Pathology and Diagnostics news

  • UK SNOMED CT Clinical Edition, RF2 - new releases

    New releases of ‘UK SNOMED CT Clinical Edition, RF2’ items are now available:

    The format of the SNOMED CT UK Editions has changed.

    Read more on the format change and other important SNOMED CT UK Edition information on the SNOMED CT Releases: Important Notices & Known Issues page on Delen.

    Read the release notes and supporting documentation on the SNOMED CT UK Clinical Extension Release Documentation page on Delen.

    For TRUD issues, email information.standards@nhs.net or call 0300 303 4777.

    Regards,

    Information Standards Service Desk
    NHS Digital

    By Chris Hood 11 days ago

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  • NHS Digital Receive Approval for the Pathology Information Standards - A New Vision for Patient-Centred HealthCare

    The Pathology Team at NHS Digital are delighted to announce the approval of the Pathology Information Standards by the Data Alliance Partnership Board (DAPB).  This is a positive step towards the future of pathology with an overall objective to improve patient care. It will enable Clinicians to access pathology tests and results across health and care, receiving the right information at the right time and right place, supporting improved clinical decision making and patient safety. 

    The Pathology Information Standards Notice and associated documents can be found here.

    As part of NHS England CCIO7 workstreams, NHS Digital are delivering the ability to share pathology results across health and care.  Following The Future of Healthcare Vision and the NHS Digital standards framework response, NHS Digital were commissioned by NHSX to define Information Standards aligned with clinical, commissioning and patient needs to support the sharing of pathology tests and results across care settings and organisational boundaries.   

    The need to accelerate the development of a standardised universal test list for Pathology services formed part of the recommendations made by Professor Sir Mike Richards in a wider diagnostic review commissioned by NHS Chief Executive Sir Simon Stevens in October 2020. 

    To meet future NHS needs for interoperability and secondary care use within the Pathology domain, three inter-related specifications have been identified based on relevant component parts of international standards, namely: 

    Unified Test List (UTL) – a national catalogue of Pathology test requests and results to replace the Pathology Bounded Code List (PBCL), based on SNOMED CT 

    Units of Measure (UoM) – an unambiguous representation of commonly used units, aligned with the UTL, based on Unified Code for Units of Measure (UCUM) 

    Pathology Message Specification – for interoperable data exchange of Pathology information, based on Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR)   

    Together, as an information standard, they enable the future communication and exchange of tests, results, quantities, and units used in the Pathology domain across the NHS. The full standard is intended for use by GP, Labs, secondary care and social care (where applicable), used in GP systems, LIMS, Order Comms, pathology middleware, & clinical research. 

    Pathology Standards Component Parts 

    This diagram shows that the three Pathology standards are inter-related. The FHIR message consists of the SNOMED CT clinical coding describing the pathology test request or result, alongside the test result value and unit of measure describing how the value should be interpreted by the recipient. 

    ISN

    We would like to thank everyone who has contributed to the development of the Pathology Information Standards, both internally, within NHS Digital, and externally, without whose input and guidance the approval of our standards would not have been possible.  Although our contributors are too numerous to mention, we would like to give special thanks to our strategic partners as part of the wider NHS family, our Governance Boards, the PRSB, the Royal Colleges and all our stakeholders, including National User Group members, who have lent us their time and subject matter expertise.

    Dr Michael Osborn BSC MBBS MRCS FRCPath

    President of the Royal College of Pathologists

    Consultant Histopathologist for North West London Pathology at Imperial College Healthcare NHS Trust, London

    “I’d like to thank the Pathology Team at NHS Digital for their excellent work, which has culminated in the approval of the Pathology Information Standards. This is an important step towards the development of a standardised universal test list for pathology services which will benefit patients care and contribute to the promotion of pathology.”

     

    Prof. Jo Martin, MA PhD RCPathME FIBMS(Hon) FRCPI (Hon) FRCPath

    National Specialty Advisor for Pathology NHSE/I

    Professor of Pathology, Queen Mary University of London

    “I am really pleased with the work the Pathology Team at NHS Digital has done in helping make the vision of an interconnected system a reality.  I am excited to see the progress towards improving patient care for the future.”

