Friday, December 14, 2007

The Health Care Rosetta Stone?

Yesterday we examined the amazing news that the VA health system has turned around, an about face brought on by the implementation of electronic medical records. The streamlining of procedure and upgrading of efficiency that resulted are proof positive that EMR's are one of the keys to ending our current health care crisis.

Today eMaxHealth looks at another facet of the issue in an article they titled "The Dirty Work of Health Care Information Technology." Using EMRs can eliminate a vast array of problems with the current system but like all computer programs they are only as good as the data put into them. An old saying among computer professionals is "garbage in, garbage out," and that is the point addressed here.

A study by researchers from the Regenstrief Institute, the Indiana University School of Medicine and the Indiana University School of Health and Rehabilitation Sciences, looked at hospital laboratories from five hospital systems in the Indiana Network for Patient Care and found that even in the same metropolitan area - Indianapolis and its suburbs - a variety of names were assigned to the same test - for example: complete blood count, hemogram and CBC.
As EMRs (hopefully) become more common across the health care industry this looms as a critically important element of reform. Currently only 5% of non-VA hospitals use EMR's, with cost of implementation often cited as the main reason for their absence. The fact that many of these digital systems are proprietary or use different coding for the various procedures they document isolates them from each other. Standardized naming conventions are absolutely crucial to using information technology to effect change.

What we need is a Rosetta Stone to translate them. To that end the Regestrief Institute of Indiana developed one over ten years ago: LOINC.

LOINC, the Logical Observation Identifiers Names and Codes database, acts as a universal standard of reference for laboratory and clinical data. In plain English it provides a common language for testing and results that can be correlated to the local test names creating a means of accurately translating from one "dialect" of health care terminology to another. As they put it on their own website:
...most laboratories and other diagnostic care services identify tests in these messages by means of their internal and idiosyncratic code values. Thus, the care system cannot fully "understand" and properly file the results they receive unless they either adopt the producer's laboratory codes (which is impossible if they receive results from multiple sources), or invest in the work to map each result producer's code system to their internal code system. LOINC codes are universal identifiers for laboratory and other clinical observations that solve this problem.
Could this be the Rosetta Stone we need to implement EMRs effectively? If this keeps up, we may some day have a common language that unites all health care providers, improving service across the board.

SOURCE: "The dirty work of health care information technology"
SOURCE: "Logical Observation Identifiers Names and Codes (LOINC®)"
photo courtesy of namlhots, used under this Creative Commons license

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