Pathology Integration
- Mohammad Al-Ubaydli
Giving patients their test results is one of the most helpful things you can do for your patients. PKB can show a patient their test results in the NHS App and the PKB web site, with no additional work for the patient when the hospital has given permission
 Test results in NHS App |  Test results in PKB web site |
Benefits
Through access to their test results patients can:
Better understand and manage their own health without using up scarce health care resources.
When they do need help from professionals they can explain their own health saving the professionals time.
Allow professionals and carers to view their test results.
The Patients Know Best platform includes a section to show a patient their test results. Test results can come via an HL7 integration from any source, including when multiple laboratories have processed samples from all the providers looking after the patient. As well as from patient and carers who might manually upload test results from print-outs.
Enabling access
The information governance for test results is already included in the Data Processing Contract which covers all data release from the hospital to Patients Know Best. No permission is required from patients (data subjects) the data controller can release all data for the patients it is providing direct care to.
Technical integration requires adding PKB as an extra destination for existing HL7 test results feeds. This is part of the standard integration with other routine feeds such as appointments.
Clinical governance may make a decision on which minority of test results require a delay while the majority of test results are immediately visible to patients. The PKB team provides a draft of typical and recommended delays based on the experience of other hospitals releasing 20 million test results a month. The hospital’s chief medical officer can modify then approve the final version.
Technical implementation
Full instructions are available on the developer wiki about how to send data via HL7 into PKB, which includes the specifications for the HL7 ORU messages used to send pathology and radiology data. Corrections and deletions can be issued by the lab IT systems using the HL7 interface. Only the lab that authored a test result can correct or delete it. A data point marked for deletion is hidden from users but stored for medico-legal audit purposes.
The individual tests normally appear in the same groupings as they were sent from the laboratory, supported by appropriate graphical representation and additional data such as the source of each data point (e.g. patient-entered data vs lab-transferred data), exact timestamps, notes and ranges. Data points on the table can be discussed with members of the clinical team via messaging and a warning at the top of the page reminds the patient that the clinical team is the first point of contact, rather than the laboratory team.
When test results arrive, the patient and carer are notified on the email addresses that they registered with. The email does not divulge what the test result is or which team it came from, only that new data is available to see. The patient and their carers can see these test results after logging into the patient's record, unless the team had set up a delay for the display of some test results. Professionals are not notified but they can see the latest results, with no delays, when looking at a patient's record.