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Daniel J. Vreeman, PT, DPT, MScAssociate Research Professor

, Indiana University School of Medicine

Associate Director for Terminology Services, Regenstrief Institute, Inc

© 2014

An Introduction to LOINC

Laboratory LOINC Workshop - Indianapolis, IN USA

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Acknowledgements

LOINC Development TeamJami Deckard, Katy Holk, Swapna Abhyankar,Rachel Fuhr, David Baorto, Clem McDonald

RELMA Development Team

John Hook, Anandhi Sowmyan, James Dennis

Others

LOINC Committee, Theresa Pritchard,

Sandy Poremba

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Overview

1. Origins and purpose of LOINC

2. The LOINC way

3. LOINC today

4. Overview of implementation resources

photo via Vernio77

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Origins of LOINC

McDonald et al. Canopy Computing: using the Web in Clinical Practice.  JAMA

. 1998;280(15):1325-1329.

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Informatics Pioneers

40 years of EMR work

Indiana Network for Patient Care

Regenstrief serves as neutral 3rd party

convener

Most comprehensive and longest tenured Health Information Exchange (HIE) in USA 

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Informatics Pioneers

40 years of EMR work

Indiana Network for Patient Care

Regenstrief serves as neutral 3rd party

convener

Most comprehensive and longest tenured Health Information Exchange (HIE) in USA 

Crash Test Dummies

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http://slidepdf.com/reader/full/2014-12-03-loinc-introduction 7/161photo via noshaMcDonald et al. Canopy Computing: using the Web in Clinical Practice.  JAMA. 1998;280(15):1325-1329.

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http://slidepdf.com/reader/full/2014-12-03-loinc-introduction 8/161photo via noshaMcDonald et al. Canopy Computing: using the Web in Clinical Practice.  JAMA. 1998;280(15):1325-1329.

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Forrey AW, McDonald CJ, et al. Logical observation identifier names and codes (LOINC) database: a public use set of codes and names for electronicreporting of clinical laboratory test results. Clin Chem. 1996 Jan;42(1):81-90. PubMed PMID: 8565239.

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More than Meets the Eye

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Fundamental challenges: 

Local systems have different ways of

identifying the same concept.

Things that look alike aren’t the same.

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Forrey AW, McDonald CJ, et al. Logical observation identifier names and codes (LOINC) database: a public use set of codes and names for electronicreporting of clinical laboratory test results. Clin Chem. 1996 Jan;42(1):81-90. PubMed PMID: 8565239.

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Logical 

Observation 

IdentifiersNames and

CodesA universal code system that facilitates exchange,

pooling, and processing of clinical data.

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Established in 1994 byRegenstrief Institute. 

Vocabulary standard for

observation identifiers.

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LOINC is like a bar code for

test data…

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photo via puuikibeach

WE DOMEASUREMENTS

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Laboratory LOINC

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Top 10 Lab Domain Overview

Microbiology  10,700

Chemistry 9,200

Drug/Toxicology 7,200

Allergy 3,900Chemistry - Challenge 3,700

Serology 2,500

Hematology 2,100Antibiotic Susceptibilities 1,700

Cell Markers 1,500

Molecular Pathology900

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Clinical LOINC

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If an observation is a question

and the observation value isan answer…

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LOINC provides codes for questions 

 Where needed, other vocabularies

provide codes for answers 

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What is my patient’shemoglobin level?718-7:Hemoglobin:MCnc:Pt:Bld:Qn

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How fast does mypatient usually walk?41959-8:Walking speed:Vel:1W^mean:^Patient:Qn:Calculated

photo via Ed Yourdon

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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||

 OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|

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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||

 OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|

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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||

 OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|

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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||

 OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|

LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem

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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||

 OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|

LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem

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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||

 OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|

LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem

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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||

 OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|

LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem

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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||

 OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|

LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem

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Codes for individual observations

Leukocytes [#/volume] in Blood by Automated countErythrocytes [#/volume] in Blood by Automated count

