Thank you for the details. I'll convene some of our experts at Epic next week to evaluate the feasibility of doing development to support linking FLO to LOINC (either via a new FLO item or updates to the EXM framework). That said, you should probably prepare for moving forward without the development. I do not know if we will be able to accommodate a timeline that will meet your relatively short-term needs.
Rob Szymanski | Cogito R&D | Epic From: Campbell, James R [mailto:[email protected]] Sent: Tuesday, March 18, 2014 9:37 AM To: Rob Szymanski; Binit Mohanty; John Oehlert Cc: Stephanie JeSchonek; [email protected] Subject: RE: Research Data Mapping 1. Clinical observations in Flowsheets will map to LOINC (or some SNOMED CT) observables. While IHTSDO and Regenstrief are harmonizing their content, we cannot count on that within the next 12 months. A single flowsheet row will map to a single observable code but the builds across Epic sites have created many duplicate rows that means the mapping (Flowsheet row to Observable code) will be many to one in cardinality. 2. We are creating our Clarity extracts to i2b2 to map all lab results to lab LOINC. We will also be coding radiology reports and document types to LOINC although those are lower priority items in our i2b2 build. Jim From: Rob Szymanski [mailto:[email protected]] Sent: Tuesday, March 18, 2014 8:34 AM To: Campbell, James R; Binit Mohanty; John Oehlert Cc: Stephanie JeSchonek Subject: RE: Research Data Mapping My understanding is that we currently use the LNC masterfile to store LOINC codes because it drives Beaker functionality for sending out results. We create a record for LOINC observables because each entity has more information than just the code that is needed to drive our functionality, such as synonyms, example units, HL7 information, etc. For this reason the mapping to LNC isn't done through EXM like it is for SNOMED. In order to support mapping from a flowsheet row to a LOINC code we would most likely want to add an item in FLO that points to LNC. You would then populate this item for the flowsheet rows you are interested in and we would need to make the information available in Clarity for the i2b2 mapping. This wouldn't be a terribly difficult development project, but it would be functionally equivalent to maintaining a separate list of FLO records and their corresponding LOINC observables (which you could do today without waiting for development). Two questions for you: 1. Would this be a 1-to-1 mapping, or can a single flowsheet row resolve to multiple LOINC observables? 2. Are there other things besides flowsheet rows that you would want to map to LOINC? Currently we support mapping to LOINC for procedures and lab results. Based on this we can assess the level of work required to support what you're looking for, and evaluate whether or not we could deliver any development in your required timeframe. Rob Szymanski | Cogito R&D | Epic From: Campbell, James R [mailto:[email protected]] Sent: Monday, March 17, 2014 2:51 PM To: Binit Mohanty; Rob Szymanski; John Oehlert Cc: Stephanie JeSchonek Subject: RE: Research Data Mapping I am planning to map our flowsheet data of importance to LOINC and SNOMED observables so that our Clarity tables can load i2b2 with standardized data. When we import diagnoses, we load the coding to ICD* and SNOMED CT from EXM. Right now my immediate use case is clinical LOINC coding of vital signs. I could conceivably create my own mapping table and load into Clarity but I would like to operationalize this with our build team so that our database is standardized as new data elements are populated into our copy of Epic. Jim From: Binit Mohanty [mailto:[email protected]] Sent: Monday, March 17, 2014 1:58 PM To: Campbell, James R; Rob Szymanski; John Oehlert Cc: Stephanie JeSchonek Subject: RE: Research Data Mapping Dr. Campbell, EXM mappings were designed only HLX records (SNOMED and SmartData Elements). So standard Epic utilities will not work for this. Apart from the mapping itself did you have any use in mind for these mappings? Also I have cc'ed our LOINC expert who can shed more light on this and suggest alternative if there are any. Binit From: Campbell, James R [mailto:[email protected]] Sent: Monday, March 17, 2014 6:12 AM To: Rob Szymanski; John Oehlert; Binit Mohanty Subject: Research Data Mapping In order to map clinical data to LOINC I am going to have to create EXM records mapping such items as FLO~0.1~301070 to LOINC#39156-8 for an example from our system for BMI. Right now the Informatics workbench does not allow reference concept mapping to LOINC. What sort of extensions to Epic utilities will be required? Jim ________________________________ From: Rob Szymanski [[email protected]] Sent: Tuesday, February 11, 2014 12:37 PM To: [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]>; Campbell, James R; [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]>; Sarah Peters; Nancy Smider Subject: Epic's Research Data Network Terminology and Standards Working Group Bi-Monthly Call When: Occurs every other month on the third Thursday of the month from 10:00 AM to 11:00 AM effective 3/20/2014 until 1/15/2015. 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