dtr-agency
commented
3 years ago ANALYSIS OF CANDIDATE CODES
v2 DIAGNOSTIC SERVICE SECTION ID
This set of codes is fundamental to exchanges of pathology information using HL7 v2 and is ubiquitous in Australia. It is weak outside pathology.
Each code is assigned to one set of diagnostic codes (Pathology / Diagnostic Imaging / Specialist Diagnostic) or to None if it is not for any.
| Code | Display | Pathology / Diagnostic Imaging / Specialist Diagnostic / None | Notes |
|---|---|---|---|
| AU | Audiology | Specialist Diagnostic | |
| BG | Blood Gases | Pathology | |
| BLB | Blood Bank | Pathology | aka Transfusion Medicine |
| CG | Cytogenetics | Pathology | |
| CH | Chemistry | Pathology | aka Chemical Pathology |
| CP | Cytopathology | Pathology | |
| CT | CAT Scan | Diagnostic Imaging | |
| CTH | Cardiac Catheterization | None | treatment, not diagnostic |
| CUS | Cardiac Ultrasound | Diagnostic Imaging | Maybe just have ultrasound. Is this Specialist Diagnostic? |
| EC | Electrocardiac (e.g., EKG, EEC, Holter) | Specialist Diagnostic | type of electrodiagnosis or electrography, all heart. Cardiology |
| EN | Electroneuro (EEG, EMG,EP,PSG) | Specialist Diagnostic | type of electrodiagnosis or electrography, includes brain, muscles and sleeping. Neurology |
| GE | Genetics | Pathology | |
| HM | Hematology | Pathology | |
| ICU | Bedside ICU Monitoring | Specialist Diagnostic | Seems very narrow. Does anyone want it? |
| IMG | Diagnostic Imaging | Diagnostic Imaging | Deprecated, added v2.4, removed after v2.4. We want a grouper for all of DI |
| IMM | Immunology | Pathology | |
| LAB | Laboratory | Pathology | aka Pathology |
| MB | Microbiology | Pathology | |
| MCB | Mycobacteriology | Pathology | |
| MYC | Mycology | Pathology | |
| NMR | Nuclear Magnetic Resonance | Diagnostic Imaging | now called magnetic resonance imaging |
| NMS | Nuclear Medicine Scan | Diagnostic Imaging | |
| NRS | Nursing Service Measures | None | treatment, not diagnostic |
| OSL | Outside Lab | Pathology | not a useful category |
| OT | Occupational Therapy | Specialist Diagnostic | |
| OTH | Other | None | not a useful category |
| OUS | OB Ultrasound | Diagnostic Imaging | Maybe just have ultrasound |
| PAR | Parasitology | None | Deprecated, added v2.4, removed after v2.4 Study of parasites, not of infections. |
| PAT | Pathology (gross & histopath, not surgical) | Pathology | Deprecated, added v2.4, removed after v2.4 |
| PF | Pulmonary Function | Specialist Diagnostic | aka Respiratory |
| PHR | Pharmacy | Pathology | |
| PHY | Physician (Hx. Dx, admission note, etc.) | Specialist Diagnostic | Hx=medical history, Dx=diagnosis |
| PT | Physical Therapy | Specialist Diagnostic | |
| RAD | Radiology | Diagnostic Imaging | |
| RC | Respiratory Care (therapy) | Specialist Diagnostic | treatment, not diagnostic |
| RT | Radiation Therapy | None | treatment, not diagnostic |
| RUS | Radiology Ultrasound | Diagnostic Imaging | Maybe just have ultrasound |
| RX | Radiograph | Diagnostic Imaging | Does this exclude or include cineradiograph? |
| SP | Surgical Pathology | Pathology | type of Anatomical Pathology |
| SR | Serology | Pathology | |
| TX | Toxicology | Pathology | |
| URN | Urinalysis | Pathology | Deprecated, added v2.4, removed after v2.4 Is this too specialised? aka Urology |
| VR | Virology | Pathology | |
| VUS | Vascular Ultrasound | Diagnostic Imaging | Maybe just have ultrasound. Is this Specialist Diagnostic? |
| XRC | Cineradiograph | Diagnostic Imaging | aka fluoroscopy |
The codes for pathology are widely used and accepted in Australia, they are part of how pathologists think of and organise their work. Some of the terms are different, e.g. "Laboratory" is better known as "pathology" in Australia.
