At 6:38 am +1100 22/12/06, Tim Churches wrote:
See
http://www.nehta.gov.au/component/option,com_docman/task,cat_view/gid,122/Itemid,139/
Worth scrutinising and commenting upon, in writing, to NEHTA (but
perhaps comments can be CCed to this list to promote discussion firts?).
But don't only send comments to this list, send them to NEHTA as well as
formal responses, for goodness sake.
and
http://www.nehta.gov.au/component/option,com_docman/task,cat_view/gid,151/Itemid,139/
For path test and result codes, it seems like SNOMED CT is where it is
going to be at, and the Auspath codes (see ), which are based on LOINC
codes, are deprecated, which makes sense to me since LOINC, although
freely available, doesn't adequately cover all of health and health
care, and ultimately it doesn't make sense to have to build decision
support and other information systems which have to deal with one
terminology and corresponding set of codes for pathology, another for
procedures, another for more general diagnoses, yet another for
disabilities and so on.
Usual grumbles about the use of Microsoft Excel files as the format used
to distribute the draft code sets, when three more clicks by the
relevant NEHTA functionary could have rendered the lists as CSV text
files, acceptable to everyone.
Tim C
The Auspath codes are here:
http://www.austpath.uow.edu.au/index.cgi
lack of revision could mean one of two things:
1. lack of use - which probably applies to request codes
2. good fitness for purpose - which probably applies to report codes
sent routinely in HL7 messages daily.
The NEHTA effort reads like 1 steps forward, 3 steps back.
Auspath request codes have:
* preferred terms
* synonyms
* infinite extensibility based on usage - if you want a new code or
synonym you can have it and someone will figure out a preferred term
and linkage
If there is any problem in requesting, it is the lack of interest in
electronic requests driven partly by poor penetration of PKI signing
and poor acceptance by pathologists who are worried about medicolegal
risk of having unfulfilled requests.
Auspath report codes are based on a simplified set of LOINC codes,
because proper LOINC codes go down to method of analysis, which makes
them too unique for cross-comparison. LOINC codes are part of SNOMED
last I looked. (Has it changed???)
The general method for codifying reports is described in AS4700.2 and
HB262 which is presently under revision I think. Not all reports are
encoded as LOINC, as it depends on the nature of the report.
Certainly individual biochemical analytes are LOINC coded. Pap smears
are SNOMED coded as one would expect. The general principle is the
test/analyte name would have a LOINC code and the result value would
be numeric or SNOMED coded. It should be a piece of cake to translate
unique LOINC test codes to unique SNOMED Procedure codes, but the
complexity of pathology reporting is not well described in the
available NEHTA documents. It is well understood by the pathology
informaticians who actively contribute to standards development in
Australia and NZ.
Perhaps someone can understand the rationale for flying a new flag
when everyone is happy standing behind the old one.
Ian.
--
Dr Ian R Cheong, BMedSc, FRACGP, GradDipCompSc, MBA(Exec)
Health Informatics Consultant, Brisbane, Australia
Internet: [EMAIL PROTECTED]
(for urgent matters, please send a copy to my practice email as well:
[EMAIL PROTECTED])
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