Hematocrit [Volume Fraction] of Blood by Automated count

and collections of observations

CBC W Auto Differential panel - Blood

Vital signs, weight and height panel

PHQ-9 quick depression assessment panel

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OBX||CE|600-7^Bacteria Bld Cult^LN||56415008^Klebsiella pneumoniae^SCT

Result with a Coded Value

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OBX||CE|600-7^Bacteria Bld Cult^LN||56415008^Klebsiella pneumoniae^SCT

Result with a Coded Value

Data type of result

(OBX-5) is a coded

element

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OBX||CE|600-7^Bacteria Bld Cult^LN||56415008^Klebsiella pneumoniae^SCT

Result with a Coded Value

This code is from

LOINC

Code identifying this

observation

(what are these results?

Bacteria identified by

Blood Culture )

Data type of result

(OBX-5) is a coded

element

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OBX||CE|600-7^Bacteria Bld Cult^LN||56415008^Klebsiella pneumoniae^SCT

Result with a Coded Value

This code is from

LOINC

Code identifying this

observation

(what are these results?

Bacteria identified by

Blood Culture )

Data type of result

(OBX-5) is a coded

element

This code is from

SNOMED

Code identifying the result

(K. pneumoniae)

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LOINC fits well withother data standards

photo via Temari 09

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The LOINC WayOpen. Nimble. Pragmatic.

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Development Approach

Worldwide distribution at no cost 

New terms requested by end-users 

Welcome all comers Committees are volunteers

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Development Approach

Worldwide distribution at no cost 

New terms requested by end-users 

Welcome all comers Committees are volunteers

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Development Approach

Worldwide distribution at no cost 

New terms requested by end-users 

Welcome all comers Committees are volunteers

It’s free, but invaluable 

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Financial Support

Many sourcesAHCPR, ASPE, CDC, CHCF, CMS, Hartford Foundation, IN

CTSA, Regenstrief Foundation*, Regenstrief Institute,

NCRR, NIBIB*, NLM*, LOINC User Community**active now

Today, the U.S. National Library of Medicine

(NLM) accounts for about 2/3 of our funding.

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Major releases

twice per year

(June and December)

photo via striatic

LOINC C d O Ti b R l

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1

2

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5

6

7

8

  4   /   2  4

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   5     |     1 .   0

   5

   /   2  4   /

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     |     1 .   0  a

  6

   /   2   3   /

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     |     1 .   0    b

  6

   /   2   8   /

   1   9   9   5

     |     1 .   0  c 

    7

   /   1  4   /

   1   9   9   5

     |     1 .   0  d

   9

   /   1   5   /

   1   9   9   5

     |     1 .   0  e

   1   2   /

   2   1   /   1

   9   9   5     |     1 .   0   f

  4

   /   2   8   /

   1   9   9  6

     |     1 .   0  g 

   8   /   2   9   /

   1   9   9  6

     |     1 .   0    h   (    2    )

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   1   9   9  6

     |     1 .   0    h   (    3    )

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   1   9   9   9

    7     |     1 .   0    i

   1   0

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   9   9    7     |     1 .   0    j 

