PITUS-18-20 Project

The Pathology Information, Terminology and Units Standardisation (PITUS 18-20) Project continued the standardisation of pathology requesting and reporting. The Project was fully funded by the Department of Health.

Project activities were completed by the PITUS-18-20 Steering Committee and five working groups:.

  1. Evaluation and Promotion to educate and promote SPIA adoption and compliance with respect to pathology reporting
  2. Terminology Development to maintain and expand existing SPIA pathology terminology reference sets
  3. Systems Design and Compliance to specify systems for maintenance and publication of SPIA artefacts by NCTS and develop SPIA FHIR extensions to record terminology-related knowledge
  4. SPRC Infostructure and Conformance to develop a FHIR model and terminology for five cancer protocols and complete an RCPAQAP Informatics External Quality Assurance (IEQA) trial for the RCPA SPRC Colorectal cancer protocol
  5. Report Standardisation to develop best practice guidelines for results flagging and for the grouping of tests in pathology reports.

February 2022: The RCPA SPIA Terminology Reference Sets and Information Models have been updated on the NCTS website for authorised users. Terms of Use, Release Notes and updated Terminology Reference Sets are now available. FHIR Terminology Resources (Code Systems, Value Sets and Concept Maps) are also available for download using JSON, XML or TSV.

Standardised Pathology Informatics in Australia (SPIA)
A new edition of the SPIA Guidelines is now available for SPIA implementers i.e. pathologists, scientists, health informaticians and software vendors. The guidelines contained in SPIA Version 4.0 have been condensed and also include reference to some of the PITUS 18-20 Project outcomes with URL links to: RCPA SPIA Exemplar Reports, SPIA Rendered Report Compliance Checklists, Best Practice Guidelines and the NCTS Tool Development Requirements.

To download SPIA V4.0, click here or visit the Downloads page.

Australian Pathology Messaging - Localisation of HL7 Version 2.4

The PITUS 15-16 Project collaborated with HL7 Australia to developed the Australian Pathology Messaging - Localisation of HL7 v2.4, Release 1 was a localisation of the HL7 International messaging standards, which will provide the required information for implementers of electronic pathology messaging in one document.

The Australian Digital Health Agency has published a draft release of the Diagnostic Report FHIR Implementation Guide 1.0.0 now available for stakeholder engagement and review.

The NCTS Tool Development Requirements have been developed to assist laboratory software vendors, implementers and FHIR subject matter experts to author, maintain and validate the RCPA SPIA information models and terminology reference sets in one central location without error. They are intended to improve the efficiency, quality and integrity of RCPA SPIA terminology and related artefacts and to support laboratory accreditation processes.

PITUS wg2 contacted Microbiology, Serology, Virology and Molecular Biology experts representing every Australian public and private laboratory to ascertain the scope of sample types, methodologies and reporting units being used for COVID-19 testing after fielding various queries regarding the most appropriate requesting and reporting terminology for SARS-CoV-2.  Subsequently, mappings to all existing SNOMED-CT (requesting ) and LOINC (reporting) terminologies was undertaken, with a gap analysis demonstrating the need for further requesting and reporting terms to be developed for Australian laboratories.

To date a number of RCPA endorsed subsets of SNOMED-CT and LOINC terms have been developed, initially specimen specific, but now more generic.  To improve the quality of national data collection, adoption of the RCPA endorsed SARS-CoV-2 terms by all Australian public and private laboratory providers is highly recommended.  The standardisation of requesting terms improves the ability for clinicians to identify the correct orderable from multiple provider order catalogues as consultations occur across different organisations and clinical settings.   The standardisation and encoding of COVID-19 data not only improves overall data quality, but also allows for greater insights to be derived at a national level for the retrospective analysis of the pandemic, such as geographic distribution of results, hospital acquired infections, quality, or cost of various testing methods, etc.

The SPIA Compliance Checklists are a summary of the relevant SPIA Guidelines, NPAAC and NATA design elements which, when followed, will ensure the development of RCPA SPIA compliant pathology reports

The SPIA Exemplar Reports have been designed to provide laboratory staff and software vendors with visual representations of SPIA compliant reports for a range of disciplines with respect to report formatting.  The inclusion or exclusion of tests, Preferred terms, Reference Intervals and the order in which the tests appear on each report are not necessarily meant to be indicative of true report content, merely to demonstrate formatting.

HL7 V2, FHIR and CDA representations of each Exemplar Report are now available to assist software vendors with the design of SPIA compliant messages.

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