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The pan-Canadian LOINC Observation Code Database (pCLOCD) standard is published as an Excel file that contains ten tabs. The three tabs that were edited in this release include LOINC® Copyright, Nomenclature and the Change Log. The standard is also published as a Microsoft Access database and both file types are available on the Terminology Gateway. The access file includes LOINC copyright information; the Infoway Terms of Use and the "Nomenclature" tab from the Excel file. The contents of the Nomenclature tab are conceptually identical in the MSAccess version although various columns may be expressed in a more specific data type (e.g. A "Yes/No" column in Excel may be expressed as a formal Boolean attribute in the MS-Access version; calculated fields may be translated to direct value fields).
In both the Excel and Access files, information about the changes that occurred to each code is contained in the current Release Change Description attribute. Notes are separated by a semi-colon, changes that occur in different releases are separated by a semi-colon and a space and each new change description begins with a capital letter. Change release descriptions separated only by a semi-colon that do not begin with a capital letter have all occurred in the same release. The current change is the last entry. (i.e. “Changed property from ACnc;changed system from Ser” represents two changes that both occurred in the same release whereas “Changed component from Isocyanate MDI Ab.IgE; Changed CDN component from Isocyanate MDI IgE” represents two changes but only the last change occurred in the current release.)
LOINC records that only changed the Viewer Name in both English and French are called out as a separate change type. A change type of ‘V Name’ in the Current Release Change Type column in either language indicates that only the viewer name was changed. Note that changes to the LOINC component or the EN or FR pan-Canadian Component may also result in a Viewer Name change. Records with a change type of Major or Name should be reviewed carefully for impact to the use of the code as well as the Viewer Name.
II. Terms of Use
"This material contains content from the pan-Canadian LOINC® Observation Code Database (pCLOCD). Canada Health Infoway Inc. (Infoway) has created pCLOCD from LOINC® to address local requirements in Canada. Infoway maintains the copyright on these localized additions. Access to pCLOCD and other pan-Canadian standards and supporting information is available to anyone who accepts the applicable license agreements. Find out more about Standards Access and the pCLOCD Terms of Use on InfoCentral:
https://ic.infoway-inforoute.ca/en/resources/standards/standards-access and https://ic.infoway-inforoute.ca/en/about/tou/pclocd-terms. This material also includes a portion of the LOINC table and is subject to a license from Regenstrief Institute, Inc. which is available at http://loinc.org/terms-of-use.
III. Implementing a New Release
Jurisdictions that have not previously used the pCLOCD may begin to use a new version immediately. Jurisdictions that have already begun mapping to the pCLOCD will need to do a careful quality control review of this release to determine how the changes will impact the work they have completed so far. Some things to consider:
1. Review the records that have been deprecated to see if they are currently in use. Alternate codes will need to be chosen for those records deprecated from the pCLOCD.
2. Review records that have been modified to ensure the modification does not impact the use of that record in the jurisdiction. Things to consider with each Change Type:
a. Change Major – this includes system (specimen) changes, methodology changes and property changes as well as changes and/or corrections to Canadian Component Name. These changes may impact mapping decisions made previously and may change the intent and use of the code; they need to be reviewed carefully.
b. Change Minor – this includes subtle changes to the Canadian Component/Name, property or changes to the LOINC class. These changes will have little impact on previously mapped tests.
c. Name – this includes changes to the LOINC component name which ultimately affects the Canadian Component name and the Canadian Name. These changes may impact mapping decisions made previously and may change the intent and use of the code; they need to be reviewed carefully.
3. Review records that have had the XCA number changed to a LOINC code number and ensure the LOINC number is implemented within the jurisdiction. It may be important to keep track of the previous XCA or jurisdictional number in the audit trail of that record. If appropriate, it may also be important to keep track of its associated mapping as well as the cross reference it back to a jurisdictional number.
4. Review new records added to the pCLOCD to see if they solve any current mapping problems or if they match local codes that have been previously created but not submitted to Infoway. The LOINC number should take precedence.
IV. French Implementers
All of the above considerations should be reviewed for those implementers who are using the translated codes. The following should also be considered:
1. Not all codes have been translated. Review the French Translation Status to determine if the code is ‘Not Yet Translated’.
a. Missing translations can be provided using the RFC tool InfoRMS.
2. Many of the rules applied to the English CDN Component Name have not been used for the French CDN Component Name. Changes can be suggested as per section VII.
V. Maintenance Release Updates
Regenstrief publishes an update twice a year, once in June and once in December. New codes submitted to Infoway will be submitted to Regenstrief for incorporation into these updates. All requests to Regenstrief should be facilitated through Infoway.
Updates from Regenstrief will be reviewed and those that are applicable to Canadian implementers will be incorporated into the pCLOCD. New versions of the pCLOCD will be published twice a year and Infoway targets the publication to occur in the month following the Regenstrief update. Regenstrief pre-releases codes prior to each release, they can be found here.
VI. Future Releases
Future releases of pCLOCD will provide, on a best effort basis, all codes that are applicable to Canadian implementers. If implementers find LOINC codes missing, they should submit a change request as described in Section VIII to have the missing code added to pCLOCD. Infoway staff will respond timely to these requests.
Ongoing maintenance support to the pCLOCD attributes ‘Example Viewer NameEN’ and Example Viewer Name-FR’ will be limited to corrections and changes that result from new releases as published by Regenstrief.
VII. Questions, Concerns, Changes, Corrections
Readers should recognize that new codes will be added from time to time to accommodate the requirements of Canada's implementers. As such the aggregate list can never be seen as "complete" but rather as a framework through which data interchange can be enabled by recognizing and documenting applicable order and/or result observation codes.
Questions and concerns to the current version of the pCLOCD should be made via the Infoway Infodesk: toll free: 1-877-595-3417 or 416-595-3417 or e-mail:
Requests for a change must be made using the RFC tool, InfoRMS. The tool supports individual and batch requests. More information on the pCLOCD Maintenance and RFC process can be found at Canada Health Infoway's InfoCentral.
When a request is received, it will be evaluated as to the completeness, accuracy, and priority level. Further information will be requested for incomplete or inaccurate requests. An acknowledgement of the request is provided by the tool. For more information on InfoRMS, check the User Guide, which can be found under the Help Menu in the InfoRMS tool.