If you want to exchange information with someone who speaks only Urdu, you don't communicate in English. You find a way to convey your message in Urdu.
Systems for exchange of laboratory data—laboratory information management systems or "LIMS"—likewise rely on common languages of standardized coding to communicate with other laboratories, public health partners and health care providers. Examples of such standards are Logical Observation Identifiers Names and Codes (LOINC) and Systematized Nomenclature of Medicine (SNOMED), which are familiar to many responsible for clinical testing.
A LIMS does not arrive at a laboratory pre-coded and ready to run. It has to be fed all the information it will need to synthesize and replicate over the testing process, from accessioning to analysis to reporting. It's the role of informatics terminologists to analyze system requirements and map the dozens of codes that allow the LIMS to "speak" with other data exchange systems.
Recently APHL completed a particularly complex and unusual LIMS coding project at the Marion County Public Health Laboratory, which serves the Indianapolis metro area. The laboratory wanted to deploy its new LIMS across the facility after first deploying the system in its microbiology section. However, such systems are not commonly implemented in the environmental section of a laboratory. Different regulations, formats, operating procedures and reporting requirements apply to microbiological and environmental testing. Consequently, most public health laboratories support these functions with different LIMS.
APHL, working with Marion County laboratory's LIMS administrator, other laboratory experts and the APHL Environmental Health Committee, took on the challenge of implementing a LIMS that would work across all sections of the county's laboratory. APHL's lead terminologist began the enormous project by assessing the data required by environmental medicine and obtaining more information on environmental standards. She then poured through 175 standard operating procedures and mapped each of the 89 environmental tests used in the county to its analyzed chemical substance. She also mapped additional codes for test results, units, methods and sample types. Where no terminology existed, she created codes.
The result is a model for other public health laboratories that want to operate all sections, including environmental testing, on a single LIMS.
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For more details on this complex project, contact Informatics' lead terminologist Riki Merrick at riki.merrick@aphl.org.