Standards Australia has published a revised standard for the electronic exchange of pathology and diagnostic imaging orders and results using HL7 v2.4, the NEHTA preferred specification.
The standard, AS 4700.2 2012, is a revision of the existing standard and provides requirements and guidance for the implementation of electronic messages using the Health Level Seven (HL7) Version 2.4 protocol.
The standard will also ensure that patients and providers will be identified using the HI Service in both test orders and results. It is expected that this will help improve positive identification of the subject, the requester and the report recipients.
Co-chair of the Standards Australia sub-committee for diagnostics messaging, Michael Legg, said while there will be no big changes, the revised standard will provide greater clarity around how to send diagnostic reports, and will also show how to use the new identifiers by reference.
“We have also firmed up guidelines on the rendering of the report so a proper message from a pathology practice should, in addition to the atomic results, send a rendering of the report as they would expect the viewer to see it,” Professor Legg said.
“This is to address the risk of of receiving systems losing or changing meaning by displaying data in a different format.”
Most general practice software has been tweaked over time to receive a number of different message report formats, including the old Pathology Information Transfer (PIT) format that has been used for more than 15 years. Professor Legg said the revised standard now deprecated the use of PIT and required the use of alternative display formats such as XHTML.
He said all private pathology practices are able to send HL7 messages but that the receiving systems were often a reason for variation.
“What they have done is often shoehorn stuff in to fit the receiving systems and so you end up with variations. What we at the Standards Australia working group have continuously worked toward is a standardised message that conveys all of the information accurately and in a form that can be used by the receiving system for things like alerts and other decision support to make it safer and easier to provide the best care for the patient.
“Depending on how the receiving systems deal with the pathology reports, the intention is to provide the capacity to still see on the receiving systems the report in the way that the laboratory would show the results.”
The working group is also now revising its handbook for messaging between diagnostics providers and health service providers, HB 262, to reflect the changes in the standard.
“The handbook is a detailed how-to guide,” Professor Legg said. “With changes to both terminology and the identifiers, we are going to go back to the handbook and update that. That is on our work program and we expect that will be finished by the end of June 2013.”
Standards Australia is also looking at how clinicians can ask for results from a pathology laboratory before seeing the patient in a clinic, and also how to put complex structured reports such as those recommended by the College of Pathologists for cancer into a pathology message. Both of those are projects that will all be complete by June 30, Professor Legg said.
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