August 24-25, 2006, Cologne, Germany
| International HL7 Interoperability Conference IHIC 2006
August 24-25, 2006, Cologne, Germany |
|
||
To the IHIC 2006 conference program committee
Email: ctliu@tmu.edu.tw
Primary presenter and corresponendce author:
Dr. Chien-Tsai Liu,
Associate Professor,
Graduate Institute of Medical Informatics,
Taipei Medical University
250 Wu-Xing Street, Taipei, Taiwan.
Email: ctliu@tmu.edu.tw
Phone: +886-2-23776730 ext 202
Fax: +886-2-27339049
Approaches to Adoption of Laboratory LOINC in Taiwan
research
25 minutes
Approaches to Adoption of Laboratory LOINC in Taiwan
Taiwan’s Department of Health (DOH) has been focused on development of electronic health records (EHRs) nationwide for improving quality of healthcare and controlling the increase in healthcare expenditures in recent years. There have been a series of projects, such as national health insurance smart cards, promotion of health information network services, adoption of international health information standards, enhancement of law and regulations for health information privacy and security, and improvement of portability of electronic medical records, have been initiated and implemented by the DOH since 2001. The projects have been designed to establish the infrastructure foundations and building blocks for EHR applications, through which different EHR systems can be interoperable nationwide facilitating the sharing of patient medical information. After years of efforts, it has become possible to share medical records for referrals and to transmit radiology images and reports from hospitals to the Bureau of National Health Insurance (BNHI) electronically.
One of essential components of health records is the laboratory data, produced by medical laboratories which analyze specimens as ordered by clinicians to assess the health status of patients. Currently the laboratory orders and observations in Taiwan are named and coded on an individual hospital basis. Thus, the resulting code sets may be different from one hospital to another. Even worse, we can hardly find a code for some tests in most hospitals or laboratory centers, for example, a tolerance test, “Gentamycin at peak”. Physicians issue the order by writing a comment on an order sheet. Due to lack standardized names and codes, when pooling laboratory data from different clinical laboratories for some applications such as outcomes research, quality assurance programs, and clinical research, the interpretation must rely largely on medical professionals even though they can be transmitted and received with a standard format of messages such as Health Level Seven, ASTM, CERN, and so on.
In Taiwan, hospitals and clinical laboratory centers use local codes to report their laboratory data. However, they use National Health Insurance (NHI) codes for insurance reimbursement. For this reason, NHI codes are the best choice as an intermediate tool for mapping local codes into the LONIC ones. In this paper, firstly, we will present methods for building up a NHI-LOINC laboratory mapping database; then, describe a tool, called NHI-LOINC mapping assistant (NLMA), for facilitating the mapping of hospital local codes into the corresponding LONIC codes; and lastly, report the status of adoption of LOINC in Taiwan.