No lab is an island: universal coding of laboratory test names

Abstract

The local laboratory with a local client-base, that never needs to exchange information with any outside entity, is a dying breed. As marketing channels, animal movement, and reporting requirements become increasingly national and international, the need to communicate about laboratory tests and results grows. Local and proprietary names of laboratory tests often fail to communicate enough detail to distinguish between similar tests. To avoid a lengthy description of each test, laboratories need the ability to assign codes that, although not sufficiently user-friendly for day-to-day use, contain enough information to translate between laboratories and even languages. The Logical Observation Identifiers Names and Codes (LOINC) standard provides such a universal coding system. Each test—each atomic observation—is evaluated on 6 attributes that establish its uniqueness at the level of clinical—or epidemiologic—significance. The analyte detected, analyte property, specimen, and result scale combine with the method of analysis and timing (for challenge and metabolic type tests) to define a unique LOINC code. Equipping laboratory results with such universal identifiers creates a world of opportunity for cross-institutional data exchange, aggregation, and analysis, and presents possibilities for data mining and artificial intelligence on a national and international scale. A few challenges, relatively unique to regulatory veterinary test protocols, require special handling.