     

    Dr Laszlo Igali

    Consultant Histopathologist, Norfolk and Norwich University Hospital

    Member of the Pathology Informatics Group at the Royal College of Pathologists

    Co-Chair of the Pathology Informatics National User Group

    “This is a very positive step in the development of digital pathology improvements and the standardisation of digital pathology data.”

     

    Ian Townend

    Chief Architect, NHS-X

    “I’d like to thank the Pathology Team for all their hard work in the development of these core standards for the pathology area.  This work closely aligns with NHSX’s top priorities around interoperability, information standards and supporting the use of new technologies. I'm looking forward to starting to see implementation across health and social care.” 

     

    Gill Foley

    Data and Clinical Content Standards Lead, NHS-X

    "It's great to see the Pathology Standards have been approved by the Data Alliance Partnership Board. This standard provides the much-needed foundation for sharing pathology tests and results nationwide.”

     

     The team can be contacted via email at pathologyanddiagnostics@nhs.net

    More information can be found at the Pathology & Diagnostics Information Standards Collaboration Space

    We also encourage interested parties to join our online collaboration space and take part in the regular Pathology Informatics National User Group (PINUG) meetings. 

    The Pathology Team at NHS Digital are facilitating an all-day virtual Supplier Forum event on Thursday, 23rd September 2021, which will comprise a series of interactive workshops.  The aim of this Forum is to increase supplier engagement and discuss the challenges relating to implementation following the approval of the Pathology Information Standards.  To register your interest in attending this Forum, please contact the Pathology Team at pathologyanddiagnostics@nhs.net.

    By Chris Hood 4 weeks ago

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  • UTL release v0.9.0

    Dear all,

    In line with the NHS Digital Pathology and Diagnostics Product Roadmap we are pleased to announce that version 0.9.0 of the Unified Test List has now been published in human-readable form on our collaboration space.

    This release includes updates to the following domains:

    • Microbiology Antigen tests (48)
    • Microbiology Culture tests (203)
    • Gram stain (1) - for consultation
    • Quality Improvements across all domains (1300+)

    UTL now has 4232 SNOMED CT concepts in total split into 3878 Reportable and 354 Requestable.

    The Human readable release can be found here. A Machine-readable release will be published week commencing 16th August.  Both versions will contain the same content.

    An overview presentation of the release content is available to view here.

    Please note, the columns for the attributes including substance, property and specimen are included in the release files purely for information. Please use the links below to access the updated supporting documentation:

     Please provide feedback via: 

    As a Pathology and Diagnostics stakeholder, you will have received an invitation for a kick-off meeting and workshop, on 13th August and 25th August respectively, where the team will provide an overview of the release and aim to address any feedback received.

    Kind regards,

    National Pathology and Diagnostics

    NHS Digital

    By Chris Hood 5 weeks ago

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  • UK SNOMED CT Clinical Edition, RF2 - new releases

    New releases of ‘UK SNOMED CT Clinical Edition, RF2’ items are now available:

    The format of the SNOMED CT UK Editions has changed.

    Read more on the format change and other important SNOMED CT UK Edition information on the SNOMED CT: Important Notices & Known Issues page on Delen.

    Legacy-format releases of the SNOMED CT UK Editions are now released under the UK SNOMED CT test releases item on TRUD. The final release using this format will be on 14 July 2021.

    Read the SNOMED CT UK Clinical Extension Release Documentation on Delen.

    For TRUD issues, email information.standards@nhs.net or telephone 0300 303 4777 weekdays between 9:00am and 5:00pm.

    Regards,

    Information Standards Service Desk
    NHS Digital

    By Chris Hood 2 months ago

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  • UTL v0.8.0 released

    In line with the NHS Digital Pathology and Diagnostics Product Roadmap we are pleased to announce that version 0.8.0 of the Unified Test List has now been published in human-readable form on our collaboration space.

    This release includes updates to the following domains:

    • Chemical pathology
    • Haematology
    • Microbiology

    The Human readable release now has 3985 SNOMED CT concepts in total and the Machine readable release has 3162.

