In reply to the does Bill Bartlett's group still exist the answer is yes
and no. The original group as established by Ian Barne's who was then on
NCAB included Rick, James Paton and others does not meet as such. We
were particularly looking at the message content for requesting and
reporting and asked to produce a specification against a very tight time
frame.   Through various machinations there now exists a  Pathology
Messaging Requesting and Reporting group that is chaired by Simon Withey
under the Connecting for Health Banner. The output of the previous group
formed the starting point for this new group. It is composed of
Connecting for Health bods, commercial reps, James Paton and I attend
regularly with Ian Barnes and Rick Jones being kept in touch by e-mail,
Mike Catchpole of the HPA is protecting there interests.. The primary
role of this group relates to message content, but also is feeding into
the bigger picture by highlighting issues around Lab med that impact on
the Care Record and vice versa. Issues such as rendering of reports,
carrying of images,  minimum data sets, which data sets should and
should not be reported, general business processes around requesting and
reporting are all frequent topics for discussion. 

James Paton and Stephen Pill (GP) have been appointed  as National
Clinical Advisors on Pathology reporting and requesting.  

It appears that much of the functionality of that people might be expect
as part of the National System will really be existing at the local
level. There are many issues surrounding what will or will not be
available in the NHCRS centrally and also about the content of the
secondary uses services and functionality. I am told the EPR will exist
at a local level. What level of content/functionality that will be
restricted to the so called local level and whether the local level
means Cluster or Trust or  confuses  leaves me scratching my head a bit.


We certainly need to have as many forward thinking people as possible
active at the cluster level to ensure that we don not have systems
thrown at us that will define the way we work in such a way that it
restricts our opportunities to move forward. If I was particularly
cynical I would suggest that there is more profit for the LSPs if they
can force us to adopt old revamped technology than in investment in the
type of systems we would like to see in place. I hear a lot more about
what is happening in the Southern cluster than I do about the North
West. It is interesting to note that while the LSP contracts do not
include Pathology as core, requesting and reporting are. That is to say
that the LSPs have a contract that to provide systems that control our
inputs and what we can output. Rendering reports is an  just one
horrifyingly important issue that we need to consider and stand up and
shout about. I think that we all agree as lab specialist we do not
produce numbers, we produce reports. Thos reports are formatted often in
a way that we believe imparts information and knowledge  in a format
that we wish to our users to view it. While the informed users and
specialist user may be able to apply their own knowledge base to the
report not all will have this ability and hence the reason for
Laboratory Consultant, algorithms, expert systems etc that put together
the reports.  Deconstructing reports into a series of codes and numbers
that can be reconstructed by receiving systems may seem attractive to
some users, software providers and network managers, however if the
reconstruct does not reflect the format of the  original report
(admittedly in some cases it might be better) you can change the sense
of the original reports. If you cannot carry images (e.g. graphs) but
only the constitutive data which can be used to construct them  you can
again change the original sense of the report. For instance by changing
the magnitude of an axis on a tumour marker graph you can visually
change the impact of a change in consecutive results.  I am banging the
drum for an image of reports to be carried  alongside coded data to
enable best of both worlds. Of course this has ramification in terms of
message size and thus bandwidth. 

There are a whole raft of issues around requesting and reporting
functionality that are being addressed by various individuals at local
levels that will have a major impact on service delivery. Your Trust may
be purchasing systems from an LSP with ordering functionality that you
have had no role in specifying.  

 On another point if things become national (e.g. catalogues handbooks)
we need to ensure an infrastructure is in place that is not so ponderous
and complex that it stifles innovation and change. It can take may
months currently to get a new code in the bounded code list. Systematic
problems such as this require resource to manage the bottlenecks.

Regards

Bill Bartlett

PS this started as a two liner. Sorry seems to have turned into a rant.




