Standardising pathology test results

Overview

More than 1 billion test results are reported across the NHS each year, making pathology reporting a crucial part of the health and care system.  The standards used for primary care test results at the moment are based on a retired coding standard, and a transport standard which does not support the NHS approved terminology standard.  Across the rest of the NHS there is no single set of standards used for pathology results. Different laboratories use different test lists and different units to measure and report results. For clinicians this can mean they need to interpret results for the same type of test differently depending on which laboratory has carried out the testing and reported the results. This can lead to misinterpretation and errors.

NHSX/Digital have a programme to implement new standards for pathology test requests and results across the NHS.  PRSB was commissioned to support this programme by developing demonstrators to show the feasibility of implementing the new standards. We were then asked to engage with stakeholders to gather their feedback on the feasibility of implementing those standards.   

The work was conducted in two phases. Phase one developed demonstrators to show how the three standards could work.  Phase two engaged with stakeholders, using the demonstrators or the outputs from them to gather feedback on the feasibility of implementing the new standards.   

The PRSB report is now published. The work is based on the clinical terminology, SNOMED CT, to define test requests and results, and machine readable standards for units of measure. These will all be shared between systems digitally using FHIR (fast healthcare interoperability resources) messaging, the technical standards for sharing information between systems.  

More details on the individual standards being developed by NHS digital are available at https://hscic.kahootz.com/connect.ti/PathologyandDiagnostics/grouphome

 

Download the report Publication date: March 2021

“If someone’s been working for a period of time, in a form of therapy, for instance, where there’s an agreed plan for the locality when they may present in an emergency situation … then it’s really important for us to be able to see that that information and be able to act appropriately according to that because, you know, there isn’t and there shouldn’t be a stock response to that. These plans are designed to be individualised and personalised.  All services should be giving that personalised approach to care wherever possible. And a standard such as [PCSP standard] definitely moves us closer towards being able to do that. [Not acting on agreed plans] is a key finding in terms of emergency responses over the years where responses have been inappropriate.” – Mental Health Nurse

“Following a particular plan that’s been put into place will result in much better outcomes and prevent the sort of poor outcome which would otherwise be leading to an unplanned hospital admission.” – General Practitioner