Public Health & Clinical LOINC
- Feb 17th 2012
CDC Vocabulary Team
Office of Surveillance, Epidemiology and Laboratory Services (OSELS)
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Agenda
 Follow-up of Clinical LOINC Submissions
 Collaboration between CDC and other partners regarding vocabulary
distribution
– Data Elements (questions)
– Value Sets
 Public Health Data Element Standardization: Seeking guidance from
Clinical LOINC committee
– ONC S&I Public Health Case Reporting
– Federal Health Architecture Information Modeling and Terminology
– Discuss briefly about current artifacts and history of public health data
element standardization project.
– Next steps
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Follow-up of Clinical LOINC Submissions
 Immunization
– Vaccine Information Statement (Document type) - Completed
 Cancer Registry
– NAACCR Volume 2 - LOINC panel update (Summer 2012)
– Collaborative Staging (CS v2) – Tumor Markers
• CDC, NAACCR and College of American Pathologist forming a workgroup
• Discuss about Clinical LOINC code submission – Summer / Fall 2012
 Maternal and Child Health (MCH) – CDC NCHS
– Birth, Death and Fetal death reporting
• First batch of Clinical LOINC codes - Received
• Second batch of Clinical LOINC code submission in Spring/Summer
2012.
 ICF to Clinical LOINC mapping project – CDC NCHS (John
Hough)
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Vocabulary Distribution Collaboration
- Data Elements (questions)
 NCI caBIG CDE browser (Denise Warzel – NCI / Sundak)
– Pilot project with National Cancer Institute to distribute CSTE
common core data elements and hepatitis using NCI CDE browser
/ NCI forms repository (PHI Conference 2011 Session recording
link)
– NCI CDE has curated content with detailed definition for many of
the common data elements related to patient. These data elements
and permissible values were developed based upon consensus
and existing CHI standards.
– Mapping to Clinical LOINC metadata can be hosted in NCI CDE
browser.
– Public health data elements in NCI CDE browser could be linked to
CDC PHIN VADS value sets for answer list (permissible values)
via browser or HL7 CTS web services.
– NCI caBIG CDE browser link https://cdebrowser.nci.nih.gov/CDEBrowser/
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Vocabulary Distribution Collaboration
- Data Elements (questions)
 RELMA
– Panel to organize public health data elements with sub-categories
(Demographics, Epidemiology, etc..) similar to NAACCR Vol 2
panel
– RELMA would facilitate and distribution of public health
data elements to EHR community as well as mapping.
– Link from RELMA data elements to value sets present
in PHIN VADS
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Vocabulary Distribution Collaboration
- Value Sets
 CDC NLM Collaboration – Meaningful Use value sets
 Quality Measure value sets
– Integrate CDC PHIN VADS value sets with National Quality Forum
Measure Authoring Tool (MAT)
 HIMSS IHE Connectathon
– Supporting IHE Sharing Value Set (SVS) specification
 PHIN VADS Value Set Authoring Tool (UAF)
– ONC S&I
– Federal Health Architecture Information Modeling & Terminology
workgroup
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Public Health Data Element Standardization
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Public Health Data Element Standardization
 ONC S&I Public Health Case Reporting –
– Nikolay Lipskiy, Co-lead for ONC S&I PH reporting and CDC lead for
standards and interoperability
 Federal Health Architecture Information Modeling and Terminology
– Steve Wagner / Rob McClure
 Current Artifacts / Projects:
–
–
–
–
–
CSTE position statements
Standardizing data elements in CSTE position statements (CRSWg)
Common core data elements (CRSWg)
Case Notification – Generic Guide v2 (HL7 2.x IG) – CDC NNDSS
Case Reporting (CDA IG) – 4 conditions – Anthrax, Tularemia, Hepatitis B
and Tuberculosis
 Next Steps Discussion
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Council of State and Territorial Epidemiologists (CSTE) website www.cste.org
11
•CSTE Position Statement Website
•E.g. CSTE Tuberculosis Position Statement - http://www.cste.org/ps2009/09-ID-
•CDC Case Notification Criteria for T.B. - website
http://www.cdc.gov/osels/ph_surveillance/nndss/casedef/tuberculosis_current
.htm
Case Reporting Standardization
Workgroup (CRSWg)
– Data Element Standardization project
 Goal: standardize the questions/data elements in CSTE
position statements (i.e. to represent the data elements
consistently across all CSTE position statements).
– Overview of CRSWg Public Health Data Element Standardization
project (S&I link)
– Analysis of all the data elements present in CSTE 2009/ 2010
position statements (S&I PHCR link for spreadsheet)
– CSTE Common Core Data Elements compared with IHE profile
cancer and Meaningful Use data elements (Immunization,
Syndromic) – S&I link

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Case Notification – Data Elements
 Map the current PHIN Variable ID (UID) to Clinical LOINC.
– Generic Version 2 Message Mapping Guide
illustrates the common core data elements for
case notification and condition specific data
elements.
• Latest version of Generic V2 Message Mapping Guide (phConnect link)
• Event Codes and Case Notification Reporting Mechanism (phConnect link)
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Next Steps / Discussion
 Seeking guidance from Clinical LOINC committee regarding public health
data element standardization
1) Get Clinical LOINC Codes for Generic V2 Message Mapping Guide
data elements (i.e. observations that come in OBX-3).
2) Reuse the case notification data elements in case reporting as
much as possible
3) Identify the case reporting data elements that are not included in
case notification and standardize them using Clinical LOINC / map
to HL7 segments / CDA .
4) Collaborate with ONC S&I PH Case reporting data element
harmonization workgroup and ONC FHIM Terminology subgroup.
5) Propose PH panel structure including categories in Clinical LOINC.
6) Provide link between Clinical LOINC PH data elements and PHIN
VADS value sets in RELMA.
7) Follow-up with CSTE regarding the standardization of CSTE data
elements in position statements.
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