-----Original Message-----
From: IT working group of the Association of Clinical Biochemists
[mailto:[log in to unmask]] On Behalf Of Muir Gray
Sent: 20 August 2005 08:09
To: [log in to unmask]
Subject: Re: Catalogue of Investigations in Laboratory Medicine

Where do westand with the nat lab handbook


On 16/8/05 09:44, "Jonathan Kay" <[log in to unmask]> wrote:

> This is very important. Let's just check which forum we want to use to

> discuss it...
> 
> College rep is James Paton.
> 
> It's multidisciplinary.
> 
> Does Bill Bartlett's group still exist?
> 
> Lead at CfH is Ian Arrowsmith
> 
> I'd prefer it to be national, but it's currently Southern Cluster.
> 
> There is an identified "Wave 1 of early adopters". We are one at the 
> Nuffield Orthopaedic Centre.
> 
> Jonathan
> 
> 
> On 16 Aug 2005, at 09:32, O'Connor John (Royal Devon and Exeter 
> Foundation Trust) wrote:
> 
>> Morning Chaps
>> 
>> I thought that the following offering from the Fujitsu Alliance on 
>> the naming of things might provoke a discussion thread on the SIG. 
>> But before I release it to the wider world, I thought it prudent to 
>> air it on mailbase first. It may become a national template so it is 
>> of relevance to all.
>> 
>> Cheers
>> John
>> 
>> 
>> 
>> 
>>> 
>>> 
>>> 
>>> Subject: Viewing of Southern Cluster Pathology Catalogue
>>> 
>>> 
>>> 
>>> Dear Pathology clinicians,
>>> 
>>> 
>>> 
>>> Based on the last 2 weeks of discussions and recommendation from the

>>> Southern Cluster Clinical Advisory Group and representative members 
>>> from the cluster Pathology steering group, we have taken 2 key 
>>> actions to ensure that NHS/FJA/Cerner will move together 
>>> successfully through our deployment programme for R0 - we have:
>>> 
>>> 
>>> 
>>> (1)     Revised the content configuration and layout of the
catalogue
>>> (with inclusion of some of the earlier comments from last week)
>>> 
>>> (2)     Provided a viewing opportunity of this catalogue for R0
>>> deployment
>>> trusts (Path Labs)
>>> 
>>> 
>>> 
>>> Background:
>>> 
>>> 
>>> 
>>> * The signed agreement between the NHS and FJA was that for R0, the 
>>> Southern Cluster will use an existing Cerner Millennium build and 
>>> configuration that is the Homerton and Newham hospitals. Their 
>>> current catalogue contained around 600+ investigations. After 
>>> analysis of this catalogue against our previous CSP catalogue, PBCL 
>>> catalogue, and the below mentioned national catalogue, we had 
>>> recognised that the existing catalogue is clearly not sufficient to 
>>> maintain current business processes for many of the trusts. We have 
>>> taken input from a number of these resources to build a catalogue 
>>> which we aim will meet most of the NHS business needs (see content 
>>> below).
>>> * The NHS CfH is also concurrently trying to complete an NHS version

>>> of the Path catalogue for the purposes of standardising the content 
>>> across the country - this is nearing completion. While not formally 
>>> released, FJA had been given a provisional viewing of this to 
>>> facilitate our rapid deployment programme. The NHS authority 
>>> themselves concurs with our experience that no catalogue will ever 
>>> be complete, without ongoing maintenance. Cerner will be adopting 
>>> the full NHS catalogue as we move to the next phase (or as and when 
>>> the NHS catalogue is finally completed and released). Future 
>>> maintenance will be based against the NHS standards. No formal date 
>>> is set for this NHS release, but is anticipated for later this year.

>>> This national catalogue is based on a SNOMED CT naming convention, 
>>> which is the NHS mandated standard.
>>> 
>>> 
>>> 
>>> 
>>> 
>>> OBJECTIVE:
>>> 
>>> 
>>> 
>>> *       To provide a viewing opportunity by the R0 deployment sites
>>> 
>>> *       To try and clarify any queries
>>> 
>>> 
>>> 
>>> Special note:
>>> 
>>> 
>>> 
>>> * Any new content recommendation, we will be submitting this to the 
>>> NHS authority to be considered for inclusion in their National 
>>> Pathology catalogue - please note that we have drawn our content 
>>> from the proposed NHS Path catalogues. So if an item is not in our 
>>> catalogue, it is not likely to be in the National Catalogue. The NHS

