The first exchange of pathology messaging results to new national standards has just taken place. Jane Dudman celebrates an NHS IT success

Published: 24/01/2002, Volume II2, No. 5789 Page 9

Phyllis Seddon is looking forward to putting her feet up. She's the practice nurse at the surgery of Dr Brian Lightowler - the first, and so far the only, GP practice in England to run live, online pathology messaging according to new national standards.

'I hope it will reduce my workload, ' she says.

'But they may find me something else to do.'

It is early days for both this practice, near Stockport, and the NHS as a whole to have online pathology messaging up and running - but it is a tight timetable. The NHS Information Authority's pathology messaging implementation project says 60 per cent of GP practices must be able to receive results for haematology, biochemistry and microbiology electronically, to the new national standards, by March.

By December, every GP practice in England and Wales is supposed to be ready to receive these tests online from all pathology labs.

The pathology lab at Stockport's Stepping Hill Hospital, to which Dr Lightowler's practice is connected, is the first in the country to demonstrate compliance with the new online National Messaging Assurance Service, which sets 20 separate test criteria.

Once it gained green lights for all the criteria, the lab declared its system compliant. It began sending encrypted test messages shortly afterwards and went live in December. Deputy IT manager Paul Carling admits the hospital is 'delighted' to be first - and worked very hard to be so. But as yet, it is sending test results via the new system to only one GP practice, out of the 60 in the area.

'Now we are waiting for the GPs, ' says Graham Tonks, IT manager at Stepping Hill.

Both ends of the messaging system have to be fully compliant with the new standards, so though the lab's system is live, it has to wait for the suppliers of the systems to local GP practices to gain full compliance clearance. The Stepping Hill lab has no control over the pace of supplier compliance - so far only one, Torex Health, has clearance - and this software is used by relatively few local GPs. 'The big one is Emis, which we believe is in the middle of compliance testing, ' says Mr Tonks. 'Once we have that, it would bring in at least half of our GPs.'

The work at Stepping Hill has still put the laboratory at the forefront of the move towards the new NHS standard, though glitches remain.

Part of the compliance test is getting an acknowledgement back from the GP that they have received and read the message. This is not yet happening, but it is regarded as a minor software problem that is being sorted out at the GP end.

To reach full compliance with the new standard, the Stepping Hill lab worked closely with iSOFT, its pathology system supplier, and Indigo 4 Systems, whose ProLinks Keystone software provides the encryption and messaging parts of the system.

The first step was to allocate Read codes to the lab's data, for which the lab used an automated mapping tool from iSOFT.Getting Read codes accurate is vital in ensuring the system works properly, says Mr Tonks. It is also important to allocate NHS numbers accurately against patient records when results are being sent and received.

At the GP end, too, Read codes are the biggest hurdle.At the moment, Ms Seddon enters them manually. 'Once we get all the Read codes coded in, that will be brilliant, ' she says.

In its first live week, Dr Lightowler's surgery sent more than 150 tests over to Stepping Hill Hospital using the new system. 'We are into anything that will save us time.We are a very innovative and progressive practice, ' says Ms Seddon.

Other GP practices are proving slower to move towards the new standards. Software supplier iSOFT says it has received only 30 orders for the software that will enable users of its own pathology laboratory information management systems, Apex and TelePath, to meet the national standards.

The company believes this reluctance may be partly due to existing messaging systems being in place. It says there may be a failure to appreciate the benefits of the new standard, of which the most important is that pathology messaging will run in the same way in every part of the country.

GPs will also be able to take information straight into their records, since practice software suppliers will have to comply with the messaging format.