    An overview presentation of the release content is available to view here .

    The human readable release is provided in three parts:

    • PBCL (Pathology Bounded Code List) request codes and Covid-19 request codes

    Panels/groups and high-volume single test requests – 225 concepts

    Screening test requests – 131 concepts

    • Outstanding PBCL reportable codes and Covid-19 reportable codes (included in the main Report code set file) – 133 concepts.
    • Concepts representing the “qualitative result of presence” including Covid-19 codes – 447 concepts (including updates to codes published in 0.7.0)

    The concepts representing the “qualitative interpretation of presence” was flagged as an area that may be ambiguous in use.

    To establish a consensus from users and stakeholders we have published this terminology pattern as Qualitative Result alongside the main content but separate from the core terminology recorded in the machine-readable form, to solicit further beta feedback on the preferred pattern for these concepts.

    The columns for the attributes including substance, property and specimen are included in the release files purely for information. They will ultimately be used to formally classify the SNOMED content using the observable entity concept model, where the attributes and corresponding values will be used to create the SNOMED CT machine readable description logic definitions.

    Please use the links below to access the updated supporting documentation:

     Please provide feedback via: 

    As a Pathology and Diagnostics stakeholder, you will have received an invitation for a kick-off meeting and workshop, on 28th May and 9th June respectively, where the team will provide an overview of the release and aim to address any feedback received.

    By Chris Hood 3 months ago

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  • UK SNOMED CT Clinical Edition, RF2 - new releases

    New releases of ‘UK SNOMED CT Clinical Edition, RF2’ items are now available:

    The format of the SNOMED CT UK Editions has changed.

    Read more on the format change and other important SNOMED CT UK Edition information on the SNOMED CT: Important Notices & Known Issues page on Delen.

    Legacy-format releases of the SNOMED CT UK Editions are now released under the UK SNOMED CT test releases item on TRUD. The final release using this format will be on 14 July 2021.

    Read the SNOMED CT UK Clinical Extension Release Documentation on Delen.

    For TRUD issues, email information.standards@nhs.net or telephone 0300 303 4777 weekdays between 9:00am and 5:00pm.

    Regards,

    Information Standards Service Desk
    NHS Digital

    By Chris Hood 4 months ago

    Read this article

  • Designing information standards for the future

    We keep NHS systems running and secure using our digital frontline expertise. We have published the Release 0.7.0 of the Unified Test List (UTL) as a Draft Standard for Trial Use by pathology and diagnostic services. We are actively encouraging NHS organisations and system suppliers to download and evaluate the data set and provide feedback on usability and coverage, ahead of fundamental standards approval scheduled later in 2021.

    Although there is no mandatory system for reporting pathology data within the NHS currently, most reporting uses the Pathology Bounded Code List (PBCL), last published in October 2018, following the final April 2018 release of Read CTV3.

    A review of PBCL highlighted that it no longer met the needs of the NHS, with three main issues identified:

    • Large numbers of inconsistencies and duplications.
    • Does not cover the full range of laboratory tests used by the NHS.
    • Read codes have been discontinued in favour of internationally recognised SNOMED CT codes.

    Our Pathology and Diagnostics team is developing future-proofed information standards to enable the sharing of pathology results to support clinical, commissioning and patient needs across care settings and organisational boundaries, aligned with the Secretary of State’s roadmap for greater digitalisation of the NHS.

    UTL is one of the three National Pathology and Diagnostics information standards designed to meet future NHS needs for interoperability and secondary care use:

    • Unified Test List (UTL) – a national catalogue of Pathology test requests and results to replace the Pathology Bounded Code List (PBCL), based on SNOMED CT.
    • Units of Measure (UoM) – an unambiguous representation of commonly used units, aligned with the UTL, based on Unified Code for Units of Measure (UCUM).
    • Pathology Message Specification – for interoperable data exchange of Pathology information to replace the Pathology Messaging Implementation Programme (PMIP) ISB 1557 EDIFACT Pathology Messaging (NHS003), based on Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR).

    These standards will enable the NHS to replace existing legacy systems with up-to-date solutions based on strategic data standards to improve data quality and interoperability.

