Lab Data Mapping
What is Mapping?
This allows the appropriate incoming laboratory value (eg HbA1C) to automatically populate the “Measurements” field in the patient’s chart. This has already been set up for the flowsheets (Diabetes, HBP, CHF etc) but there are times when you may need to either correct the existing mapping or create a new customized mapping.
LOINC stands for Logical Observation Identifiers Names and Codes and is an open-source project out of Indiana Medical School.
It has been developed in an attempt to standardize the transfer of information electronically and provides coding for information like lab results but extends to clinical content as well.
What one is doing is linking one or more LOINC codes to a specific Measurement.
How to map values in OSCAR
1) Check that what you want to map to is in measurements– there are a lot of values already there so look carefully.
Administration>System Management>Customize Measurements>View All Measurement Types
If the item is not in measurements, create it:
Administration>System Management>Customize Measurements>Add Measurement Type
You are allowed to use up to 4 characters in the first field (Type) and unless you want specific instructions repeating the characters in the second box, expanding on the measurement name in the third box if you want (Display name) and leaving the last blank works EG: Ca Ca Calcium . For validation Ca normal range is 2.1-2.6 so choosing a validation of 0-10 is probably appropriate. Don’t expand the name too much as the third box (Display name) is the name you see in the measurements table on the patient encounter view.
It would be useful if everyone used the same nomenclature in the first field (Type) (for example Ca) as this is the identifier for the database tag – so we need to work on a central listing.
3) Now the actual mapping is the easy part:
Administration>System Management>Customize Measurements>View Mapping : Look for 2000-8 Calcium- Map – At top is “Select measurement” and use the drop down box to select the appropriate measurement (Ca)- Update Measurement Mapping. Congratulations you are now done!
(NOTE: this will not move previous lab values into measurements, only new arrivals).
3) Now we can have these values auto-populate into eForms text fields using the special tags:
*So the BIG issue is working out which is the correct LOINC code to map…and sometimes different labs use different LOINC codes for what appears to be the same test, likely because of different methodology.
The bottom line is be careful and don’t map without knowing that you are doing the correct thing, as undoing a linkage has not been tested!!! It appears that the “hover over the lab test” to show what LOINC code is being used may not work in Ontario at the present time but that it is functional in British Columbia.