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   2   /   1   2

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   9     |     1 .   0    l

    7   /   2

   3   /   1   9

   9   9     |     1 .   0   m

   8   /  6

   /   1   9   9

   9     |     1 .   0   m  a

   2   /  4   /

   2   0   0   0

     |     1 .   0   n 

  6

   /   1   3   /

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   2   0   0   1

     |     2 .   0   0

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   2   0   0   1

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    7   /   1   /

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   2   0   0   2

     |     2 .   0  4

   2   /   1   /

   2   0   0   2

     |     2 .   0   5

   2

   /   1   9   /

   2   0   0   2

     |     2 .   0  6

   8   /   1   /

   2   0   0   2

     |     2 .   0    7

   9   /   1   /

   2   0   0   2

     |     2 .   0   8

   5   /   1   /

   2   0   0   3

     |     2 .   0   9

   1

   0   /   1   /

   2   0   0   3

     |     2 .   1   0

   1   /   1   /

   2   0   0  4

     |     2 .   1   1

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   2   0   0  4

     |     2 .   1   2

   1

   2   /   1   /

   2   0   0  4

     |     2 .   1   3

   1

   2   /   1   /

   2   0   0  4

     |     2 .   1  4

  6   /   1   /

   2   0   0   5

     |     2 .   1   5

   1

   2   /   1   /

   2   0   0   5

     |     2 .   1  6

  6   /   1   /

   2   0   0  6

     |     2 .   1    7

   1   2   /

   2   1   /   2

   0   0  6    |    2 .   1   9

  6   /   2   1

   /   2   0   0

    7    |    2 .   2   1

   1   2   /

   0   3   /   2

   0   0    7    |    2 .   2   2

    7   /   1   0

   /   2   0   0

   8    |    2 .   2  4

   1   /   1   0

   /   2   0   0

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   0    7   /

   0  6   /   2

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   /   2   0   1

   0    |    2 .   3   0

  6   /   1   5

   /   2   0   1

   0    |    2 .   3   2

   1   2   /

   2   9   /   2

   0   1   0    |    2 .   3  4

   0  6   /

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   1   2   /

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   2    |    2 .  4   0

   1   2   /

   3   0   /   2

   0   1   2    |    2 .  4

   2

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  6

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   8

LOINC Codes

Only Lab LOINC Codes

LOINC Codes Over Time by Release

laboratory terms only

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73,000 codes…haven’tyou finished yet?

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Lots Cooking…Always more lab tests

Genetic testing

Patient reported outcomes

Translational research data

Document titles

Radiology reportsphoto via liber

photo via liber

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Legal Stuffhttp://loinc.org/terms-of-use

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photo via 917press

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Just kidding.

Copyright is a good thing for

standards. 

It’s the licensing part that issometimes interesting.

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No cost

Worldwide

In perpetuity

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Use

Copy

Distribute

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Any purpose:

commercial

non-commercial

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Encourages

translation into

other languages

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CANNOT use anyLicensed Material to

develop or promulgatea different standard for

orders or observations.

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That would defeat

the purpose of

having a standard!

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Does LOINC have anycompetitors?

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 And if it should cross yourmind to develop yet another

biomedical vocabulary,please DON'T do it.

~ Betsy Humphreys, Morris Collen Award Acceptance Speech

“  

photo via wikipedia

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Only crazy people buildterminologies

photo via Tatiana Gerus

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Collaboration Trumps Competition

We're committed to working together with

other standards development

organizations to help health data moveseamlessly when and where it's needed.

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LOINC in action today

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photo via iboy_daniel

Data standards are like telephones. 

They require a critical mass of usersbefore they become useful.

~ Clem McDonald, MD (1998)

“  

35,500+ registered users in 163 countries

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35,500 registered users in 163 countries

loinc.org registered users

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0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

 6 /  1 /  0  8

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 6 /  1 /  1  0

  1  2 /  1 /  1  0

 6 /  1 /  1  1

  1  2 /  1 /  1  1

 6 /  1 /  1  2

  1  2 /  1 /  1  2

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  1  2 /  1 /  1  3

 6 /  1 /  1 4

  1  2 /  1 /  1 4

g g

loinc.org registered users

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0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

 6 /  1 /  0  8

  1  2 /  1 /  0  8

 6 /  1 /  0  9

  1  2 /  1 /  0  9

 6 /  1 /  1  0

  1  2 /  1 /  1  0

 6 /  1 /  1  1

  1  2 /  1 /  1  1

 6 /  1 /  1  2

  1  2 /  1 /  1  2

 6 /  1 /  1  3

  1  2 /  1 /  1  3

 6 /  1 /  1 4

  1  2 /  1 /  1 4

g g

8,000 new users per year

loinc.org registered users

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0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

 6 /  1 /  0  8

  1  2 /  1 /  0  8

 6 /  1 /  0  9

  1  2 /  1 /  0  9

 6 /  1 /  1  0

  1  2 /  1 /  1  0

 6 /  1 /  1  1

  1  2 /  1 /  1  1

 6 /  1 /  1  2

  1  2 /  1 /  1  2

 6 /  1 /  1  3

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 6 /  1 /  1 4

  1  2 /  1 /  1 4

g g

8,000 new users per year

 Doubled in 2 years

LOINC Translators

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22 organizations.