    The UTL is intended to replace PBCL for primary care diagnostic reporting and hospital reporting needs with a single standard. UTL is based on SNOMED CT and offers greater consistency and more precise definition of clinical terms than PBCL. Some of the key benefits of UTL are:

    • Standardised data to support machine-readability, enabling secondary uses like analytics or machine learning intended to improve outcomes from areas such as population health and research.
    • Ability to communicate and interpret pathology results to improve clinical decision making and patient safety.
    • Ability to identify tests performed to support commissioning and costs review across the system.

    The coverage of UTL is envisaged as expanding over time to cover many more diagnostic disciplines than the limited scope of PBCL, with the FY21/22 roadmap focused on Cellular Pathology, Cytology, Paediatric & Perinatal, and Neuropathology, among other specialisms.

    Richard Sutcliffe, Product Owner, said: ”I wish to thank the team for all their hard work on this project. We have engaged with software suppliers alongside NHS organisations during the development of UTL, following an agile approach prioritised against user needs and priorities. Each of the code ‘patterns’ used in UTL was designed in consultation with Subject Matter Experts (SME’s) with expertise in clinical practice and laboratory science.”

    Alex Elias, Associate Director Information Representation Services, added: “Thank you to the Pathology and Diagnostics team who have accomplished this fantastic achievement over the last few months. The team have worked hard on this project which will have huge benefits – by standardising data we can improve clinical decision making and improve the patient experience. Well done to everyone involved.”

    Current versions of UTL are available on TRUD in machine-readable RF2 form, or in a human-readable form for review via the NHS Digital Pathology and Diagnostics Information Standards Collaboration Space.

    The team can be contacted via email (pathologyanddiagnostics@nhs.net), we also encourage interested parties to join our online collaboration space  and take part in the regular Pathology Informatics National Interest Group (PINUG) meetings.

    By Chris Hood 5 months ago

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  • Pathology and Diagnostics education and training plan

    The education and training plan for the coming year has been developed with input from members of the Pathology Informatics National User Group (PINUG), the Pathology Programme Board and the Royal College of Pathology. After consultation with the PINUG about their priorities, they put FHIR messaging at the top of their list, following closely by SNOMED CT, with their preferred way of learning being e-learning. The Programme Board and Royal College of Pathology have prioritised high level materials explaining things in a simplistic way that all can understand and has given us access to upload materials onto the eCPD app that already has over 40k pieces of learning relating to Pathology.

    The priorities for the coming months are:

    • Visual display of a test journey through to result
    • What happens to a pathology result from a pathology point of view and from a GP point of view
    • Why does standardisation and interoperability matter to a pathologist
    • High level overview of FHIR

    All of the above will be developed in selected formats to cater for different learning styles.

    By Chris Hood 5 months ago

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  • Pathology Product Roadmap and meeting schedule published

    Dear all,

    In line with our recently updated Pathology and Diagnostics Product Roadmap we have published a meeting and events schedule which shows all of our forthcoming planned release dates for the Unified Test List for the next fiscal year. The calendar also shows upcoming dates for the Pathology Informatics National User Group (PINUG), Pathology Standards Governance Board (PSGB) and the Pathology Programme Board (PPB)

    If you would like to be added to the PINUG distribution list to receive invitations for the meetings, please email Pathologyanddiagnostics@nhs.net

    The information below provides an overview of the function of the PINUG (open group) and our advisory and decision-making boards:

     

    Pathology Informatics National User group (PINUG)

    The Pathology Informatics National User Group will have a membership drawn from organisations and regions covering NHS and Arm’s Length Bodies, laboratories, healthcare system suppliers and other relevant stakeholders.

    The fundamental purpose of the PINUG will therefore be to ensure:

    • Pathology product backlog is prioritised and assessed from a user impact and business value perspective to support NHS Digital Pathology Product Owner decision making.
    • Feedback on the Unified Test List (UTL), Units of Measure (UoM), Information Model and Pathology FHIR profiles are provided and relevant business activity across the reporting period is discussed.
    • Identify suitable candidates to support user research or user story elaboration from a user perspective.

