Inching towards standardised pathology messages

Fortunately, I’m now almost old enough to have forgotten the christmas pudding ritual – helping my father cut up the suet, spread out on sheets  of newspaper on the dining room table. In those days, I was then already tall enough to also be able to peer down into the saucepan my mother used to boil clean the threepences and sixpences. And then when the pudding was finally mixed, it boiled away for hours and hours. The whole pudding making ritual seemed to take forever. All that effort for a minute morsel of pudding, that eventually arrived at the very end of an endless christmas lunch!

About this time last week, whilst reviewing the Australian Standards for pathology messaging, the smell of suet returned, reminding me of those yules of yesteryear. If, like me, your brain addles when presented with hundreds of acronyms squirming out from reams of paper, you may have some understanding of my state of mind. I really struggle when presented with bowls of suet that look something like this:-

MSH|^~\&|QDOC|HL7V1.1|AGFA|AGFA1AGFA|20051206150559||ORM^O01^ORM_O01|00004848|P|2.4|||||||
PID|||QP-110||Norman^Harvey||19401009|M|||200^^E.ST ALBANS^^3021|ORC|SC||51205041^TGH||IP||^^^20051206150400^^R|||PALEX^^^^^^^^Q541||^Gasser^Rudy^^^^^^Q541|||||OPH^Ophthalmology^L|

I thought that there had to be a better way for humans to deal with this – some easier way to interpret each arcane piece of HL7 v2 in context. I looked around, but could find nothing that met my requirements. So I have spent the past week writing an online message validator for Australian pathology messages. It is available at pathology.healthbase.info/hl7-test , and may be of some use to anyone dealing with pathology messaging, whether in the standards arena, or even if merely wanting to understand what some of the issues might be. There are a number of sample messages that can be explored. The validator also includes checking against LOINC and SNOMED terminologies.

I can’t help thinking that Gen-Xers and Gen-Yers probably wonder why pathology messaging just doesn’t work. I suspect they can’t relate to such a seemingly primitive state of development. Well most of them would not have had to change a valve in their television set, or even replace the blades on a lawnmower. They probably think that “stripping a carburettor” is some arcane ritual – an ancient precursor to “plug and play”. And they’d be right. But that is about where the state of pathology messaging currently sits.

My validator is just one tiny step in the long journey of pathology messaging standardisation. A journey that has already taken the industry some 20 years. At the current rate of progress it may well take another 20 before we really do have plug and play. Hopefully by then, I will no longer smell the suet.

Merry christmas!