New Regenstrief-McDonald chair supports data standards critical to health information exchange
INDIANAPOLIS — The Regenstrief-McDonald Chair in Data Standards has been established and endowed by the Regenstrief Foundation at Indiana University School of Medicine. The new position honors and perpetuates the legacies of two giants who have focused on improving human health — Sam Regenstrief, the namesake of the foundation and of the internationally respected Regenstrief Institute, and Clement McDonald, MD, a pioneer and innovator in biomedical informatics and the former director of the institute.
The newly endowed chair is based at the Regenstrief Institute and held by the program director for Logical Observation Identifiers Names and Codes — LOINC for short — the standards necessary to the exchange of health information. Regenstrief Institute investigator Daniel Vreeman, DPT, has been named the first Regenstrief-McDonald Scholar in Data Standards.
“The impact of LOINC and data standards generally is enormous and far reaching,” said D. Craig Brater, MD, president of the Regenstrief Foundation and dean emeritus of Indiana University School of Medicine. “Such programs often struggle for traditional external sources of funding. If they must charge fees to survive, those fees are often of sufficient magnitude to preclude use by many. The Regenstrief Foundation’s goal is to provide a source of stable support for LOINC that will allow it to continue its great work indefinitely while also enabling access to its expertise by all.”
LOINC began in the mid-1990s when, under Dr. McDonald’s leadership, Regenstrief investigators used their extensive experience with electronic medical records to develop the Indiana Network for Patient Care (INPC), the nation’s first citywide health information exchange. The researcher-clinicians found they could receive data from various INPC-member institutions but that the clinical content was difficult for computers to interpret because each institution might use a different code for the same test or observation. A serum folic acid result at one institution might be called a serum folate at another or something totally different at a third facility. It was like receiving messages in French, Spanish and Italian when only English could be understood. Dr. McDonald saw the need for standard terminology, and LOINC was born.
Today LOINC is the world’s most commonly used universal code system for identifying medical test results, observations and other clinical measurements. LOINC provides the interoperability that ensures that medical data can be recorded, electronically exchanged and ultimately used to improve health — when and where needed. Two new versions of LOINC are issued annually, with more than 2,000 new terms for tests or clinical observations per release. Typically, new additions are based on requests from the growing number of end users.
LOINC now includes more than 80,000 clinical and laboratory test codes. It is used in 172 countries. It is available in Chinese, Dutch, Estonian, French, German, Greek, Italian, Korean, Portuguese, Russian, Spanish, and Turkish in addition to English.
In addition to hospital systems, clinical laboratories, health information exchanges and other private and quasi-private sector entities, LOINC users include ministries and departments of health around the world. U.S. government agencies that rely on LOINC include the National Library of Medicine, departments of Veterans Affairs and Defense, Indian Health Service, National Cancer Institute, Food and Drug Administration and the Centers for Disease Control and Prevention.
“Health data standards like LOINC are essential to enabling the kinds of data sharing and analyses that are increasingly essential to the practice of medicine and the conduct of biomedical research,” said Peter Embi, MD, president and CEO of the Regenstrief Institute and associate dean for informatics and health services research, professor of medicine and Sam Regenstrief Professor of Informatics and Health Services Research at IU School of Medicine. “The Regenstrief Institute has a long history of leadership in the establishment of data standards and the impact that LOINC has had on health care cannot be overstated. This chair, for which we are extremely grateful to the Regenstrief Foundation, will go a long way toward ensuring the continuation of this important work.”
The gift to establish the Regenstrief McDonald chair counts toward For All: The Indiana University Bicentennial Campaign, which is taking place on all IU-administered campuses. The campaign will conclude in December 2019 to coincide with IU’s bicentennial year celebration in 2020. Thanks to a gift-matching program that is part of the campaign, the financial support available from the endowed fund each year will essentially be doubled.
“It is a tremendous honor to hold the chair named for these innovators who envisioned solutions even before many recognized needs,” said Dr. Vreeman. “The late Mr. Regenstrief, who came to this country as a poor immigrant and became a philanthropist devoted to improving health care, had the vision of applying the techniques and technological advances of manufacturing to make better and more efficient medical services available to all patients. Dr. McDonald is a true visionary who made electronic medical records and health information exchange a reality for improving care quality and efficiency through data standards. I feel so fortunate to have worked closely with him for many years. Dr. McDonald has had such a significant impact not only on my professional career, but on health care around the world.”
Dr. Vreeman is a graduate of Cornell University, earned his doctor of physical therapy degree at Duke University, and came to the institute’s Center for Biomedical Informatics as a medical informatics fellow in 2003, where he began working with Dr. McDonald on LOINC soon thereafter. Dr. Vreeman was appointed to the faculties of the institute and IU in 2005. He was named LOINC director in 2006. He recently was presented with a Distinguished Alumni Award by the Duke University Physical Therapy Alumni Association.
With support from the National Library of Medicine, the Regenstrief Institute, the Regenstrief Foundation and other organizations, LOINC is an open, freely available standard. With the establishment of the Regenstrief-McDonald Chair in Data Standards, the Regenstrief Foundation ensures LOINC’s long-term sustainability.