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Pathology information standards review

Here we describe the information standards within the scope of this review, the measures we are taking, and the objectives we aim to achieve.

Review scope

The NHS England Pathology Standards Programme have revised the governance around pathology data flows by making changes to 3 interlinked information standards:

  1. The legacy ISB 1557 EDIFACT Pathology Messaging Standard (Amd 39/2003 EDIFACT v1.003) which governs the use of the Pathology Messaging – EDIFACT integration.
  2. The DAPB4017: Pathology Test and Results Standard introduced in 2021 with the intention that it would replace ISB 1557 - now retired
  3. The DAPB4101 Pathology and Laboratory Medicine Reporting Information Standard (AMD 63/2023) that will replace the above standards. DAPB4101 supports the interoperable sharing of pathology reports between laboratories and GP practices (extending to other healthcare settings in time, including secondary care) using the Pathology Messaging – FHIR integration.

Our objective

Our primary objective is to change the pathology reporting data flow in primary care from one which uses Read v2 codes for the payload and PMIP EDIFACT as the messaging standard, to one that uses SNOMED CT and FHIR R4; moving the pathology estate away from the legacy terminology and messaging products that caused significant informatic complications during the pandemic. To achieve this, ISB 1557 will be deprecated and DAPB4101 initiated concurrently in April 2024, thereby enabling a legal mechanism to enforce the change.

Although DAPB4017 was intended as this mechanism, this standard has been retired**. This is because its key data product (the Unified Test List) evolved into SNOMED CT, and because standardisation of other data elements mandated by DAPB4017 are out of initial scope of DAPB4101.

*Deprecated standards are older versions of a standard that is being phased out. The standard can be used but is no longer maintained so may be out of date. The deprecation phase continues until the standard is retired.

** Retired standards are not being maintained and should not be used.

DAPB4101 scope, initiation, and conformance dates

In the pathology report sent from laboratories to Primary Care, DAPB4101 governs the use of SNOMED CT Observable entity concepts to represent specific pathology laboratory test result codes and SNOMED CT Procedure concepts to represent the specific laboratory test initially requested (including panels/batteries of tests). To support complex pathology reporting structures containing fully atomic, coded results, DAPB4101 mandates the use of pathology-specific UK Core FHIR R4 profiles, the goal being the interoperable sharing of pathology reports for the purpose of direct care.

DAPB4101 does not govern how variants of the EDIFACT messaging standard (such as NHS002, NHS004 messages) are used to exchange pathology data, such as in Bowel Cancer Screening – EDIFACT or Cervical Screening – EDIFACT.

DAPB4101 has been approved by the Data Alliance Partnership Board, with a provisional initiation date of April 2024. A requirements specification and implementation guidance will be published alongside an Information Standards Notice to facilitate national adoption of the Pathology Messaging – FHIR integration.

To help providers and system suppliers integrate our data products and reach conformance with DAPB4101, we are working together with NHS England’s Diagnostics Digital Capability Programme and Digital Primary Care Programme towards creating an implementation strategy, guidance, and roadmap for national adoption; our role being to provide informatic support.

April 2025 has been proposed as the full conformance date to meet the Standard, at which point ISB 1557 would be retired, and the Pathology Messaging – EDIFACT integration would cease to flow.

Please bookmark the NHS England Pathology Standards and Implementation website for information about our data products, information standard, and implementation support.

If you require further information, please contact us at [email protected].

Last edited: 28 November 2023 3:08 pm