LOINC Mapping Experiences in Italy: The Case of Friuli-Venezia Giulia Region

Interoperability in healthcare requires accurate data exchange and interpretation across systems, making standard terminologies essential for achieving semantic interoperability. This paper presents the approach adopted by the Friuli Venezia Giulia Region in Italy to implement LOINC, the most widely used standardized coding system for laboratory tests, into the electronic Laboratory Reports of five hospitals. Mapping was conducted manually by physicians using RELMA, supported by training and guidance from LOINC Italy experts. The validation process involved a dual-review procedure to ensure semantic accuracy but also to face issues, such as implicit or incorrect information in local catalogues and the complexity of some specialties. Collaboration among clinical staff, LOINC experts, and IT professionals proved essential in overcoming these issues. As a result, over 7,000 local tests were mapped to LOINC, and 675 new codes for unrepresented concepts were requested, thus creating a regional LOINC knowledge base. This experience highlights the importance of training, support, and integrated management in adopting LOINC, as these elements are crucial for a standardization process that enhances data traceability, minimizes errors, and supports semantic interoperability. Additionally, this experience could be an example for other healthcare systems aiming to standardize laboratory tests and achieve meaningful data exchange.