First Evidence of Meaningful Use

We recently received an email from a laboratory system that sends us results. They currently send laboratory tests to us that are coded using "local vocabulary." They asked us if we could accept LOINC codes (http://loinc.org/) in the alternate codes.

What they are proposing is adding LOINC codes to the OBX-3 Observation Identifier field. The OBX-3 data type is Coded With Exceptions (CWE), The structure of this field is:

<Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)>

So, they are proposing to send their local code in the first "triplet" of the CWE and the LOINC code in the second "triplet". This would change:

OBX|1|CWE|xxxxx^Local Test Value||result goes here.....

to

OBX|1|CWE|xxxxx^LocalTestValue^L^yyyyyy-y^Loinc Test Name^LN||result goes here.....

The first three subfields of obx-3 (aka the first triplet) are the local code (xxxxx), description (LocalTestValue), and the "L" indicates a local code. The second set of subfields (aka the second triplet) are the alternate identifiers and are the LOINC code for the test (yyyyyy-y), the description of the test from LOINC, and "LN" which specifies that the alternate code comes from LOINC.

This lab has been sending local codes for its tests for many years. The meaningful use requirements of ARRA/HITECH are nudging them to use LOINC.

Who says that we are not making progress :-)

NHL Playoffs 2010

This is my favorite time of the year. I love the Stanley Cup Playoffs. I love that teams play every other night, unlike the endless delays in the NBA playoffs. It does not take long for teams to develop a strong dislike for each other during a playoff round. Because the coaching and film study have advanced in recent years, each team knows the other's tendencies and can develop counters for them.

I love playoff overtime. The overtime games tend to end either very quickly or go on and on.... As long as I don't have to get up for work the next morning, I will stick it out to the bitter end.

Here are a few things that I will be watching for during the first round (I refuse to call them "the conference quarter finals"):

• Which of the goalies that are in the playoffs for the first time will shine? Jimmie Howard? Bryzgalov? Quick? Rask? Halak? Niemi? Wow. That's a lot of teams that are relying on untested goaltenders.
• Upsets. The first round always seems to give us an upset.
• San Jose. Can the Sharks make it out of the first round?
• Officiating. Which games will be decided by a crucial call or non-call?
• Who will step up and who will disappear? The playoffs usually give us an unlikely hero as well as some disappointing performances by "stars"?

Let's enjoy the next two months.