INFORMATION TECHNOLOGY
national consistency in laboratory test reporting using a common language. In his presentation, Hughes said Clinisys is developing new middleware to support the Pathology Messaging Service. Although, he added, the Clinisys Hub will eventually be able to ingest, transform, integrate, and re-export data for many kinds of integration and research projects.
The Belfry offered a comfortable and modern venue for the event.
Internet Explorer browser, which Microsoft ended most support for in June 2022. The good news is that the native UI will work on modern, internet technology, run on different web browsers, and gives users a more consistent look and feel. “We are pleased to say that around 20% of customers are in testing mode,” Hughes said. “To everybody else I would say: get it into testing, play with it, break it, let us know what works for you and what doesn’t.”
Preparing for the Pathology Messaging Service It’s not just technology that changes over time. In the early days of healthcare computing, the NHS in England adopted the Read Codes to provide a standard vocabulary for recording patient information and procedures in IT systems. Later, it moved to an international coding system, SNOMED CT. GP providers made the switch, however, the data flow from laboratory information management systems (LIMS) to general practice continues to be sent as PMIP EDIFACT, governed by the NHS 003 Pathology Messaging Standard. ‘Middleware’ like Clinisys Labcomm has for 20 years provided a reliable mechanism for supporting the data flow. Karim Nashar, a terminology specialist
at NHS England, said unfortunately the reliance on PMIP EDIFACT and Read Codes is fundamentally limited. Read Codes were developed in the 1980s, they don’t cover any new patient laboratory tests since NHS England stopped maintaining them in 2016 to support medical developments. We could issue an emergency SNOMED CT release with new codes in a matter of days. “During COVID, we couldn’t send COVID test results to GPs, and we had to find a work around,” he explained. “Building on our experiences we are actively working on measures to ensure this doesn’t happen in the future.”
The first step will be to update the messaging standard that systems like ICE use (from a UN trade standard called EDIFACT to the global, health specific, Fast Healthcare Interoperability Resources or FHIR) which can handle SNOMED CT coding.
And the second will be to encourage
LIMS providers to adopt SNOMED CT. Karim argued that just the first step will benefit laboratories because they will be able to access and analyse much more SNOMED CT coded data; then the second step would entail laboratories accessing more accurate SNOMED CT representations of patient testing, encouraging better data quality, and
Many flavours of ICE This kind of ‘under the bonnet’ development is far from the only response that Clinisys and its ICE team are making to the changing healthcare environment. Solomon said one trend is Regional ICE, or the deployment of one instance of ICE across a pathology network that will almost certainly be running or deploying a single LIMS, such as Clinisys WinPath. “The benefits are that it is easier for clinicians to access results from across the network, and for the network to run a single testing catalogue,” he said. ICE is already being deployed at four pathology networks on this basis.
A well-established option for sharing
results is to use ICE OpenNet to enable the users of one instance of ICE to see results from another instance of ICE. Solomon said this is being updated in line with the wider rewrite of the system and will adopt the new UI. Then, there is ICE Gateway, which
responds to the needs of community and mental health providers that work across network boundaries by enabling them to see a consolidated view of results from numerous ICEs.
Better for patients, better for clinicians
Dr Rizwan Malik, a radiologist and imaging IT leader, told the final session on day one that however it is done, sharing results is essential. Reflecting on a project to create a
regional hub to share imaging outputs, he said this led to a reduction in repeat testing, which is more efficient and better for patients because “it reduces the number of times people have to come in to be scanned – or stabbed”. He also argued it helps to create smoother workflows and better load balancing, by allowing tests to be sent to sites and clinicians with the expertise and capacity to conduct them, and it is better for clinicians, because it supports flexible working.
The Clinisys Hub will eventually be able to ingest, transform, integrate, and re-export data for many kinds of integration and research projects
42 “I am more than happy to do a few
hours’ reporting in the evening, if I can do it from home, and I don’t have to drive into a breeze-block office to do it,” he said. And he’s not alone. Malik’s region has been able to do more work in house
FEBRUARY 2025
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