National Research
Council of Italy
Laboratory LOINC
Committee Meeting
Regenstrief Institute,
Indianapolis
December 7, 2012
Institute for High
Performance Computing
and Networking
LOINC Italia News
Maria Teresa Chiaravalloti
Technologist at National Research
Council, Italy
PhD Student at University of Calabria,
Italy
Giovanna Sannino
Research fellow at National
Research Council, Italy
PhD Student at University of Naples
“Parthenope”, Italy
Where we left last time…
National Research
Council of Italy
Institute for High Performance
Computing and Networking
Mapping results: an example
2376 local lab tests
(Laboratorio Lamberti)
National Research
Council of Italy
89% mapped
VS
11% unmapped
Institute for High Performance
Computing and Networking
What we understood
 It is strictly necessary a standardized mapping
procedure/guidelines
 The chance to look at what other labs have
done is a key factor in mapping success
LOINC Mapping Repository
and RELMA “Community
Edition” Project
National Research
Council of Italy
Institute for High Performance
Computing and Networking
Where we left last time…
National Research
Council of Italy
Institute for High Performance
Computing and Networking
Governamental adoption of
LOINC
LOINC is one of the
standardized
vocabulary
recommended for
identifying single items in
clinical report
documents
National Research
Council of Italy
Institute for High Performance
Computing and Networking
Part translation updates
LOINC 2.34
RELMA 5.0
(Dec 2010)
LOINC 2.36
RELMA 5.3
(Jun 2011)
LOINC 2.37
RELMA 5.4
(Dec 2011)
LOINC 2.41
RELMA 5.9
(Dec 2012)
Translated
atomic parts
11,748
11,748
12,924
19,275
Synonyms
3,341
6,026
7,092
9,092
Translated full
term names
43,152
43,720
45,813
?
+ Clinical Parts
National Research
Council of Italy
Institute for High Performance
Computing and Networking
Mobile Health Monitoring
Systems
 Aims:
 This research activity aims at designing and realizing
an intelligent mobile system for clinical care and
remote patient monitoring, in particular for heart
monitoring of patients with chronic heart diseases.
 Monitor parameters is not enough:
 Example:
 a system monitors Heart rate and Heart rate variability;
 if (HR >= 120)

alarm
 If the person under monitoring is running?
 Intelligent context awareness
National Research
Council of Italy
Institute for High Performance
Computing and Networking
Mobile Health Monitoring
Systems
 Idea:
 Proposed approach aims at solving some m-Health
open issues about intrusiveness, technological limits,
reliability, interoperability and security in order to
guarantee :
 Non-intrusive data capture by using wearable
monitoring devices
 Intelligent data analysis for Medical aims or healthy
LifeStyle
 Pervasive data transfer and access (e.g. Electronic
Health Record)
 Interoperability between health services and devices
 Reliability in communications
 Security in terms of privacy and data Integrity
National Research
Council of Italy
Institute for High Performance
Computing and Networking
Mobile Health Monitoring
Systems
 Results:
 A prototype system has been designed and
realized in order to:
 Guarantee an intelligent data analysis in terms of reliability
 Assure a correct monitoring and warning system for
doctors and for patients reducing false positive alarms
 The prototype is for Android Tablets and Smartphones and
for PC Desktop Windows based.
 The proposed approach consists in:
 Correlation of biomedical parameters with patient’s
context-aware information:

Biomedical information: HR, HRV, SpO2, Glycemia, Body
Temperature, Respiratory Rate, etc.

Physical activity: Posture, Movements, etc.
 Use of knowledge technologies to build proper
applications

National Research
Council of Italy
e.g. Decision Support Systems
Institute for High Performance
Computing and Networking
Mobile Health Monitoring
Systems
 More biomedical sensors are integrated in our system, like:
 Zephyr BioHarness:
a physiological monitoring system. The subject wears a Smart Fabric chest strap
or shirt which incorporates sensors to monitor heart ECG signals, and respiration
rate. Attached to the strap is the BioHarness Module. This contains a
temperature sensor and a 3-axis accelerometer for monitoring attitude (subject
posture) and activity (acceleration).
 Alive ECG Monitor:
a small device aimed at monitoring the user's ECG. The ECG signal can be
stored in an SD memory card placed on the device and/or transmitted via a
Bluetooth connection to a mobile phone, PDA, or PC for real-time display,
recording and analysis. It is a wearable system suitable for the screening,
diagnosis and management of cardiac chronic diseases. It is also able to
monitor movements and physical activities performed by the user by means of
an embedded accelerometer sensor.
National Research
Council of Italy
Institute for High Performance
Computing and Networking
Mobile Health Monitoring
Systems
 The system was tested on:
 Asus Eee Pad Transformer Prime
 Android 4.0.3
 Samsung Galaxy “gio”
 Android 2.3
 PC Desktop
 Windows XP
National Research
Council of Italy
Institute for High Performance
Computing and Networking
Mobile Health Monitoring
Systems
 What LOINC can do for us:
 Terminology standard:
 Communication with Electronic Health Record Systems (EHR)
 LOINC coding system is used to identify all monitored parameters
 Definition of Rules
 (?m http://mH#heartRate ?hr), greaterThan(?hr,100) ->
newInstance(?abn, http://mH#abnormalCondition), (?abn
http://mH#conditionType 'Tachycardia'^^xsd:string), (?abn
http://mHealthOnto#dueTo ?m) ]
 (?m http://mH#8867-4 ?hr), greaterThan(?hr,100) -> newInstance(?abn,
http://mH#abnormalCondition), (?abn http://mH#conditionType
'Tachycardia'^^xsd:string), (?abn http://mHealthOnto#dueTo ?m) ]
National Research
Council of Italy
Institute for High Performance
Computing and Networking
Mobile Health Monitoring
Systems
 What we can do for LOINC
 Contribute to upgrade the
database with new codes
related to parameters detected
by wearable sensors
 “Sagittal plane body position” :
LOINC number 72282-7
National Research
Council of Italy
Institute for High Performance
Computing and Networking
Conclusions and future work
 We would like to suggest to start thinking about the need of a
«translation control».
 Could be challenging BUT it is LOINC content that goes all over the
world
 LOINC is part of a third stage of the InFSE project (started July
1st 2012)
 LOINC tutorial
 LOINC online helpdesk
 Clinical LOINC, especially Tumor Registry class, to be used in a
recently approved project by Pharmacy Department of the
University of Calabria
National Research
Council of Italy
Institute for High Performance
Computing and Networking
National Research
Council of Italy
Laboratory LOINC
Committee Meeting
Regenstrief Institute, Indianapolis
December 7, 2012
Institute for High
Performance Computing
and Networking
Thank you for your attention!
Maria Teresa Chiaravalloti
chiaravalloti@icar.cnr.it
Giovanna Sannino
giovanna.sannino@na.icar.cnr.it