FAQ

There is an increasing tendency towards the aggregation of pathology data in the Australian health sector, however the usefulness of this data is limited due the wide variability in test requesting and reporting practice. Variability is demonstrated in many components e.g. test names, units, reporting intervals (decimal places), reference intervals and clinical comments, etc.

Variability has the potential to create confusion and misunderstanding as pathology results are viewed by a wider range of people, including requesting doctors, patients, nurses, pharmacists, dieticians and other allied health workers. Additionally pathology data is becoming more likely to be sent to databases such as practice software, national or regional registries and personal health records. In these settings, data from several laboratories may be combined into a single record and removed from, or at least separated from, the original supporting information (name, units, reference intervals etc). Standardised pathology information structures and terminologies allow improvement in recording, decision support, communication and analysis of pathology results, safeguarding the intended meaning of the information being requested or reported.

SNOMED (Systematized Nomenclature of Medicine) is a systematically organised computer processable collection of medical terms providing codes, terms, synonyms and definitions covering diseases, findings, procedures, microorganisms, substances, etc. It is owned and maintained by the IHTSDO. SNOMED CT (Clinical Terminology) is the current form and the Australian variant SNOMED CT-AU is available from https://www.healthterminologies.gov.au/tools website.

Logical Observation Identifiers Names and Codes (LOINC) is a database of terms and standards for identifying medical laboratory observations. It was developed and is maintained by the Regenstrief Institute. For more information visit the LOINC website.

The Unified Code for Units of Measure is a code system intended to include all units of measures with the purpose of facilitating unambiguous electronic communication of quantities together with their units. The focus is on electronic communication, as opposed to communication between humans. For more information visit the Unified Code for Units of Measure website.

A set of standards from Health Level Seven (HL7) for electronic messaging to support clinical practice and the management, delivery and evaluation of health services. The most commonly used set of standards for this purpose in the world, HL7 v2.x messages use a human-readable (ASCII), non-XML encoding syntax based on segments (lines) and one-character delimiters. For more information visit the Health Level Seven (HL7) Website.

AS4700.2 is the Australian Standard for the Implementation of HL7 for messaging pathology and medical imaging (diagnostics). It was developed by, and is maintained by, Standards Australia’s IT-14-6-5 committee. The standard is available at the Standards Australia website.

ADRM is the Australian Diagnostics and Referral Messaging - Localisation of HL7 Version 2.4. PITUS 15-16 and PITUS 18-20 have collaborated with ADHA and HL7 Australia to produce this latest version of the messaging resource, Release 2021.1. This guide has been developed to assist implementers of electronic pathology, radiology and diagnostic requesting and report messaging. The Australian localisation of the international HL7 V2 Standard covering laboratory/diagnostics/clinical result reporting, laboratory/radiology ordering specification and patient referral. In Australia, the term “pathology” covers all aspects of laboratory medicine including clinical and anatomical pathology domains, while the term “radiology” is understood to include all diagnostic imaging modalities, whether X-ray based or other e.g. ultrasound. The term "diagnostics" covers non-laboratory reporting including reporting of diagnostic imaging and non-referral related clinical reporting for example: echocardiography, respiratory function, endoscopy, stress testing, sleep studies.

This updated guide supersedes HL7AUSD-STD-OO-ADRM-2018.1 Australian Diagnostics and Referral Messaging – Localisation of HL7 Version 2.4 and HL7AUSD-STD-OO-ADRM-2017.1 Australian Pathology Messaging – Localisation of HL7 Version 2.4. The guide is now available for download via HL7AUSD-STD-OO-ADRM-2021.1 Australian Diagnostics and Referral Messaging - Localisation of HL7 Version 2.4

FHIR^R is a healthcare interoperability standard used to describe data formats and elements published by Health Level 7 (HL7). FHIR^R makes implementation and ongoing maintenance of the RCPA SPIA information models and terminology reference sets much easier as it is suited to a wide variety of contexts - mobile phone apps, cloud communications, EHR-based data sharing, server communication in large institutional healthcare providers, etc. The terminology work was facilitated by the CSIRO and is now available via the NCTS. For more information visit the Health Level Seven (HL7) Website.

Does your laboratory want to implement RCPA SPIA requesting or reporting terms? If so, check the latest RCPA SPIA terminology reference sets loaded to the NCTS website for all desired Preferred terms and their relevant codes and attributes.

If you can’t find a SNOMED CT-AU (requesting) term, download the bulk request template from the NCTS website and email your submission along with supporting documentation to help@digitalhealth.gov.au.

To request a new LOINC (reporting) term, download the LOINC Lab Submission template from the LOINC website and email your submission template along with supporting documentation to submissions@loinc.org.

Interoperability is defined as the ability of a range of health information systems, devices or applications to connect in a coordinated manner, within and across organisational boundaries. This allows health practitioners to access and exchange data with unambiguous meaning. This is necessary to make healthcare safer, more efficient and more effective for individuals and the community.

Introduction to interoperability v1.2

Although all PITUS 18-20 Project activities are now complete, you may contact the RCPA Project Management Office with any PITUS or SPIA queries via the generic PITUS email account pitus@rcpa.edu.au.