Currently translations into 18 variants of 12 languages

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Vreeman DJ, Chiaravalloti MT, Hook J, McDonald CJ. Enabling international adoption of LOINC through translation. J Biomed Inform.2012 Aug;45(4):667-73. PMID: 22285984.

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Ad t d N ti l St d d

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Australia

Austria

Belgium

Brazil

Canada

Cyprus

Estonia

Finland

FranceGermany

Iceland

India

Mexico

Mongolia

The Netherlands

New Zealand

Philippines

Portugal

Rwanda

Slovakia

Slovenia

SpainThailand

Turkey

United States

Adopted as National Standard

L I l t ti

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Large Implementations

SIGA Saúde project7+ Provincial systems in Canada

8+ Regional Health Information Exchanges in Spain

ePSOSAssistance publique - Hôpitaux de Paris

Hong Kong Hospital Authority

Philippine Health Insurance CorporationInFSE Project in 5 regions in Italy (LOINC Italia)

M y

Oth K Ad ti

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Other Key Adoptions

Many “big” labsAll health-related federal agencies in USA

Lots of care organizations

Professional societiesHealth information exchange networks

Insurance companies

EHR vendorsInstrument manufacturers (nascent)

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For the last few years, the AP-HP has

been using the LOINC internationalnomenclature… 

Thanks to this catalogue, the AP-HPis able to use the nomenclature in itstreatment processes, whenever

biology analyses and test results arerequested.

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Vandenbussche PY, Cormont S, André C, et al. Implementation and management of a biomedical observation dictionary in a large healthcare information system.J Am Med Inform Assoc. 2013 May 1. PMID: 23635601.

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Vandenbussche PY, Cormont S, André C, et al. Implementation and management of a biomedical observation dictionary in a large healthcare information system.J Am Med Inform Assoc. 2013 May 1. PMID: 23635601.

The results of our workvalidate the choice made to

develop a local dictionaryaligned with LOINC.

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Vandenbussche PY, Cormont S, André C, et al. Implementation and management of a biomedical observation dictionary in a large healthcare information system.J Am Med Inform Assoc. 2013 May 1. PMID: 23635601.

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Members of the Korean National StandardsCommittee have enthusiastically embraced LOINC 

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LOINCing in Hong Kong

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Some ad hoc LOINCing

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 Talking about LOINC at the Thai Ministry of

Information and Comm nication Technology

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Dr Case leading some LOINCing in Cypr s

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In USA, major driver ofeHealth standards adoption is

EHR Incentive Program 

a.k.a. “Meaningful Use” 

Blumenthal D, Tavenner M. The "meaningful use" regulation for electronic health records. N Engl J Med. 2010 Aug 5;363(6) :501-4. Epub 2010 Jul 13. PubMed PMID: 20647183.

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Stage 12011-2012

Data capture

and sharing

Stage 22014

Advance clinical

processes

Stage 32016

Improved care

outcomes

progressive requirements for data standards

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LOINC adopted for: 

1. View, download, transmit data to third party 

2.Cancer case reporting to state registry 

3.Send/receive electronic lab results inambulatory settings 

4.Provide a care summary at care transition 

5.Provide clinical summaries for patients 6.Submit reportable lab results to public health

Lab reporting to EHRs

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Use in Quality Measures

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LOINC Adopted For

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LOINC Adopted ForPatient Characteristics

[Non-lab] Diagnostics studies

Patient experience

Family history

Functional status

Health record component

Interventions (that produce an assessment or measured results)

Laboratory tests

Physical examPatient preference

Risk evaluation

System resources (healthcare resources)

An Example Quality Measure

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An Example Quality MeasureNational Committee for Quality Assurance

Diabetes: Hemoglobin A1c

Poor Control

Percentage of patients 18-75 years of age with diabetes who had

hemoglobin A1c > 9.0% during the measurement period.