Partial list of missing codes
| Anatomical Pathology | |
| Forensic Pathology | |
| Diagnostic Imaging | |
| Cardiology | |
| Gastroenterology | |
| Neurology | |
| Ophthalmology | |
| Orthopaedics | |
| Speech pathology | |
| Ultrasound | |
| Urology |
SNOMED CT
SNOMED CT has relevant codes in two branches: Qualifier value and Environment. The table has values that are the children of the qualifier 310028002|Diagnostic investigation service and those for organisational units that have diagnostic investigations as a primary function.
| Branch | Code | Display | Pathology / Diagnostic Imaging / Specialist Diagnostic /None |
|---|---|---|---|
| Qualifier value | 310028002 | Diagnostic investigation service (qualifier value) | |
| Qualifier value | 310024000 | Colposcopy service (qualifier value) | Specialist Diagnostic |
| Qualifier value | 310005003 | Diagnostic audiology service (qualifier value) | Specialist Diagnostic |
| Qualifier value | 708175003 | Diagnostic imaging service (qualifier value) | Diagnostic Imaging |
| Qualifier value | 310128004 | Computerised tomography service (qualifier value) | Diagnostic Imaging |
| Qualifier value | 310127009 | Magnetic resonance imaging service (qualifier value) | Diagnostic Imaging |
| Qualifier value | 310125001 | Radiology service (qualifier value) | Diagnostic Imaging |
| Qualifier value | 310169008 | Ultrasound service (qualifier value) | Diagnostic Imaging |
| Qualifier value | 708172000 | Cardiac ultrasound service (qualifier value) | Diagnostic Imaging |
| Qualifier value | 1248891000168107 | Gynecological ultrasound service (qualifier value) | Diagnostic Imaging |
| Qualifier value | 708173005 | Obstetric ultrasound service (qualifier value) | Diagnostic Imaging |
| Qualifier value | 708171007 | Vascular ultrasound service (qualifier value) | Diagnostic Imaging |
| Qualifier value | 24011000087101 | Vascular imaging service (qualifier value) | Diagnostic Imaging |
| Qualifier value | 310030000 | Endoscopy service (qualifier value) | Specialist Diagnostic |
| Qualifier value | 310074003 | Pathology service (qualifier value) | Pathology |
| Qualifier value | 708183009 | Anatomic pathology service (qualifier value) | Pathology |
| Qualifier value | 708182004 | Histology service (qualifier value) | Pathology |
| Qualifier value | 708187005 | Surgical pathology service (qualifier value) | Pathology |
| Qualifier value | 708184003 | Clinical pathology service (qualifier value) | Pathology |
| Qualifier value | 711332004 | Allergy service (qualifier value) | Pathology |
| Qualifier value | 708194008 | Blood bank service (qualifier value) | Pathology |
| Qualifier value | 310076001 | Clinical biochemistry service (qualifier value) | Pathology |
| Qualifier value | 708193002 | Coagulation service (qualifier value) | Pathology |
| Qualifier value | 310200001 | Cytology service (qualifier value) | Pathology |
| Qualifier value | 708196005 | Hematology service (qualifier value) | Pathology |
| Qualifier value | 708190004 | Immunology service (qualifier value) | Pathology |
| Qualifier value | 708188000 | Serology service (qualifier value) | Pathology |
| Qualifier value | 708191000 | Toxicology service (qualifier value) | Pathology |
| Qualifier value | 708180007 | Dermatopathology service (qualifier value) | Pathology |
| Qualifier value | 1135871000168104 | Forensic pathology service (qualifier value) | Pathology |
| Qualifier value | 788006003 | Genetic laboratory service (qualifier value) | Pathology |
| Qualifier value | 1248841000168104 | Genetic pathology service (qualifier value) | Pathology |
| Qualifier value | 788124003 | Histopathology service (qualifier value) | Pathology |
| Qualifier value | 708179009 | Molecular pathology service (qualifier value) | Pathology |
| Qualifier value | 310079008 | Neuropathology service (qualifier value) | Pathology |
| Environment | 309914005 | Audiology department (environment) | Specialist Diagnostic |
| Environment | 309952006 | Chemical pathology department (environment) | Pathology |
| Environment | 309913004 | Clinical allergy department (environment) | Specialist Diagnostic |
| Environment | 309930002 | Clinical cytogenetics department (environment) | Pathology |
| Environment | 309929007 | Clinical genetics department (environment) | Pathology |
| Environment | 309919000 | Clinical immunology department (environment) | Pathology |
| Environment | 309931003 | Clinical molecular genetics department (environment) | Pathology |
| Environment | 309920006 | Clinical neurophysiology department (environment) | Specialist Diagnostic |
| Environment | 309922003 | Clinical physiology department (environment) | Specialist Diagnostic |
| Environment | 846664008 | Community radiology (environment) | Diagnostic Imaging |
| Environment | 441662001 | Diagnostic imaging department (environment) | Diagnostic Imaging |
| Environment | 309925001 | Endocrinology department (environment) | Pathology |
| Environment | 309926000 | Gastroenterology department (environment) | Specialist Diagnostic |
| Environment | 309953001 | General pathology department (environment) | Pathology |
| Environment | 309928004 | Genetics department (environment) | Pathology |
| Environment | 309954007 | Haematology department (environment) | Pathology |
| Environment | 441950002 | Histopathology department (environment) | Pathology |
| Environment | 73588009 | Hospital-based laboratory facility (environment) | Pathology |
| Environment | 79491001 | Hospital-based radiology facility (environment) | Diagnostic Imaging |
| Environment | 309934006 | Infectious diseases department (environment) | Specialist Diagnostic |
| Environment | 309956009 | Medical microbiology department (environment) | Pathology |
| Environment | 309935007 | Medical ophthalmology department (environment) | Specialist Diagnostic |
| Environment | 309937004 | Neurology department (environment) | Specialist Diagnostic |
| Environment | 309957000 | Neuropathology department (environment) | Pathology |
| Environment | 309988001 | Ophthalmology department (environment) | Specialist Diagnostic |
| Environment | 309950003 | Pathology department (environment) | Pathology |
| Environment | 309964003 | Radiology department (environment) | Diagnostic Imaging |
| Environment | 225747005 | X-ray department (environment) | Diagnostic Imaging |
LOINC
LOINC does not represent organisational units. "LOINC codes represent the “question” for a test or measurement." - from What LOINC is. There are no LOINC codes for service section.
