LOI+Vocabulary+WG+Meeting+Minutes+2012-06-05

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**Meeting Agenda:**

 * < **ID** ||< **Key Discussion Items** ||< **Duration** ||< **Presenter** ||
 * < 1 ||< Review of LOINC Common Orders Value Set
 * Usefulness for LOI Order Code Vocabulary
 * Identify gaps/conflicts/issues ||< 20 Minutes ||< Cindy Johns ||
 * < 2 ||< Review of ELINCS summary documents - additional input from WG ||< 10 Minutes ||< Cindy Johns ||
 * < 3 ||< Identify additional discussion points; begin conversations ||< 30 Minutes ||< WG Members ||

Attendance
Cindy Johns, Riki Merrick, Virginia Sturmfels, Shalina Wadhwani, Bill Ormerod, Freida Hall, Lester Keepper, Saunya Williams, Maribeth Gagnon

Action Items
//1. Riki will follow-up with Glen Moy to clarify the ELINCS recommendation to transmit LOINC codes or not// //2. Riki will ask VA PHL whether they have implemented the ELINCS Orders Specifications// //3. Cindy checking with Regenstreif to determine if there is a possibility for renaming the LOINC Common Laboratory Orders Value Set to something more "universal" since that is the terminology being used in the IG//

Meeting Notes

 * Review of LOINC Common Orders Value Set**
 * The WG leads would like feedback on the list of LOINC common order values and will track and risks or issues in using this value set as a recommendation
 * Is this a list that the Vocabulary WG should consider using for the purpose of submitting LOI comments?
 * This represents a common language and common set of tools, so Lester supports the use of this list for inclusion in recommendations for a Vocabulary standards
 * We should consider what the reportable components of the list panels are before we recommend them as a group
 * The group is in agreement that this file is an appropriate starting point for coming up with LOI Vocabulary recommendations; the LOINC vocabulary can be used as the basis for a common order code recommendation
 * There are SNOMED value sets to choose from, but they are not compiled in a similar format, so LOINC is probably the closest thing to a common order code vocabulary
 * In order for this to work, they need to work on reflex testing
 * One conflict identified is that there may be providers who can’t find specific codes identified in our list, which may come into conflict with Meaningful Use 3


 * Review of ELINCS Summary Documents**
 * ELINCS Orders Technical Working Group Meeting Summary
 * Virginia checked to see if Quest tried to pilot the LOINC order code provided in the solution in the spec provided, but found that Quest had no experience with this as part of ELINCS
 * We should be able to compile a profile version of the LOI guide that looks the same as the what the ELINCS orders looks like
 * It would be helpful for the LOI Vocabulary WG to understand the intent of the LOI ELICS specifications
 * In the meeting they reiterated the lab’s concern that what the lab performs matches what is ordered by the physician; they may need to address this with CMS in terms of punitive measures that would be taken in response
 * It doesn’t seem as though the environment has changed in the last year since this document was published, so these conclusions have not been invalidated in any way
 * The overwhelming conclusion determined by ELINCS is that the environment was such that it would not be reasonable to consider using a standard vocabulary only; they need both a lab’s propriety code and recommended the LOINC code be included where possible (selecting from the constrained common order set list)
 * Its contradictory to say “ EHRs would only send LOINC codes in orders for tests for which mappings have been provided by the laboratory” and “When sending orders, the EHR will ONLY include the lab’s proprietary code. The EHR should not include the LOINC code in the order message in v.10 of ELINCS Orders.” Riki will clarify this statement with Glen Moy


 * Additional Discussion Points**
 * The WG recognizes the challenges with using the LOINC common order value set
 * It is possible to have a disparity between the universal service code ordered and the universal service code returned by the laboratory with the results (order code and returned universal service code may not be the same)

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