    Pathology Standards Governance Board (PSGB)

    The purpose of the Pathology Standards Governance Board (PSGB) is to ensure a high quality UTL containing SNOMED CT concepts and processes for maintaining them to ensure they are clinically safe, accepted and effective for the user community.

    The objectives are:

    • Execute oversight of the pathology standard (UTL) for reporting pathology test requests and results.
    • Approve the UTL releases, including new test requests and results and retiring inactivated codes.
    • Provide recommendations to IReS on UTL related products and service developments including:

    -         Test request and result names and codes

    -         Units of Measures

    -         Central repositories/APIs of UTL

    -         Review tracking tools associated with clinical assurance of the UTL and associated products.

    • Recommend priorities for UTL development.
    • Oversee the clinical and technical assurance of the UTL releases and the associated UoM.
    • Oversee the clinical and technical assurance processes used to maintain the quality of UTL.
    • Approve and oversee the maintenance of the Editorial Principles for the UTL
    • Facilitate the expansion of the UTL, as required for the pathology disciplines, in consultation with stakeholders.
    • Promote uptake and use within the user community.
    • Provide leadership in acceptance and integration of the UTL deployment in the NHS aligned with the mandatory requirements identified by NHS England and NHS Improvement’s National Pathology Optimisation and Delivery board

    Pathology Programme Board (PPB)

    The role of the Pathology Programme Board is to own the high-level roadmap to enable the sharing of Pathology test results within the NHS and ensure the programme is operating to a central vision and common objectives.

    The Pathology Programme Board is responsible for:

    • Providing overall direction for the CCIO7 Pathology Programme, ensuring clear objectives and defined deliverables are set.
    • Committing resources to ensure the successful completion of the programme.
    • Prioritising deliverables and resources
    • Resolving strategic and directional cross-organisational/stakeholder issues or dependencies.
    • Ensuring effective engagement and communications with external stakeholders across the NHS.
    • Informing the Senior Responsible Owners, Decision Making

    Kind regards

    National Pathology and Diagnostics

    NHS Digital

    By Chris Hood 5 months ago

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  • UTL v0.7.0 released

    UTL v0.7.0 

    In line with the NHS Digital Pathology and Diagnostics Product Roadmap we are pleased to announce that V0.7.0 of the Unified Test List has now been published both in human-readable form on our collaboration space and as machine-readable (RF2) format on TRUD .

    This release includes the following domains:

    • Chemical pathology
    • Endocrinology
    • Toxicology
    • Andrology
    • Haematology
    • Immunology
    • Microbiology

    The Human readable release now has 3677 concepts in total and the Machine readable release has 3162.

    The release is provided in two parts:

    1. Outstanding PBCL (Pathology Bounded Code List) codes
    2. Concepts representing the “qualitative interpretation of presence” (Human readable release only)

    The following are not included in this release:

    • Small batches of PBCL content identified by laboratory / clinical experts as obsolete, erroneous, or requiring further review.
    • PBCL content already existing in the SNOMED CT UK clinical extension that are acceptable representations in line with UTL.
    • New requestable codes will be included in a future update release.

    The concepts representing the “qualitative interpretation of presence” was flagged as an area that may be ambiguous in use, as the value attached could potentially be overlooked, for example:

    Presence of HIV 1 RNA by NAAT = negative (value)

    To establish a consensus from users and stakeholders we have published this terminology pattern alongside the main content but separate from the core terminology recorded in the machine-readable form, to solicit further beta feedback on the preferred pattern for these concepts.

    The columns for the attributes including substance, property and specimen are included purely for information. They will ultimately be used to formally classify the SNOMED content using the observable entity concept model, where the attributes and corresponding values will be used to create the SNOMED CT machine readable description logic definitions

    Please use the links below to access the updated supporting documentation:

     Please provide feedback via: 

    As a Pathology and Diagnostics stakeholder, you will have received an invitation for a kick-off meeting and workshop, on 25th March and 8th April respectively, where the team will provide an overview of the release and aim to address any feedback received.

    By Chris Hood 5 months ago

    Read this article

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