I’m now starting to work on a proof of concept to implement the transmission of Pathology Messages to GPs via MESH, however I’m struggling to find the specification for this kind of messages.
I also found some references to “ISB1557 EDIFACT Pathology Messaging” that apparently is been replaced to HL7 FHIR messages but one more time all the links for technical specifications were not found or didn’t work.
I’ve found a couple of Pathology messaging specifications (using HL7 messages) used in other countries such as US and Australia but nothing about UK.
Can anyone point me some documentation\resources where I can get some information about this subject?
I don’t believe the UK issued any central guidance on the use of HL7v2 for pathology but HL7v2 is used quite extensively to send reports to GP’s via MESH (formerly known as DTS).
One of the goals of the POC we are working on is to send this kind of messages to INPS Vision to be handled by their Mail Manager module.
@benmcalister, @mayfield.g.kev Do you have any experience with this kind of use case? Or do you know any good source of information about this subject (I’ve dropped an email to Vision but I don’t know if I’ll have any answer from them)?
In our situation there is no ICE OrderComms involved. The ideia here is to have a 3rd party application sending a simple message with clinical codes (Health Check data) to update a patient into the GP clinical system.
This integration with the GP systems is a little bit tricky because they don’t provide a really open API that we can use, so we are using pathology messages with Mail Manager for Vision and for Emis Web we are looking to send the messages via their Keystone messaging interface.
Regarding your poc I am assuming that you are using a REST API because the device already exposes that API , am I right?
No, we’re looking at how the problem can be sorted by an API. So mobile devices and possibly other systems who didn’t receive the lab report via normal methods.
@riksmithies have asked around and the ex-TPP/EMIS experts here all agree it was a mix of formats.
@mayfield.g.kev I just spoke about the Keystone messaging interface because from my initial research it seems to be the easiest way to interact with EMIS, but maybe I am wrong (my knowledge on these subjects is minimal - GP system and NHS interoperability system in general).
From your comment I can assume that it will be possible to use DTS\MESH to delivery the messages to EMIS. If so, can you give me some more information about it?
Can I also have your comment about what I am tying to achieve with my poco and if my assumptions are the best way to implement it.
So, lets assume the following simple scenario:
Use Case: Send a message with clinical data (a few clinical codes and their values) to the GP system in order to allow the GP user to add “automatically” the information to the patient record.
Message: Because I know that the digital reporting of pathology test results are very common and that kind of messages can be used to communicate the data I need to send (health checks data). My ideia is to use this kind of messages, technically I am looking to the following messages:
GP Systems: Process the messages in the following GP systems:
Vision :: via Mail Manager module (according to their documentation: "Health Check data received via the pathology message route can now be filed into the patient record in the usual way using the Read codes received" )
EMIS Web :: via Keystone (this needs more investigation )
SystmOne TPP :: TBD (but maybe using the same approach used to process the pathology messages)
I’ve been struggling to find documentation regarding how the GP systems are consuming pathology messages or other DTS\MESH messages in general.
Can I have your opinion\comments regarding the assumptions\decisions above?
The ADT^A31 is normally used to alter Patient demographics, nothing else. The ORU^R01 also carries patient demographic information, which should be enough for a GP system to match the patient. So I don’t believe you would need an A31.
I think you would need to speak to GP suppliers to get more details.
ASTM is what lab analysers tend to speak natively - very low level. It pre-dates even HL7 V2, and I think some of V2 was actually based on it. That doesn’t sound like a good format to target these days. I thought only Lab systems tend to use that, converting it to V2 to talk to PAS etc.
The other format mentioned there, MEDRPT, is the name of the format used by GP PMIP messages (aka ISB1557 EDIFACT Pathology Messaging).
Basically to get lab in to GPs you would probably want to use PMIP messages at the moment (they have all supported that for 20 years), until FHIR gets adopted one day, but there are no formal plans for that that I am aware of.
)