>>> will need to know this as they need to ensure that all Clusters' 
>>> needs are met through their final catalogue releases.
>>> * Our maintenance of content will be against NHS catalogue content 
>>> releases
>>> 
>>> 
>>> 
>>> General explanations about the catalogue:
>>> 
>>> 
>>> 
>>> 
>>> 
>>> The content of the attached catalogue are drawn from:
>>> 
>>> 
>>> 
>>> *         The proposed NHS national catalogue for pathology
>>> investigations
>>> (this is the enhanced version of the current PBCL catalogue, later 
>>> to be formally released by the NHS. It extends the range of 
>>> procedures to secondary care settings)
>>> 
>>> *         Best practice data collection from the Common Solution
>>> Project
>>> from hospital trusts and its sub-departments
>>> 
>>> *         Cerner's internal catalogue from their content drawn from
>>> various existing deployment sites in UK
>>> 
>>> *         Newham and Homerton input
>>> 
>>> *         Provisional input from the SCCAG and Path Steering group
>>> 
>>> 
>>> 
>>> The naming convention of the catalogue:
>>> 
>>> 
>>> 
>>> *         The naming convention is based on SNOMED CT (fully
specified
>>> names) - the reason is to eliminate any ambiguities during the 
>>> review process
>>> 
>>> *         When viewing, please think of proper/generic chemical
names
>>> of
>>> the test to ease locating the test within the catalogue (eg. 
>>> "Dilantin level" is not in the catalogue, but "Phenytoin level" is)
>>> 
>>> *         The SNOMED naming convention will be adopted by all the
LSPs
>>> across the other clusters to minimise training needs of clinicians 
>>> as they move across clusters, which they invariably do during their 
>>> working careers.
>>> 
>>> *         Synonyms, or clinically common descriptors will be built
>>> within
>>> the catalogue to ease searching (most of this will be based on 
>>> SNOMED recommendations, and some others are common clinically 
>>> accepted acronyms).
>>> 
>>> 
>>> *         Where a SNOMED CT concept does not exist, we will use the
>>> current naming convention in Cerner until one is determined by the 
>>> NHS.
>>> The key is that we will provide the investigation to maintain 
>>> current processes
>>> 
>>> 
>>> 
>>> Deployment:
>>> 
>>> 
>>> 
>>> * The content of this list contains the entire catalogue which will 
>>> be loaded into the Cerner database. This does not mean all tests 
>>> will need to be provided at all sites. This only allows the trusts 
>>> to pick and choose the tests to be made available or hidden away 
>>> from viewing locally because the trust labs do not provide that 
>>> service.
>>> 
>>> 
>>> 
>>> Summary:
>>> 
>>> 
>>> 
>>>             We wish to provide a successful viewing opportunity for 
>>> the NHS R0 deployment sites. We will try to capture queries 
>>> associated with this catalogue. Please note that we are working 
>>> closely with the NHS authority to ensure that their National 
>>> Catalogue will in the future contain all the necessary content. Any 
>>> content we identify which are not currently available within the 
>>> National Path catalogue we will submit to the Authority for 
>>> inclusion in their later releases. We will be releasing the Cerner 
>>> Radiology catalogue within the next day or 2 for final viewing, so 
>>> please let me have contact names of any Radiology clinicians who you

>>> know need to be included.
>>> 
>>> 
>>> 
>>> Queries to send to:
>>> 
>>> 
>>> 
>>> [log in to unmask] <mailto:[log in to unmask]>
>>> 
>>> 
>>> 
>>> NOTE: ALL QUERIES ARE TO BE SUBMITTED BY CLOSE OF PLAY NEXT THURSDAY

>>> (25th August 2005)
>>> 
>>> 
>>> 
>>> Kind regards,
>>> 
>>> 
>>> 
>>> Wyman Kwong
>>> 
>>> 
>>> 
>>> Healthcare Domain
>>> 
>>> Fujitsu Alliance
>>> 
>>> Contact No.: +44 (0) 7867821276
>>> 
>>> Web: <http://uk.fujitsu.com>
>>> 
>>> 
>>> 
>>> This email is only for use of its intended recipient. Its contents 
>>> are confidential and may be privileged. Fujitsu Services does not 
>>> guaranteethat this email has not been intercepted and amended or 
>>> that it is virus-free.
>>> 
>>> 
>>> 
>>> 
>>> 
>>> ********************************************************************
>>> **
>>> ****
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>>> * <<FINAL PATHOLOGY ORDER CATALOGUE APB1.xls>>
>> <FINAL PATHOLOGY ORDER CATALOGUE APB1.xls>


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