Cross-mapping clinical notes between hospitals: an application of the LOINC Document Ontology

Abstract

Standardization of document titles is essential for management as the volume of electronic clinical notes increases. The two campuses of the New York Presbyterian Hospital have over 2,700 distinct document titles. The LOINC Document Ontology (DO) provides a standard for the naming of clinical documents in a multi-axis structure. We have represented the latest LOINC DO structure in the MED, and developed an automated process mapping the clinical documents from both the West (Columbia) and East (Cornell) campuses to the LOINC DO. We find that the LOINC DO can represent the majority of our documents, and about half of the documents map between campuses using the LOINC DO as a reference. We evaluated the possibility of using current LOINC codes in document exchange between different institutions. While there is clear success in the ability of the LOINC DO to represent documents and facilitate exchange we find there are granularity issues.

Figure 1:

LOINC DO Values and Hierarchy coded in MED. Every Field contains the LOINC DO term and its unique identifier in the MED (the MED code). Every row represents parent, child, even grandchild relationships.

Figure 2:

Processing Note Titles. Clinical note title with MED code 106506 is processed. Four LOINC DO values are extracted. The title is represented with the combination of LOINC DO values coded in MED.

Figure 3:

Mapping Note Titles with LOINC Codes. MED code 124597 and LOINC code 34100-8 are processed. LOINC DO values are extracted. The MED code and LOINC code are associated through the matching of the combinations of LOINC DO values