Context and References

Introduction

In 1998, a consensus-based Australian Standard for the electronic reporting and requesting of pathology (AS4700) was first published localising HL7 version 2 messaging for Australian use. The second edition in 2012 includes recommendations around use of terminology. This standard has passed through several versions with the most recent update published in 2021 as the Australian Diagnostics and Referral Messaging - Localisation of HL7 Version 2.4. In 2011 the Royal College of Pathologists of Australasia (RCPA) commenced a program to define pathology terminology for use in messaging and this work continues as the RCPA Standardised Pathology Informatics in Australia (SPIA).

The Health Insurance (Accredited Pathology Laboratories—Approval) Principles 2017, administered by the Department of Health, Disability and Ageing, authorised by the Health Insurance Act 1973, Schedule 1—Accreditation materials, includes as Item 4 in the table of NPAAC materials the " Requirements for Information Communication and Reporting (Fifth Edition 2022)", herein and elsewhere in RCPAQAP tools and services identified as NPAAC RICR5.

The NPAAC RICR5 requirements oblige pathology laboratories to conform to the expectations of the standards referenced therein, which include the use of HL7 v2 messages, their structure and content, as well as the use of the RCPA SPIA-defined clinical codes, terms, units of measure and reference intervals, when applicable, for use in ordering and reporting of pathology tests in Australia, specifically these requirements explicitly defined in the NPAAC RICR5 as well as the Australian Diagnostics and Referral Messaging - Localisation of HL7 Version 2.4 (ADRM-2021.1) Standard and the Royal College of Pathologists of Australasia Standardised Pathology Informatics in Australia (SPIA), Guidelines.

The Australian Diagnostics and Referral Messaging - Localisation of HL7 Version 2.4 (ADRM-2021.1) Standard articulates the expectations for HL7 v2 messages used for ordering and reporting pathology in Australia. The NPAAC RICR5 document explicitly requires that the HL7 v2 messages used in Australia conform to the expectations of the ADRM 2021.1

The Royal College of Pathologists of Australasia Standardised Pathology Informatics in Australia (SPIA), Guidelines, v4.1, articulate RCPA's expectations with respect to ordering and reporting pathology in Australia. The NPAAC RICR5 document explicitly requires that the HL7 v2 messages used in Australia use terms, codes, units of measure and reference intervals, when applicable, defined in the RCPA SPIA Terminology Reference Sets.

As part of development work on the RCPA Standardisation of Pathology Informatics in Australia (RCPA SPIA), the RCPA SPIA team developed the mapping table that maps the ADHA Top 50 Priority tests for ordering pathology tests to the individual tests or test panels that are expected to be reported on for the corresponding ordered tests. This data set is not yet published for public access.

The Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) supports Australian Pathology and allied industries in their endeavours to improve quality of care through the use of standards-conformant HL7 v2 Pathology Orders and Results messages for the communication of pathology testing requests and pathology test results between laboratories and points of care.

The RCPAQAP developed, and provides for public access, a collection of tools and services that are intended to assist Pathology Laboratories in Australia in progressing towards meeting their accreditation requirements.

It is expected that these tools and services will also assist other members of the Pathology Industry in Australia in progressing towards adopting standards-conformant messaging for electronic communications of Pathology orders and results.

The tools implement standards, guidelines and rules articulated in the NPAAC RICR5, the ADRM 2021.1 and the RCPA SPIA Guidelines, see references below.

The tools and services use RCPA SPIA Terminologies and other Reference Sets to validate the use of codes, terms, unis of measure, references ranges and other aspects of HL7 v2 messages used in ordering and reporting Pathology in Australia.

The terminology sets data is available from the National Clinical Terminology Service (NCTS), see references below.

These resources have been used by RCPAQAP to develop applications and services with the explicit intention of supporting the pathology industry in Australia in its efforts to standardise electronic communication of pathology orders and results in Australia.

The RCPA SPIA Reference Sets used by RCPAQAP applications and services are derived from the resources listed in the references below.