UCUM+Discussion


 * < **Pros** ||< **Commenter Name** ||
 * < Provides standard codes for units of measure ||< Rob Hausen ||
 * < Adopted for case reporting for Public Health ||< Riki Merrick ||


 * **Cons** || **Commenter Name** ||
 * Reporting issues if no units of measure included with the result (see related information below) || Cindy Johns ||
 * From the UCUM document, if no UoM, it seems you can just send {titer} in OBX.6 for titers || Riki Merrick ||
 * Issues with how titers are reported || Cindy Johns ||
 * Matching UoM on paper reports vs. electronic (CLIA compliance) || Cindy Johns ||
 * Can lab systems accommodate some of the symbols defined in the UCUM standard? || Cindy Johns ||
 * One of the things that happen with lab results is the provider seldom looks at the units of measure, if we do anything to alter that process we have failed. When symbols are used that are not expected, the provider then must evaluate even the units of measure. UCUM has not been adopted by the lab domain. I have no doubt there may or may not be merits in the use of UCUM, but forcing a standard because it is the only thing available is not the proper behavior when patient safety is at risk. ONC needs to sponsor a pilot that includes hospitals, physicians, and labs that review the use of UCUM and determine the impact in a controlled process. IT people forcing standards without the benefit of their medical colleagues it is not in the best interest of those we are here to serve, patients. || Ken McCaslin ||
 * We need to get a way from the concept of 1 for defaults. The statement "Curly braces expressions are equivalent to the unit 1 ." is a bad statement particularily when one is sending titers. A default of 1 for titers implies the wrong thing. We also need to look at isolates in micro to determine the best way to represent the lack of units of measure, assumptions of 1 in this area also misrepresent the intent. || Ken McCaslin ||
 * In talking to one of the states, they indicated that many of their trading partners use the Units of Measure (UOM) fields as a data type of String rather than using it as a CE (Coded Entry) data type. There is a potential that some labs are sending the UOM not in the description field of the CE data type, but in the ID field. If that is the case, we have an additional concern, that when labs start sending UCUM and the description both maybe exposed to the user rather than just the description. || Ken McCaslin ||
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From the UCUM document regarding empty UoM field: § 50 Non-units ■ 1 Symbols commonly used as units that are no real units of measurements are not defined by The Unified Code for Units of Measure. ■ 2 Users are free to use curly braces expressions ( [|§12]) if they think it is important to use symbols rather than the default unit 1. ■ <span style="background-color: transparent; backgroundcolor: transparent; color: black; font-family: MS PGothic ,serif; font-size: 13px; text-align: left; text-decoration: none; vertical-align: auto;">3 <span style="background-color: transparent; color: black; font-family: 'MS PGothic','serif'; font-size: 16px; text-decoration: none; vertical-align: auto;">Curly braces expressions are equivalent to the unit <span style="background-color: transparent; color: black; font-family: MS PGothic ,serif; font-size: 16px; text-decoration: none; vertical-align: auto;">1 <span style="background-color: transparent; color: black; font-family: 'MS PGothic','serif'; font-size: 16px; text-decoration: none; vertical-align: auto;">. The details of the annotations in the curly braces have no defined meaning in <span style="background-color: transparent; color: black; font-family: MS PGothic ,serif; font-size: 16px; text-decoration: none; vertical-align: auto;">The Unified Code for Units of Measure.

Follow-up question from Cindy Johns -- Regarding the statement that curly braces expressions are equivalent to the unit "1", it's not clear to me what this means. If the UCUM table is used to translate local UoM to UCUM, will {titer} be translated to "1"? This may be a question for Regenstrief.

Discussed UCUM with Dr. Clem McDonald at Regenstrief and a representative from Canada Infoway (Canada has adopted UCUM as a standard vocabulary). Was advised that curly brackets mean that the units of measure are transmitted as written and are not translatable in UCUM. Square brackets mean that the units are considered standard but are not translated into anything else (i.e. [pH]). In Canada, users have the option of accepting UCUM (using UCUM units in their LIS) or adopting UCUM (having a separate translation program that takes the UoM from the LIS and translates them into UCUM prior to transmission). Also, there is a "somewhat informal" UCUM committee where comments and recommended changes could be submitted for consideration.