenciesoftheirinstancedataduringthespecifiedsamplingpreiod(in2016).August19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing7maryofDataSourcesSampleData?SourceRegions/Cities:5?i.e.,Beijing,Shanghai,Guangzhou,HebeiandSichuanNumber,TypesandSizesofSourceOrganizations:?SourceOrganizations:35communityhospitalsservices7secondaryhospitals;13tertiaryhospitals?includinggeneralhospitals,specializedhospitalsand2large3rd-partyLabs?OutpatientVisits:750to4millions/a?Admissions/Inpatients:2345to100K/a?LicensedBeds:68to2000?SampleData?SamplingPeriod:2016?LocalObservations:9698?InstancesofLocalObservations:193324503August19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing8?DataPreparing:MSExcel?32SourceOrganizationsweremergedintoonevirtualgrouptofacilitatethemappingprocess,sothereare4localtermfiles(intotal)tobemapped.?MappingTool:RELMAv6.17(December21,2016)?RELMA=RegenstriefLOINCMappingAssistant?Database:LOINCv2.58&LV=5(SimplifiedChinese)?Importlocalterms(.xlsx)intotheRELMALMOFdatabase?Mappingprocess?Asinglepersonformapping/reviewing?UsingsearchtermsinChineseand/orEnglish?Mostlybasedontheoriginallocalterms?Manuallyentry/modificationasneeded?UsingtheranksinRII’sRELMAtofacilitatecodeselectionAugust19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing9etimelineandresourcesavailablemostofthesampledataareprovidedinaratherlifiedformatratherthantheformatsuitableforanormalLOINCmappingprocess.?NotsufficienttocreateexactmappingstoLOINCfields?SothemappingprocesswasbasedonacombinationequenciesandLOINCranks.August19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing10?Onlymappedto945LOINCcodesbecauseofroughlymapping?Likelyupto2000codesorsoifexactmappingabledbysubmissioninaproperformataccordingestionfromLOINCCommittee?Themorefrequentlyatestisused,thebetterthes?SignificantoverlapwithLOINCTop2000+subset.August19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing11MappingofSerumSodium(Na+)August19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing12rganizationsToBeMappedegeHospitalosticsKingMedCenterforClinicalCoLtdSichuanAugust19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing13tionsnits%)egeHospitalosticsKingMedCenterforClinicalCoLtdSichuanAugust19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing14TheresultingmappingswereexportedintoanExcelworksheetAndtheconentconsistsoffivepartsasdescribedbysubsequentslides.1.LocalpanelsandTests3.LOINCCodesInvolved5.NamesandAbbreviations2.FrequenciesandRanks4.CategoriesofBillables/SevicesAugust19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing15★JJJ(Jing-Jin-Ji)-Beijing-*LaboratoryMutualnitionInitiativeofalsinBeijing45=0.00847)Boththelistsarefullycovered.August19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing16enciesandRanks?Instancesofeachobservation(localtest)?SourceOrganizations?Percentageofthesampleinstancedataset?Culmulativepercentage?RanksAugust19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing17hineseandseveralLOINCFieldsClassandClassTypeareprovidedforeachmapping.August19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing184.CategoriesofBillables/Sevices?Tofacilitateunderstandingandacceptanceofmappingsthroughgroupingbythefamiliar/officialcategoriesofblessevicesSource:NationalMedicalServicesPricingSpecification(Edition2012)publishedbyNationalDevelopmentandReformCommission,MinistryofHealth,ChineseMedicineAdministrationAugust19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing19IncludingLongCommonNames(Chinese,byformula),ShortNames(Chinese,manually)andAbbreviations(English,manually)AshumanreadablenamesAsdisplaynamesAugust19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing20SizeandCoverageoftheSubset?Size:945LOINCcodes?Coverage:99.012%ofthevalidinstancedata?Allthevalidinstancedatatobemapped:190007765?98.284%oftheOriginaln?Unmapped:1877864?1877864/190007765=0.988%?Mapped:188129901?188129901/190007765=99.012%August19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing21CommonboratoryTestsforInteroperability臨床檢驗(yàn)結(jié)果互聯(lián)互通項(xiàng)目常用代碼手冊(cè)neseHealthInformationTechnologyAlliance(CHIETA)?提出/起草單位：醫(yī)療衛(wèi)生信息互聯(lián)互通技術(shù)聯(lián)盟August19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing22toverlapingbetweenthissubsetandTop0+SI/USVersionswith470%437%Top2000+SI/USVersions(December2016)CommonLOINCLaboratoryObservationCodes—LOINC/usage/obs/August19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing23Thissubset(Xaxes)vsTop2000+SI/USVersions(Yaxes)CNvsTopSICNvsTop2000+USAugust19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing24?Futureupdateswouldneedmoredetailsaboutthelocalteststoenablemoreexactmapping?EstimatedsizeofactualsubsetwouldbesimilartoRII’sTop2000+subset(esp.theSIversion)August19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing25?NeedmoreLOINCers,suchaslabprofessionalswithHIT/terminologybackground?Needconsensusandcollaborationamongstakeholders?Mechanism(s)tomanagerequestsforchange,esp.foradditionofnewterms?Balancebetweenstandardizationandcustomization,e.g.,referenceterminologiescannotmeetalltherequirementsAugust19,2017LinZhang.CHIMA2017&HL7Asia2017,Beijing26?Ourusagepatternsarealsosubjecttothe80/20rule.LOINCissuitableforencodinglabtestsinthiscountry.?JustastartersetformappinglocaltestcodestoLOINCrartherthana"one-off"effort.Sofurtherupdateswouldbeneededinthefuture.?Needsintegrationintoamappingtoolforitsintendedfuntionasareal-timeguide.?Butitshouldnotrelpace/avoidmappinglocalcodesinaparticularorganization.?Ina