Pathology and Diagnostics News

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  • 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 1 year 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 1 year ago

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