How to manage local health regions wanting unique display names

Decision Status: Completed

Background

Local Health Regions will want to name their documents differently, e.g., regional display names.

For example, BC chose short version of LOINC display names

Options

  1. Endorse choice of local display names
  2. Define the structure and attributes of display names 
  3. Only allow LOINC long and short display names
  4. Provide a list of allowable display names (designated synonyms)

Discussion

  • Expect that a region will display the document name suitable for that region, we're going to have trouble stopping that.
  • The source system display name will be in the metadata for a receiving user to look at if necessary.
  • Too many display names to track if we try to do that nationally.
  • Will not restrict what people use for display names; we mostly need a common identifier.
  • Sometimes it is better for the sending system to convert names to a regional name.
  • Canadian LOINC could recommend some structure to the provinces for governing the display names.
  • How about a set of three possible regional display names for systems to send the documents with. This is a way to give choice and keep to a standard.
  • Sending systems can have their own system name internal to them.
  • The sending system should send a Pan Canadian EN/FR name with each document as a back up.
  • We can use SNOMED as an example: they have designated synonyms; we can have a few display name options for health systems to choose from.
  • We need to help frontline clinical staff have consistent names. This is done by the Canadian Ontology constraining what display names are used outside enterprises.
  • One way to constrain display names is to specify what they are or to limit construction of the names to a name standard and certain allowable abbreviations.
    • Concern: that each enterprise chooses to shorten names differently. Although typically 1) Remove ‘note’, 2) Remove any redundant words, 3) Shorten words as much as possible, 4) Use abbreviations.
    • There was confusion on the difference in content and the necessity of Long Common Name, Display Name. There was confusion about what is a regional, local and provincial name. There was no clear path to balance both controlling and giving choice to enterprises in their display names. One action: provide some suggested allowable abbreviations.

Decision

1) Our goal is to help front-line clinicians find documents.  This is often done by scanning display names.  Consistency of these display names within an EMR or EHR is important to the goal of CDCI, so we need to insist on certain display names.   We have the ability to do this at a national level, but understand that if an entire province decides on a different display name, then all the EHR/EMR's will use that name, there will be consistency, and we will have met our goal.   

Decision:

In addition to reference LOINC LCN, Short Name and Display Name, we'll have:

·       Canadian English Display Name - we make Canadian from the LCN, algorithmically

·       Canadian French Display Name. - we make Canadian from the LCN, algorithmically

·       Canadian English Short Display Name - we make Canadian from the Short Name, algorithmically

·       Canadian French Short Display Name - we make Canadian from the Short Name, algorithmically

·       Canadian Provincial Display Name - based on French or English Display Name.  This gives provincial flexibility, particularly if the law requires a certain display name, such as Power of Attorney or MAID.   At this time there is only room for one provincial alternative, but others can be made if there are multiple provinces.    

·       Canadian English Long Common Name - to use as our LCN but it has Canadian terms. 


'Non-standard displays are discouraged.  However, if they are used,  keep to the standard structure from LOINC.  Please let CDCI know, so we can document the deviations.  

DL: 5

NS: 5

ML: 5

MB:5

DO: 4



Guideline

In addition to reference LOINC LCN, Short Name and Display Name, we'll have:

·       Canadian English Display Name - we make Canadian from the LCN, algorithmically

·       Canadian French Display Name. - we make Canadian from the LCN, algorithmically

·       Canadian English Short Display Name - we make Canadian from the Short Name, algorithmically

·       Canadian French Short Display Name - we make Canadian from the Short Name, algorithmically

·       Canadian Provincial Display Name - based on French or English Display Name.  This gives provincial flexibility, particularly if the law requires a certain display name, such as Power of Attorney or MAID.   At this time, there is only room for one provincial alternative, but others can be made if there are multiple provinces.    

·       Canadian English Long Common Name - to use as our LCN but it has Canadian terms.