Lab data mapping

For a review of the relevant windows to customize measurements see Oscar Encounter

What is Mapping?

This allows the appropriate incoming laboratory value (eg HbA1C) to automatically populate  the "Measurements" field in the patients 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 new customized mapping.

Background

LOINC stands for Logical Observation Identifiers Names and Codes and is an opensource project out of Indiana Medical School.
It has been developed in an attempt to standardize 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

So 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.

Admin-Customize oscarMeasurements-View All Measurement Types
If the item is not in measurements, create it:

Admin-Customize oscarMeasurements-Add Measurement Types: 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.

2) Determine the LOINC value for the item you are wanting to map (in this example for Calcium). If your labs come in by HL7, then opening a patients chart who has had a Calcium ordered and hovering the cursor over "Calcium" will bring up a line at the bottom: javascript:popupStart('660','900','...ON/labValues.jsp?testName=Clacium&demo=16888&labType=HL7&identifier=2000-8) In this example the LOINC code is 2000-8. If you are unable to verify the LOINC code by this method, googling "Ca LOINC code" gives: http://loinc.org/discussion-documents/CDISCcommonLOINCtests20050214.pdf and you will see SEVEN codes for Calcium. It is important to look through these carefully and you will see that 2000-8 is the appropriate one (although 17861-6 could be a contender, googling "mCnc vs sCnc" indicates that mCnc are more likely the units used in the US and sCnc the units used in Canada). It is possible that more than one LOINC code could be linked to a singe Measurement (eg 14801-5 Iron Saturation and 6796-7 Transferrin Saturation are both the same tests, done in different laboratories and could link to a measurement for Transferrin Saturation). Again Google is your helper as well as questions to the user group.

3) Now the actual mapping is the easy part:

Admin-Customise 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 link these values into eForms using the special tags:
oscarDB=m$Ca#value
oscarDB=m$Ca#dateObserved
oscarDB=m$Ca#comments

*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.
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!!!