Big Data Research for Transforming USA Healthcare –
LOINC Possible Road Map
Susan A. Matney, MSN, RN, FAAN1
Bonnie L. Westra, PhD, RN, FAAN, FACMI2
13M
HIS, Murray, UT, USA;
2University of Minnesota, Minneapolis, MN, USA
Clinical LOINC Fall 2014
Vision for Nursing Data in an Electronic Health Record
Supported Clinical Data Warehouse
Clinical Data
NMDS
Other Data
Sets
Management
Data
NMMDS
Health
Policy
Continuum of Care
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Meaningful Use of EHR Requirements
http://www.siframework.org/
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Standards & Interoperability (S&I) Framework
Consolidated Clinical Data Architecture (C-CDA)
Required and Optional data
Specifies terminologies
Translation of Acronyms
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CCC – Clinical Care Classification
CPT – Current Procedural Terminology
HL7 – Health Level 7
ICD.x – International Classification of Diseases
ICNP – International Classification of Nursing Practice
LOINC – Logical Observation Identifiers Names & Codes
NANDA – North American Nursing Diagnosis Association
NIC – Nursing Intervention classification
NOC – Nursing Outcome Classification
PNDS – Perioperative Nursing Data Set
RxNorm – no translation
SNOMED CT – Systematized Nomenclature of Medicine — Clinical
Terms
Health Terminologies
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Demographics – HL7, LOINC, OMB, CDC
Encounter/ Enrollment – HL7 V3 ActEncounterCode
Vital Signs – LOINC
Problem – SNOMED CT, ICD-9, ICD-10
Procedures – SNOMED-CT, ICD-10, CPT-4
Medications – RxNorm
Laboratory data – LOINC
Clinical quality measures –
– SNOMED CT for problems, interventions, outcomes,
– LOINC - Assessments
Nursing Models & Terminologies
• Nursing has many terminologies/ data sets
recognized by the American Nurses Association
– Clinical data
– Management data – context of care
• Interoperability
– Requires common terminologies for exchange
– USA
• SNOMED CT – problems, interventions, outcomes
• LOINC for Assessments
– International
• ICNP/ SNOMED CT
Interoperability
Nursing Interoperability State
3.2%
25.4%
http://www.himssanalytics.org/stagesGraph.asp
Continue the Vision, Teamwork,
Collaboration
2nd Annual BIG DATA Conference
June 2014
Purpose
Advance a national plan to effectively capture
nursing information for big data research and
improved health outcomes
More than 70 leaders from government
organizations, national associations, health
systems, academia and the software industry
Conference Attendees
Action Plan - 2014
Education
1. Develop standard curriculum for nursing informatics faculty/students
(Tom Clancy, Daniel Pesut)
2. Certification, credentialing, and accreditation in nursing informatics
programs. (Judy Warren)
Practice
3. Transform nursing documentation. (Ann O’Brien/Charlotte Weaver)
4. Develop strategies to measure value of nursing. (Ellen Harper/
John Welton)
Action Plan - 2014
Policies/Incentives
5. Advancing the NDNQI Pressure Ulcer eMeasure work (Judy
Warren/Nancy Dunton)
6. Coordinate efforts to engage nurses in Health IT policy. (Gail
Latimer/Joyce Sensmeier)
7. Build an infrastructure for the collection and dissemination of
standardized workforce data (Amy Garcia)
Research
8. Develop and disseminate a framework and standards for integration
of LOINC/SNOMED CT coding into EHRs for interoperability.
(Susan Matney)
9. Promote harmonization and standardization of nursing data and
model. (Laura Heermann-Langford/Judy Murphy)
10. Nursing and the science of big data. (Connie Delaney/Bonnie
Westra)
Group 8 Goals
1. To identify the common assessment measures
used in nursing, map them to LOINC, place
them in a framework and publish in a public
location.
2. To identify the values associated with the
common enumerated assessment measures
and map them to SNOMED CT.
Process
• Top-down
– Bonnie Westra, Jung In Park, Susan Matney
evaluating current LOINC nursing alignment using the
following framework
• Bottom-up
– Identify the top 50 physiologic nursing assessment
questions.
– Determine LOINC mappings.
– Submit those without mapping to LOINC.
– Align with the proposed framework.
LOINC® Nursing Framework
Adapted from Clinical Care Classification System
Westra, B.L., Matney, S.A. (2014). LOINC® and Nursing Assessments.
Presentation at Big Data Conference, Minneapolis, MN.
Request from LOINC
• Nursing Web Page
– Illustrating framework
– Framework developed to browse hierarchically LOINC
codes under the framework
• RELMA
– Use framework as a class hierarchy within RELMA
Questions?