Find HbA1c in the EHR with LOINC

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Find HbA1c in the EHR with LOINC

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Many unexpected

successes along the way

photo via heyyu

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Everyone loves LOINC

photo via mccaughan

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The LOINC DistributionLOINC Table, Accessory Files, and Tools and

Resources for Implementers

loinc.org/downloads

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loinc.org/downloads

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LOINC TableThe main LOINC database content

One Record Per Term

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One Record Per Term

Long Common Name Cholesterol in LDL [Mass/volume] in Serumor Plasma b Direct assa

Short Name LDLc SerPl Direct Assay-mCnc

Class Type Lab

Class Chem

Example Units (local) mg/dL

Example Units mg/dL

Order/Obs Both

A Rich Encyclopedia

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A Rich Encyclopedia

Cells.HPV E6+E7 mRNA/cells [Presence] inCervix by Flow cytometry (FC)

Most human papilloma virus (HPV) genomes encode for eight major proteins, six"early" (E1, E2, E3, E4, E6, and E7) and two "late" (L1 and L2). The "early" are regulatory infunction. E6 and E7 genes in high-risk HPV genotypes are known as oncogenes becauseof their continuous expression, which leads to disruption of cell-cycle check points andcell genome instability through alteration of cellular p53 and retinoblastoma proteinfunctions. This test identifies cervical cells containing HPV E6 and E7 polycistronic mRNAusing in situ hybridization with oligonucleotides specific for the mRNA transcripts. The

cells remain intact, and following fixation and permeabilization, the probes enter thecells. The flow cytometer measures two things: 1. Quantification of E6 and E7 mRNA ineach cell and 2. The percentage of cells over-expressing E6 and E7 mRNA.

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LOINC Accessory FilesSpecial representations of LOINC content

Accessory Files

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Accessory Files

LOINC Panels and Forms FileAn export of key panels, survey instruments, and forms in a

detailed data structure.

LOINC Multiaxial Hierarchy FileHierarchical organization of LOINC terms based on their axes.

Lab terms are organized first by Component, then by System.

LOINC Document Ontology FileSpecial file for the detailed naming conventions for clinical

document titles (e.g. Discharge Summary, Progress Note, etc).

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Tools for

Implementers

photo via Robert S Donovan

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loinc.or

g/get-started

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search.loinc.org

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Alternate Language Search

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E t It l !Alternate Language Search

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 Everything in Italian!

forum.loinc.org

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loinc.org/usage

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loinc.org/mailing-lists

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No spam! News + release notices

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@LOINC@LOINC

loinc.org/slideshows

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loinc.org/adopters

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loinc.org/adopters

List your organization Free!

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List your organization. Free!

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RELMA®REgenstrief LOINC Mapping Assistant

RELMA Features

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Browse LOINC content

Map local terms to LOINCimport/export

translate local words to LOINC-speak

manual/automated mapping

Search Window

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Mapping Screen

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Mapping Screen

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navigate through your local term set 

Mapping Screen

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navigate through your local term set 

hit enter to run a search

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22 organizations, 5 countries, 102,000 mappings

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# of codes and institutions mapped to this LOINC 

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# of codes and institutions mapped to this LOINC 

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Click here to see the local codes!

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When you’ve got a decent number of mappings,share them back with the community

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y

When you’ve got a decent number of mappings,share them back with the community

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y

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In closing...

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Glad you’re here to at least

f

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get your feet wet...

Jump in!

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The Race is On!

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