Using Logical Observation Identifier Names and Codes (LOINC) to exchange laboratory data among three academic hospitals.

Using a standard set of names and codes to exchange electronic laboratory data would facilitate multiinstitutional research and data pooling. This need has led to the development of the Logical Observation Identifier Names and Codes (LOINC) database and its test naming convention. We conducted a study which required 3 academic hospitals (in 2 separate medical centers) to extract raw laboratory data from their local information system for a defined patient population, translate tests into LOINC, and provide aggregate data which could then be used to compare laboratory utilization. We found that the coding of local tests into LOINC can often be complex, especially the "Kind of Property" field, and apparently trivial differences in choices made by individual institutions can result in nonmatches in electronically pooled data. In our study, 72-86% of the failures of LOINC to match the same tests between different institutions were due to differences in local coding choices. LOINC has tremendous potential to eliminate the needing for detailed human inspection during the pooling of laboratory data from diverse sites, and perhaps even a built-in capability to adjust matching stringency by selecting subsets of LOINC fields required to match. However, a quality, standard coding procedure at all sites is critical.