MAY 29, 2014 06:00 AM PDT

Challenges for the Pathology Profession in the Age of the Electronic Health Record How Informatics and Standardisation Initiatives can Help

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  • Assistant Manager Biochemistry, Sullivan Nicolaides Pathology, Australia
      Robert Flatman is the Assistant Manager in Biochemistry at Sullivan Nicolaides Pathology, a large private reference laboratory in Brisbane, Australia, and part of the Sonic Healthcare group.  A longstanding interest in Laboratory Information Systems (LIS) and IT has led in recent years to participation in  eHealth and Pathology Harmonisation initiatives, including the AACB Harmonisation committee, AACB Critical Results Working Party, RCPA PUTS project (Pathology, Units and Terminology Standardisation) and its successor the RCPA PITUS project (Pathology Information, Terminology and Units Standardisation).  These groups are working on recommendations for standardisation in pathology reporting, including reference intervals, critical results, terminology for requested and reporting, units and reporting formatting harmonisation.  Robert is currently chair of the IFCC/IUPAC joint committee for Nomenclatures, Properties and Units (NPU). He also has interests in Pathology education (AACB state education representative), and attained his Fellowship in the Australasian Association of Clinical Biochemists in 2010 (FAACB).    


    Governments, pathology providers, and clients relying on pathology reports face increasing conflict between burgeoning costs versus demands for service innovation. The health industry has been generally slower than the financial industry to embrace the benefits of computerization in terms of portability and accessibility. There have however been good reasons including the requirements for privacy and security, together with the complexity of the information itself.

    Many countries have embraced programs for electronic health records (EHRs), encouraging electronic requesting and reporting of health information, including pathology. Pathology providers have long focused on excellence within their own institution by embracing the best analytical instrumentation, information technology for laboratory information systems, and the best medical expertise for interpretation and reporting. Centralised reporting to EHRs will however highlight to clinicians and tech-savvy patients unnecessary, and sometimes unsafe, variations in the requesting and reporting of pathology. Examples include variations in test profiles, test naming, reference limits and units.

    Pathology providers and clients must collaborate to create robust standards for the transmission and interpretation of health messages. There is an urgent need in most countries to standardize both requesting and reporting. Structured messaging and medical terminologies offers tools to assist.

    This presentation will focus on developments in both medical terminologies and pathology harmonisation initiatives that will require greater awareness and support from the medical community to generate maximum benefit.

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