The Pathology Standards & Implementation team have designed a first of type data flow pilot. The intention is to replace the PMIP EDIFACT standard with pathology specific FHIR profiles carrying SNOMED CT and UCUM encoded data items.

To achieve this, we are working with Berkshire and Surrey Pathology Services (BSPS), one of the largest pathology networks serving the NHS in England, & CliniSys, the market leading systems provider of laboratory data management solutions in the UK.

Our intention is to prove the full reporting flow initiated from pathology labs to GP practices. Lab test reports containing result codes and result values/interpretations/UoM will be generated by the corresponding middleware system (CliniSys LABCOMM) using the FHIR UK core R4 standard. The middleware will then send the report to the relevant GP practice using MESH. GP systems will then ingest the data in an interoperable manner.

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The solution will enable a pathology report to be sent using FHIR R4 instead of PMIP EDIFACT. This will be done on a practice-by-practice basis, rolling out to other practices within BSPS’ pilot environment once it is working correctly. The reports will include either SNOMED PBCL or UTL Observable entity concepts identifying the lab test result, plus appropriate result values, interpretations, and UoM where applicable.  

This will provide a high-level understanding that informs how a national roll out will be implemented.

The high-level requirements and outputs for the pilot are:

  • To flow all pathology lab test reports in FHIR R4 messaging format (instead of PMIP EDIFACT) from LIMS to enabled GP practices.
  • To code lab test result codes in SNOMED CT, and as UTL where appropriate and where agreed. 
  • To test and assure safe delivery and ingestion of the data into patients’ EPRs, thereby establishing a paradigm for interoperability. 
  • To gather information to supportflowing lab test result values, interpretations, and UoM (e.g., numeric, Semi-Quantitative) as appropriate to the type of test. 
  • To subsequently flow different lab test result data (e.g., Urine microscopy, culture, and sensitivity) in the same manner, and test and assure delivery and ingestion of the data.
  • To use the pilot as the basis for creating documentation that can describe the process and requirement relating to the deprecation of PMIP EDIFACT.
  • To perform an analysis of BSPS’ local coding, existing terminology, and messaging specifications to support an implementation roadmap for mapping to new lab test result patterns and the DAPB4017: Pathology Test and Results Standard.