METeOR
METeOR has codes for specialty, but for organisation unit the closest is Clinical service context code N[N] with 32 values. For organisation unit the closest set of codes is Clinical service context code N[N] with 32 values. The only values for diagnostic sections are those for Radiology and Pathology.
| Code | Display | Pathology / Diagnostic Imaging / Specialist Diagnostic /None |
|---|---|---|
| 1 | Emergency department | None |
| 2 | Cardiology | None |
| 3 | Dentistry | None |
| 4 | Cosmetic procedures (including elective plastic surgery) | None |
| 5 | Otolaryngology | None |
| 6 | General medicine (including internal medicine) | None |
| 7 | General practice | None |
| 8 | General surgery | None |
| 9 | Gynaecology | None |
| 10 | Hospital outpatient department | None |
| 11 | Neurology | None |
| 12 | Obstetrics | None |
| 13 | Oncology | None |
| 14 | Orthopaedics | None |
| 15 | Paediatrics | None |
| 16 | Perinatology (including neonatology) | None |
| 17 | Plastic surgery (non-elective) | None |
| 18 | Psychiatry | None |
| 19 | Radiology | Diagnostic Imaging |
| 20 | Urology | None |
| 23 | Cardio-thoracic surgery | None |
| 24 | Community-based care | None |
| 25 | Intensive care | None |
| 26 | Neurosurgery | None |
| 27 | Ophthalmology | None |
| 28 | Oral and maxillofacial surgery | None |
| 29 | Pathology | Pathology |
| 30 | Public health | None |
| 31 | Rehabilitation | None |
| 32 | Vascular surgery | None |
| 88 | Other | None |
Australian and New Zealand Standard Industrial Classification
1292.0 - Australian and New Zealand Standard Industrial Classification (ANZSIC), 2006 (Revision 1.0) is a classification of business units.
It has a single code that is relevant: 8520 - Pathology and Diagnostic Imaging Services
davidmckillop
Prerequisites
The issue / feature
Change description
We need to develop a set of terminology that supports the exchange and categorisation of diagnostic reports using the concept of service section.
A service section is a part of an organisation that provides services, e.g. a pathology section provides pathology services. The clinical community organises some clinical work and work groups (e.g. pathology) by the type of service undertaken, thus service section is one of the ways that the work is categorised.
The resulting value sets will be bound in DiagnosticReport profiles to support exchange of diagnostic reports issued by diagnostic service providers for the electronic exchange of diagnostic reports (e.g. pathology, imaging, specialist and other) between healthcare providers, and between healthcare providers and the My Health Record system infrastructure in Australia.
There will be 4 value sets, an encompassing one for all diagnostics and limited value sets for each of imaging, pathology and specialist diagnostics.
Terminology and modelling choices will need to consider a hierarchy of domain concepts. For example: Clinical → Diagnostic → Pathology → Anatomical Pathology
The values should, if possible, be drawn from v2 DIAGNOSTIC SERVICE SECTION ID. However, it is not well aligned for specialist diagnostics. There are some non-pathology and non-diagnostic imaging options including "Nursing service measures", "Occupational therapy", "Other", "Pulmonary function", "Pharmacy", "Physician" and "Physical therapy". Work will need to be done to determine more appropriate values.
Imaging and modality depts. Refer to #55 for feedback by Dr Nick Ferris (Radiologist) who indicated:
What it actually enables people to do
This will help diagnostic reports other than pathology and imaging ones (though imaging does need some work) to be exchanged as effectively as pathology and imaging ones are currently.
How awesome would it be?
Pretty.
Workarounds
There is no good workaround for not having these value sets.
Additional context
There are widely adopted specifications for the exchange of pathology and diagnostic imaging reports in Australia
Other categorisation is in play:
The NCTS has a value set with 491 values for organisation role type Healthcare Organisation Role Type
Candidate list of diagnostic domains