Public comment invited on pathology units and terms
The Royal College of Pathologists of Australasia (RCPA) is inviting public comment on its draft reference sets of terminology for pathology requesting and reporting and preferred units of measurement for results.
Part of the RCPA's Pathology Units and Terminology Standardisation (PUTS) project, the draft will lead to a revised policy for the units of measurement used in pathology reporting as well as a series of reference sets of terminology for requesting and reporting by the various disciplines, including biochemistry, haematology, microbiology, immunopathology, genetic pathology, anatomical pathology and cytopathology.
A new RCPA policy is expected to be endorsed after the public comment which will describe the rules around standardised units, terminology and the naming of tests. One of the key aims of the project is to standardise units of measure so they can be read by clinical software and be represented in electronic messaging.
Chair of the PUTS steering committee and fellow of the RCPA, Michael Legg, said the project had been running for just over 18 months and involved some 80 pathologists, scientists and informaticians divided into 10 working groups.
One is developing the units, one is working on requesting terminology, and the others are working on terminology for reports for each of the pathology disciplines.
Professor Legg said work on standardising measurements and terminologies in pathology was nothing new, but it not been done before in such a comprehensive and coordinated way. The steering committee has representatives from the RCPA, the Australian Association of Pathology Practices, the Department of Health and Ageing, NEHTA, the Medical Software Industry Association and the leaders of each of the working groups.
“The RCPA started with the standardisation of units in the early '70s but in practice there is significant variation of what is actually reported,” Professor Legg said. “Not only that, it is the kind of variation that may lead to serious harm as pathology reports are shared more widely. So people are keen to fix it, and we are well down the track to getting that done.”
He said the steering committee had chosen two clinical terminologies – SNOMED for requesting pathology and LOINC for reporting the results. LOINC has been developed by the US-based not-for-profit Regenstrief Institute, which has also developed a unified code for units of measure (UCUM), which sets out one logical way of describing units that can then be machine-read and used for electronic messaging.
A recent agreement between Regenstrief and the International Health Terminology Standards Development Organisation (IHTSDO), which owns SNOMED, will see LOINC incorporated into SNOMED in due course.
The requesting terminology group is aiming to standardise the names of tests that general practitioners and specialists order while allowing for common synonyms to find them. By using SNOMED for requesting, the PUTS project is selecting a list of orderable test codes for Australia, which are planned to be integrated into general practice clinical software.
The orderable test codes will cover over 95 per cent of the tests ordered by GPs. Doctors will still request pathology by the name of the test, but they will be accompanied by standard codes that will facilitate better and safer electronic ordering.
The terminology reference sets and RCPA standards and guidelines are available for comment until January 20. It is expected they will be submitted to the next meeting of the RCPA Council in late February. Professor Legg said it should be the policy of the College by March.
Once endorsed, these terminology reference sets and units will in turn be referenced by a revision of the Australian Standard for Pathology Messaging, AS4700.2. A new revision of AS4700.2 with improvements and advice on the incorporation of the new national identifiers is itself being published next week.
What this all means in practice is that it will help pathologists provide the best advice and allow those who receive pathology reports the opportunity to make better and safer use of results for electronic decision support, Professor Legg said.
Posted in Australian eHealth