SPIA Standards for Pathology Informatics in Australia, previously known as Australian Pathology Units and Terminology Standardisation (Standards and Guidelines) SPRC UCUM wg PITUS 15-16 Working group Executive summary The Royal College of Pathologists of Australasia (RCPA), with the support of the Department of Health, have been leading a program to standardise pathology information, terminology and units for safety and quality. The Pathology Information, Terminology and Units Standardisation (PITUS 15-16) project involved the collective efforts of key stakeholders (Department of Health, the Agency, RACGP, PAC, AACB, HL7 Australia and RCPA Advisory Committees) to develop standards for pathology requesting and reporting, and to facilitate adoption of these by pathology providers and associated stakeholders (clinicians, registries, MyHR). This Project aligns with the Department of Health’s published national E-Health strategy, including the MyHR, and Quality Use of Pathology Program (QUPP) and focused on activities that support quality consumer services, quality pathology requesting and quality pathology practice. The Project has contributed to a sustainable healthcare system that will improve the health outcomes for all patients through the development of pathology standards required for safe sharing and use of information between pathology providers and associated stakeholders. To this extent, the Project delivered: Best practice guidance for safe communication of pathology requests (computer generated requests communicated via paper and electronic messaging) and pathology reports (printed and electronic); An updated list of commonly requested pathology tests with 481 new pathology tests assigned a SNOMED CT-AU code to support electronic pathology requesting between pathology referrers (clinicians, physicians, etc.) and providers; Comprehensive and current pathology information models and terminology reference sets, required for atomic pathology reporting and support for the implementation of the MyHR through: Over 900 updates and amendments to the RCPA published pathology reporting information models and terminology reference sets developed under PITUS-14; New information models and terminology reference sets for colorectal cancer and prostate cancer (radical prostatectomy) structured pathology reporting of cancer protocols; New harmonised adult reference intervals for six (6) chemical pathology analytes (Bilirubin, Creatine kinase, Alanine aminotransferase, Aspartate aminotransferase, Gamma
Time constraints - stakeholders Limited availability of key technical personnel within stakeholder groups Difficulty to adhere to timelines Clear communication minimised face to face requirements, frequent monitoring of project deliverables and revised schedules where necessary to take advantage of participation by key stakeholders with the least amount of disruption to daily workloads. Time constraints – collaborators / partners (e.g. RCPA QAP, Cancer Institute NSW, HL7 Australia, Melbourne Genomics Health Alliance) Limited availability of key technical and testing personnel within collaborating / partner organisations Difficulty to adhere to timelines Clear communication minimised face to face requirements, frequent monitoring of project deliverables and revised schedules where necessary to take advantage of participation by Working groups / collaborators with the least amount of disruption to daily workloads. PITUS 15-16 Project Officer provided project support to collaborators / partners, including assistance with testing and documentation. Time constraints - discipline specific pathologist Workforce shortage, limited availability of discipline specific pathologist Difficulty to adhere to timelines Clear communication minimised face to face requirements, frequent monitoring of project deliverables and revised schedules where necessary to take advantage of participation by key pathologists with the least amount of disruption to daily workloads. Difficulty - agreeing - what to include in Standard. Difference of professional opinion. Difficulty to adhere to timelines and project may not have been completed. Key opinion leaders were included on the Project and on the PITUS 15-16 Steering Committee to ensure adequate representation and expertise. Lack of acceptance by Fellows. Difference of professional opinion. Limitation of buy-in from profession without enforced Standards Transparent communication of objectives, clear reasoning in support of the Standards, included key stakeholders throughout the development process Change of governance structure at HL7 Difference of professional opinion and approach to Fragmented approach to develop Standards PITUS 15-16 wg1 members joined the HL7 Australia’s O&O working group and collaborated on the standards