New disease? No problem. Regenstrief has new codes to help sort through COVID-19

In the world of medicine, there’s a name and a code number for everything, from serum alpha 1 antitrypsin level (which measures the amount of a protein in the blood that helps protect your lungs from emphysema and related diseases) to zygomatic arch x-ray report (which shows whether a certain facial bone has been broken).

And for 26 years, the Regenstrief Institute in Indianapolis has been updating and revising its catalog of standardized medical codes, with more than 93,000 entries.

Now, in the age of COVID-19, Regenstrief has just launched the latest version—for the first time with about 150 codes related to the coronavirus

On July 7, the medical-research institution announced the updated terminology database, which is meant to help doctors, hospitals, laboratories, and manufacturers to share a standardized language.

The codes are critical, Regenstrief said, to help track the virus by allowing health systems and public health officials around the world seamlessly exchange information. The system is used in 179 countries.

The pandemic has created a deluge of interest, said Dr. David Baorto, senior content developer for the system, which goes by the unwieldy name of Logical Observation Identifiers Names and Codes, or LOINC for short.

“It’s hot right now simply because we’re in the middle of it,” Baorto said. “And it’s the kind of thing where we’ve seen an unprecedented request for these terms.”

Regenstrief researchers and technology experts have been working since January to coordinate the new COVID-19 codes with the U.S. Centers for Disease Control, public health and reference labs and medical manufacturers.

It’s just one of many ways Regenstrief is immersing itself in the pandemic, and helping health officials make sure of a growing mountain of data. The institute also works with hospitals and health departments across Indiana to pull together information into a dashboard, which it updates daily to track the disease here.

In 1972, Regenstrief created what is widely considered one of the first electronic medical records systems in the country. Two decades later, it created LOINC (it rhymes with “oink”) to catalog and standardize medical terminology.

The LOINC system is heavy on geeky terminology that would probably twirl the eyes of non-medical readers. Example: Code 94756-4 measures the presence of N gene “in respiratory specimen by nucleic acid amplification using CDC primer-prober set N1.”

Yes, it’s inside baseball for the medical community. But Baorto said it can be appreciated by outsiders, too. He compared it to a utility that deliver electricity to your house.

“The power gets delivered to your house, but you don’t necessarily know all the details and how it got there,” he said. “But you just need to know that it’s there and it’s at the right voltage and the current is right.”

He added: “So I don’t know if the average person needs to understand LOINC per se, but it’s this common language that helps clinical data be transferred from system to system in a way that is understood as it goes from, from system to system.”

A big reason for the surge in interest now for LOINC: in recent months, manufacturers have launched hundreds, perhaps thousands, of different kits to do testing for COVID-19. The different testing methods can vary from each other.

“Some test for the nucleic acids,” Baorto said. “Some test for the patient’s antibodies against the virus. Some test for the virus itself, the antigen itself. Some test the viral RNA. It’s just all kinds of different tests.”

So by having a common terminology, the medical community can look at the test results and immediately see how the patient was tested, and what the results show.

“And that’s going to be critical moving forward and understanding the data,” Baorto said, “because eventually, we know so little about this disease now.”