Department of Veterans Affairs (VA)

The Standards and Terminology Service (STS) is responsible for enterprise wide standards and terminology applications for the Department of Veterans Affairs (VA). Current projects involving the use of LOINC® include the following:

• Veterans Health Information Systems and Technology Architecture (VistA) Laboratory HL7 interface to/from VA, Department of Defense (DoD) and commercial reference laboratories.
• VistA Laboratory HL7 interface to/from clinical laboratory automated instruments.
• VistA Laboratory HL7 interface to clinical decision support systems.
• VistA Laboratory HL7 interface to health data repositories/data warehouses.

The Department of Veterans Affairs has participated in Regenstrief's early work in standardizing laboratory and clinical terms as well as clinical and administrative note titles.  At this time VA is primarily responsible for the bulk of terms in the recently approved Document Ontology Axes of LOINC®.  STS continues to work closely with Regenstrief to refine and expand terminology in these axes in support of interoperability and aggregation of otherwise locally idiosyncratic terms.  STS is committed to the enterprise-wide creation, implementation, and continued support for Veterans Health Administration (VHA) standardized titles which will closely map to LOINC® titles and thus be universally understood.

Currently, STS extracts laboratory test data from all VistA systems and, utilizing available test information for each of the six axes of LOINC®, works with local facility staff to determine the most appropriate LOINC® code for each actively resulted Laboratory Test Result Name.  The local facility staff then enters the appropriate LOINC® code in their local VistA system. Once test results are verified by the local facility staff, the VistA laboratory application transports the verified test information and assigned LOINC® code via an HL7 message for storage in centralized databases/repositories in support of a centralized electronic health record and interoperability efforts.