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ACB-IT  October 2007

ACB-IT October 2007

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Subject:

Re: Conversion units

From:

Anthony Mottram <[log in to unmask]>

Reply-To:

IT working group of the Association of Clinical Biochemists <[log in to unmask]>

Date:

Thu, 11 Oct 2007 11:56:26 +0100

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (289 lines)

There is currently some discussion going on between the LOINC and SNOMED 
CT at the international level with a view to collaboration.

I would like to raise this issue within HL7 UK, to try to pull together 
appropriate people who have an interest in harmonising LOINC, SNOMED CT 
and CEN standards, along with the standards groups from CfH and 
personnel from the Clinical Disciplines. I believe there are sufficient 
numbers of interested parties to form a discussion group, with a view to 
establishing a recommendation for best practice at both realm and global 
levels. It could also be the start of establishing safe transform 
methodologies (if there are any to be established)

Regards on behalf of the HL7 UK Board,

Tony


-- 
Anthony Mottram
[log in to unmask]
Senior Technical Manager
Indigo 4 Systems Ltd
Aizlewood's Mill Nursery Street Sheffield S3 8GG
Switchboard: +44 (0)114 282 3110
Mobile: 07887 788744
Web: www.indigo4.com

A company registered in England & Wales no. 3345418
VAT registration no. GB 690 4241 50
For email disclaimer see www.indigo4.com/disclaimer


