LOI+Vocabulary+WG+Meeting+Minutes+2012-05-29

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**Meeting Agenda:**

 * = **ID** ||= **Key Discussion Items** ||= **Duration** ||
 * = 1 ||= Review ELINCS summary discussion surrounding use of LOINC codes for order codes ||= 30 Minutes ||
 * = 2 ||= Begin discussion on pros/cons/challenges for use of LOINC vocabulary for LOI Implementation Guide ||= 30 Minutes ||

Attendance
Bill Ormerod, Maribeth Gagnon, Pam Benning, Riki Merrick, Saunya Williams, Shalina Wadhwani, Virginia Sturmfels, Zeshan Rajput

Action Items
//No action items at this time.//

Meeting Notes

 * LOI Vocab Status Update**
 * Last week the group finished putting together the spreadsheet that showed the different data elements identified in the LOI Use Case and now is in the process of gathering HL7 tables so they can be reviewed down the road
 * The came up with a process for reviewing different vocabularies we need to consider; participants can provide feedback via email on any additional information to incorporate
 * This week the WG going to address LOINC codes; this is one of the most robust discussions
 * The use case is still in progress – it will be another few weeks before data elements in the use case are finalized
 * There are documents that have been put on the wiki to provide background information on what the ELINCS Technical WG had done when they were making vocabulary considerations:
 * The ELINCS Orders Specification document is a summary of a meeting they had in January
 * The ELINCS Orders TWG Meetings Summaries document is a summary of the LOINC discussions they had over a few days in January
 * The American Clinical Laboratory Association responded to the TWG with background on LOINC and where LOINC should be incorporated
 * The LOINC Common Orders Value Set document includes the top 300 common order codes


 * ELINCS Orders Specifications TWG Meeting 1-5-11**
 * Their discussions indicated there was concerns that laboratories weren’t comfortable with LOINC codes acting as standard order codes; EHRs saw limited value in using LOINC codes if the lab’s proprietary codes also had to be sent
 * EHRs perform LOINC mapping to lab order codes and EHR sends both codes in order
 * Labs perform LOINC mapping to LOINC order code and EHR sends only LOINC codes in order
 * Labs perform LOINC mapping to lab order codes and EHR sends both codes in order
 * Labs map test codes from their own compendium to LOINC codes listed in the LOINC common lab order value set
 * Labs provide test mappings to HER vendors during order interface implementation
 * EHR loads lab’s compendium and uses lab-provided LOINC mappings to map orderable test codes across labs and to internal test ordering rules
 * EHRs send both the lab’s identifier and the LOINC identifier when ordering the test
 * As the group works through this, they will develop a list of questions and considerations (ex. is the LOINC common order value set a reflection of something that is useful for LOI IG recommendations?)


 * ELINCS Orders Technical Working Group Meeting Summary**
 * Includes a summary of everything discussed in January, in addition to the pros and cons for the different approaches to using LOINC codes
 * They felt that the third proposal was the best compromise
 * The LOI Vocab WG Co-Chairs came up with a few summary conclusions:
 * LOINC is not granular enough/provide a 1:1 crosswalk to be sufficient as a single code at this time
 * Proprietary code is required to be sent either with or without a LOINC order code
 * LOINC order codes from the LOINC common order value set should be mapped by lab experts and provided with test compendium, if possible, but does not need to be sent in the order message by the HER unless agreed/approved by the lab
 * If it is sent by the HER, there was concern about fraud (same LOINC, different proprietary codes, if the higher price one is requested there could be suspicious of fraud)
 * Does the LOINC common order value set reflect what will be most useful for the LOI Implementation Guide?
 * How will the maintenance of the LOINC Value Set be performed as new codes are added and/or modified?
 * Who will have the burden of maintaining the labs’ test compendium? How does the eDOS figure into this?

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