Iterative Evaluation of the Health Level 7—Logical Observation Identifiers Names and Codes Clinical Document Ontology for Representing Clinical Document Names: A Case Report
- Sookyung Hyuna,
- Jason S Shapirob,d,
- Genevieve Meltonb,
- Cara Schlegela,
- Peter D Stetsonb,c,
- Stephen B Johnsonb,
- Suzanne Bakkenb
- aSchool of Nursing, Columbia University, New York, NY
- bDepartment of Biomedical Informatics, Columbia University, New York, NY
- cDepartment of Medicine, Columbia University, New York, NY
- dDepartment of Emergency Medicine, Mount Sinai School of Medicine, New York, NY
- Correspondence: Sookyung Hyun, RN, DNSc, Columbia University School of Nursing. 630 W. 168th Street, Mail Box 6; New York, NY, 10032; e-mail: <sh2138{at}columbia.edu>
- Received 8 April 2008
- Accepted 14 January 2009
Abstract
The authors summarize their experience in iteratively testing the adequacy of three versions of the Health Level Seven (HL7) Logical Observation Identifiers Names and Codes (LOINC) Clinical Document Ontology (CDO) to represent document names at Columbia University Medical Center. The percentage of documents fully represented increased from 23.4% (Version 1) to 98.5% (Version 3). The proportion of unique representations increased from 7.9% (Analysis 1) to 39.4% (Analysis 4); the proportion reflects the level of specificity in the document names as well as the completeness and level of granularity of the CDO. The authors shared the findings of each analysis with the Clinical LOINC committee and participated in the decision-making regarding changes to the CDO on the basis of those analyses and those conducted by the Department of Veterans Affairs. The authors encourage other institutions to actively engage in testing healthcare standards and participating in standards development activities to increase the likelihood that the evolving standards will meet institutional needs.
Footnotes
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Supported by grants from the National Institutes for Health: 1R01 LM 07268 (S. Johnson, S. Bakken, S. Hyun), T15 NLM 007079 (J. Shapiro and G. Melton), 5K22 LM 008805 (P. Stetson) and T32 NR 007799 (C. Schlegel). The authors thank the domain experts for their participation and the other members of the eNote working group for their advice and support, as well as the HL7 DOTF and Clinical LOINC Committee for providing the foundation for the analyses in this Case Report and for their continuing work in this important area.
