Order LOINC with Multiple Specimen Types

I am LOINC mapping in a system that allows multiple specimen types to be coded for the same test(result) code with specific observation LOINCs.

This system does not allow for multiple LOINC codes at the Orderable level based upon specimen type.

In other words, only one LOINC code per Orderable Code.



Would it be a work around to use the XXX order LOINC and the specific specimen type(system) observation LOINC?

Or use the XXX order and observation LOINC with the specimen specified elsewhere in the HL7 message.



Perhaps just not assigning an Order LOINC until the system allows for multiple specimen types at the orderable level is the answer.



Thank you,

Jane Burke

Were you able to find a solution for this, we are in the same place at the moment and wondering how do we go about this.

 

Thanks.

Hello Raj,

I believe Jane (creator of 11/27/2013 post) has retired now; sorry that a solution wasn’t posted at that time. Note that one of her comments was to not assign LOINC in the Ordering part of the system. If an automated system cannot operate in sync with a terminology standard, the automated distribution of such standard when applied to patient values is flawed.

Is your LIS an off the shelf system or a legacy system? Education to the vendor is paramount of the need to handle LOINC along with the LIS variability/options.

Perhaps with a couple of 2022 examples, we can arise at a solution. What types of orders are impacted? Are these body fluid cell counts, for example?

 

Hello Pam,

 

Thank you for your quick response.

We use off the shelf Cerner LIS and they do have perfect LOINC mapping available for result components. However for ordering they do not have LOINC mapping setup available as per LOINC standards. In theory this application vendor do not support LOINC for orders, you need to customize the system to even support order mapping for LOINC.

At the moment, we are just looking at anyone who might have implemented LOINC for orders with different specimen types in Cerner to get a reference for us to build our architecture of customization around it for us to start implementing LOINC in our system.

Yes this is body fluids, cell counts, etc. I have not started looking into Micro yet, since it has body sites for them.

Thanks once again. Hoping to hear back from you soon.