A Readiness-to-Remediation Toolkit for Standardized Laboratory Terminology Adoption in Small, Independent Laboratories. - Small, independent laboratories play an essential role in patient care, public health surveillance, and biomedical research, yet they often lack the informatics resources needed to implement standardized laboratory terminologies such as LOINC®, SNOMED CT®, and UCUM. As a result, many continue to rely on local laboratory codes or inconsistently implemented national standards, reducing semantic interoperability, increasing implementation burden for downstream data users, and limiting the quality and reuse of laboratory data. Regenstrief Institute, the global developer and steward of LOINC and UCUM, proposes this project as the prime recipient in partnership with the Association of Public Health Laboratories (APHL), combining world-class terminology standards leadership with national laboratory implementation networks. The proposed two-year project with optional third year will recruit at least three representative small, independent laboratories and guide each through a structured and scalable implementation framework that progresses from readiness assessment to data quality assessment, targeted terminology data quality improvement, implementation validation, and long-term sustainability. Rather than prescribing a single technical solution, the project will evaluate and apply the optimal combination of open-source tooling and terminology alignment resources best suited to each laboratory's technical environment. Candidate data quality assessment tools include CumulusQ, Komet, and Regenstrief terminology services. Terminology standardization resources include RELMA®, SearchLOINC, LOINC Mapping Guides, Open Concept Lab (OCL), LIVD specifications, and related open-source implementation resources. The project will evaluate laboratory readiness, identify terminology and interoperability gaps, perform structured root cause analyses, implement laboratory-specific remediation strategies, and measure improvements in semantic interoperability. Guided by a multi-stakeholder Technical Expert Panel (TEP), the implementation experience will be synthesized into evidence-based recommendations that strengthen laboratory terminology adoption, improve open-source assessment and remediation tools, and inform future interoperability guidance. Project outputs, including educational webinars, training resources, and reusable implementation guidelines, will be openly published, non-proprietary, and designed for wide-scale reuse by laboratories, health IT developers, standards organizations, and public health agencies. By combining Regenstrief's authoritative leadership in health terminology standards with APHL's trusted relationships across the laboratory community, this project will deliver a scalable, evidence-based implementation framework that enables laboratories with diverse technical capabilities to adopt standardized laboratory terminology more effectively. The resulting methods, guidance, and open implementation resources will extend the project's impact beyond the participating laboratories and support broader advancement of laboratory interoperability nationwide.