Richard Jones [Pathology] wrote:
> Just a little clarification - my understanding was that the Read codes for tests were offered to SNOMED but the US insisted in going with LOINC and hence initially isolating Pathology. 
>  
> In the end there will be one global code scheme - complex I know but necessary. OpenEHR is worth a view as it's based on open architecture and is object orientated. Problems with early code systems were that they were too rigid and lacked the ability to deal with the rapidly changing world. It's noteworthy that SNOMED is beginning to emerge into the new world of open standards - see also Microsofts open source moves with the common user interface.
>  
> In the new world it pays more to collaborate than compete - sadly we are still paying the price for previously mis-guided attempts to corner the market in codes.
>  
> As to who's in charge of UK pathology coding - I'd love to find out.
>  
> Rick
>  
> Dr Rick Jones
> Assoc Clin Director, Yorks and Humber SHA NPfIT
> Sen Lect, Yorkshire Centre Health Informatics, Univ of Leeds
> [log in to unmask]
> http://www.ychi.leeds.ac.uk <http://www.ychi.leeds.ac.uk/>  
> http://elipse.redirectme.net <http://elipse.redirectme.net/> 
> http://www.pathology.leedsth.nhs.uk <http://www.pathology.leedsth.nhs.uk/>  
> 0113 343 4961
>  
> 
> ________________________________
> 
> From: IT working group of the Association of Clinical Biochemists on behalf of Paul Schmidt
> Sent: Thu 11/10/2007 09:40
> To: [log in to unmask]
> Subject: Re: Conversion units
> 
> 
> 
> Hi Arden,
> 
> I think this call for a collaborative effort is very commendable. There is
> just one problem with it: the US have decided a few years ago that they are
> adopting the LOINC database for the names/codes of laboratory tests and
> other clinical observations, and whoever in the UK is in charge of these
> things seem to view it with antipathy or at least indifference. As I
> understand it there is collaboration with SNOMED CT so that the domains will
> be complementary. Several other countries in Europe has also agreed to adopt
> the standard.
> 
> http://www.clinchem.org/cgi/content/full/49/4/624
> 
> Nobody is saying it is yet the complete package, but it is a damn sight more
> comprehensive and systematic with potential for improvement (eg in
> describing ordering panels) than anything else I have seen. The issue of
> developing a single framework for standard units of measurement is one which
> should also tie in to that (and in the US I guess it does??).
> 
> For my part I have never understood why we in the UK cannot see the sense of
> joining the collaborative and influencing the changes one might want to see
> from the UK perspective, just like the situation was with READ codes (UK)
> and SNOMED RT (US). Then the NHS and College of American Pathologists joined
> hands and SNOMED CT hasn't looked back since. Instead there is constantly
> new little initiatives here in the UK bubbling up under various
> organizations uncluding the Southern cluster in NPfIT which seems keeps
> re-inventing the wheel (yawn!)
> 
> The point I am making is: if the UK is not even part of the broader
> collaborative of agreeing names and codes for test results, then the issue
> of agreement on SI units is almost moot, as there is unlikely to be any
> universal exhange standard.
> 
> I would be very interested if someone could enlighten me why this is
> happening (or not happening!)
> 
> Paul Schmidt
> 
> Queen Alexandra Hospital
> Portmsouth UK
> 
> 
> 
> -----Original Message-----
> From: IT working group of the Association of Clinical Biochemists
> [mailto:[log in to unmask]] On Behalf Of A. Forrey
> Sent: 10 October 2007 18:24
> To: [log in to unmask]
> Subject: Re: Conversion units - PMIP[MESSAGE NOT SCANNED]
> 
> I would like to urge that the UK clinical laboratorians dvelop a
> collaborative effort with those in the US with respect to the common units
> and their representations (whether in  messages or in data structures
> such as the EHR). The IFCC/IUPAC SI represerntations are those recommended
> both by national and international groups. The educational challenge for
> the health professional (useers and producers of measurments/observations)
> has been a majo one over  the  16 years that work of the US with the EU
> CEN TC 251 groups has been pursued. Much more could and should be done
> collbaoraively and synergistically. AACC LISMID Chair Al Jekelis is a key
> contact and he is working with LISMID memeber pam Banning on a
> terminology program for the AACC 2008 Annual meeting in July in Washington
> DC. There is still time to develop a joint effort with ACB to address this
> specific challenge and have useful information by the time of that
> presentation. I invite those interested to contact these individuals on
> this subject.
> Sincerely,
> 
> Arden W. Forrey PhD
> Dept of Restorative Dentistry
> University of Washington School of Dentistry
> 
> On Wed, 10 Oct 2007, Jonathan Kay wrote:
> 
> 
>>On 10 Oct 2007, at 10:40, Gethin Roberts wrote:
>>
>>>In Wales we are currently working towards procurement of an "integrated"
>>>LIMS. OJEU ? Feb 2008.
>>>I'm heading a project to standardize biochemistry test names, codes,
>>>units and (where possible!) reference intervals.
>>
>>I think the key question is whether that is going to give transferable
>>results...
>>
>>Best wishes
>>
>>Jonathan
>>
>>
>>
>>On 10 Oct 2007, at 10:40, Gethin Roberts wrote:
>>
>>
>>>In Wales we are currently working towards procurement of an "integrated"
>>>LIMS. OJEU ? Feb 2008.
>>>I'm heading a project to standardize biochemistry test names, codes,
>>>units and (where possible!) reference intervals. I've also represented
>>>Wales on Jonathan Berg's W Midlands Biochemistry Harmonisation group.
>>>Looking at the spreadsheet I can see how this can easily develop into a
>>>pig's breakfast!
>>>We hope to proceed in Wales by setting up a code list for tests with
>>>agreed names and (SI) units. Any translation necessary for the IHR
>>>and/or clinical portal in Wales would occur further down the line.
>>>Although we hope to agree some consensus reference ranges the reality is
>>>that most results transmitted will (hopefully) have a standard code and
>>>unit but different ref ranges depending on lab.
>>>I would be grateful for any advice on how likely this approach is to
>>>succeed and any other comment on the most effective way forward.
>>>
>>>Gethin Roberts
>>>Consultant Clinical Biochemist
>>>Bronglais Hospital
>>>Aberystwyth
>>>01970 635784
>>>
>>>-----Original Message-----
>>>From: IT working group of the Association of Clinical Biochemists
>>>[mailto:[log in to unmask]] On Behalf Of Jonathan Kay
>>>Sent: 10 October 2007 08:32
>>>To: [log in to unmask]
>>>Subject: Re: Conversion units - PMIP[MESSAGE NOT SCANNED]
>>>
>>>I don't think its safe for receiving systems to change any components
>>>of reports unless it is known that results between the different
>>>methods are transferable.
>>>
>>>Some minor conversions of units are probably OK (eg mmol to micromol)
>>>and should be based on systems sending well formed ISO units (IFCC/
>>>IUPAC to us), and be limited to those cases.
>>>
>>>If this approach isn't taken it is likely that eg enzyme results from
>>>different laboratories will be merged when the results are not
>>>transferable. (Because system implementers will look at the units and
>>>see they are the same... )
>>>
>>>NB: This is a criticism of UK laboratories, not information system or
>>>projects.
>>>
>>>Jonathan
>>>
>>>On 9 Oct 2007, at 21:23, Richard Jones [Pathology] wrote:
>>>
>>>
>>>>TPP (and I assume other GP suppliers) are now receiving data from
>>>>multiple labs with a mixed range of units. Though they store the
>>>>original unit when they display tables or graphs they have a need
>>>>to convert to a common base unit.
>>>>
>>>>They have set up the following conversions. I would be grateful if
>>>>anyone with a little time could check these for me and comment on
>>>>whether you think they are valid. see spreadsheet.
>>>>
>>>>Incidentally they have also noticed a number of labs sending
>>>>messages with 'inappropriate' units and other message content. I
>>>>have contacted CfH (at a very high level) to try to get their help
>>>>desk to resolve it without any reply - clearly the potential safety
>>>>issue is not recognised / understood.
>>>>
>>>>How do you think we should proceed?
>>>>
>>>>I have attached an anonymised list (at least only with lab ID
>>>>codes). Should I share the uncoded version?
>>>>
>>>>My feeling is that CfH should be picking this up and following
>>>>through to the labs.
>>>>
>>>>Comments welcome.
>>>>
>>>>Rick
>>>>
>>>>
>>>>
>>>>
>>>>Dr Rick Jones
>>>>Assoc Clin Director, Yorks and Humber SHA NPfIT
>>>>Sen Lect, Yorkshire Centre Health Informatics, Univ of Leeds
>>>>[log in to unmask]
>>>>http://www.ychi.leeds.ac.uk <http://www.ychi.leeds.ac.uk/>  <http://www.ychi.leeds.ac.uk/>
>>>>http://elipse.redirectme.net <http://elipse.redirectme.net/>  <http://elipse.redirectme.net/>
>>>>http://www.pathology.leedsth.nhs.uk <http://www.pathology.leedsth.nhs.uk/>  <http://
>>>>www.pathology.leedsth.nhs.uk/>
>>>>0113 343 4961
>>>>
>>>><Anonymous Copy of Invalid Units.xls>
>>>><Copy of Invalid Units.xls>
>>>
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