What's next

If you are here it is because you have some interest - there is a place for everyone to be involved to assist either your organisation or the industry succeed.

If not done so please provide us with some information about your organisation, issues you have had with implementation of the messaging standards, and options for involvement to help make this happen - click here to complete a short questionnaire

Join the team at IHE Australia - we need help to make this happen. Opportunities range from Industry sponsorship to personal volunteering. There is a role for everyone - no matter what your background is. Working with IHE is a great introduction to interoperability and how to make it happen.
Please reach out to the secretary of IHE Australia to discuss how you can contribute.

If you are here it is because you have some interest - there is a place for everyone to be involved to assist either your organisation or the industry succeed.

1. Register for the newsletter - a monthly update essential to keep in touch
2. Join the open pathology advisory panel - a Zulip group (threaded chat) with zoom meeting updates as necessary for those interested in raising and answering questions and providing feedback to the process
3. Join the IHE Australia Pathology and Laboratory Medicine (IHE PaLM) Technical committee (this group is intended to create the integrated profile or implementation guide and conformance test steps by drawing on component standards - a one stop shop for implementers). Membership is by application and willingness to comply with IHE international methodology
4. Testing existing messages and vocabularies using the RCPA QAP testing services and engage with peer support - if / when available.
5. Testing using self-service (on-demand) test services +/- technical consultancy - if / when available
6. Enrol at IHE Australia connectathon as a message sender, intermediary or receiver (covering laboratories, communication services and clinical information systems) to verify end to end workflow, safe adoption of the standards and success in complying with a component or the whole or the message standards
7. Market your success to customers at the Interoperability Showcase at the ADHAs HIC 2025 (August 2025)

Who should be involved

• Professional and business leaders of Australian pathology laboratories
• IT professionals and software system suppliers servicing the pathology sector
• NATA assessors for communication and information technology
• Public health organisations consuming pathology reports and messages
• Information technology vendors receiving and sending pathology messages in the community health sector
• Professional and business leaders representing clinicians who request pathology services from laboratories

For more information please see

• The IHE Australia paper which discusses this topic in greater detail
• The the recording of the seminar (MP4, 125MB)on the 28th of November and the 5th December 2024.
• The Presentation slides "NATA assessment - year 1 for ADRM and SPIA" (PDF, 3.4MB), Derek Holzhauser (CIO RCPAQAP)
• The Presentation slides "Implementing standards in the real world - role of IHE" (PDF 2.0MB), Vince McCauley (McCauley Software, Chair IHE Australia)
• The recording of Q&A sessions from both seminars (40 minutes) on the 28th of November and the 5th December 2024.

Background

At the present time clinical information systems used in general and specialist practice and hospitals are needing to deal with over 50 variations in clinical pathology results messages emerging form pathology laboratories in Australia. Pathology laboratories are faced with dealing with many hundreds of clinical information system who have varying capacity to accept electronic results messages. There is a significant overhead for either laboratories or communication system vendors to hold this system together with complex transformations of messages as they “move over the wire” - there are many places for error to creep in and patient care to suffer. Pathology laboratories are increasingly being expected to submit reports electronically for Quality Assurance, public health reporting for communicable disease and cancer registries, and also to submit reports into MyHealthRecord. A relatively small technical commitment by information systems sending and receiving pathology messages to upgrade their capacity to meet the Australian Diagnostic Messaging Standard (ADRM2021.1) would see all of this variation disappear. The adoption of standard terminology sets (based on careful selection of LOINC and SNOMED-CT codes and standard units of measure) will see these messages populated with information in a form from all laboratories – for the first time they will speak the same language and not need interpretation. It is understood that this work is aimed at improving the current system for pathology messaging and will support laboratories become ready to adopt HL7 FHIR in future, while ensuring that the current system will remain current, for the foreseeable future.

Consistent with the Australian Commission on Safety and Quality in Health Care NPAAC and NATA laboratory accreditation requirements, laboratories, laboratory information systems (LIS), messaging services, and clinical information/EMR systems (CIS) are invited to participate in a joint IHE /RCPAQAP community-led collaboration to support industry with implementation of the required communication standards.

Adoption of standards covers messaging, vocabulary, and use of national healthcare identifiers for consumers, providers and organisations. Adoption of NPAAC requirements will support laboratories to maintain accreditation, while also supporting the capacity to adopt HL7 FHIR based services and 3rd party reporting of laboratory results for quality improvement and public health functions. NATA assessors attending will have an opportunity to engage with IHE's approach to enabling and demonstrating conformance with standards.

Extensive work is being carried out by the HL7 International to support the adoption of FHIR. This includes a great deal of work being done to develop FHIR resources for use in Pathology ordering and reporting.

The links below are a selection of relevant pages from the HL7 International website.

• HL7 International, Orders and Observations
• HL7 International OO Project Pages (Orders and Observations)
• ServiceRequest: Reflex/Follow-Up/Add-On, HL7 International, Orders and Observations, FHIR Lab service - Request work
• FHIR Clinical Order Workflow
• HL7 International FHIR laboratory result specification. Successfully balloted Sep 2024.

In recognition of the ubiquity of HL7v2 messages in healthcare, the HL7 International has been working on mapping between HL7v2 and FHIR to support the seamless transition from HL7v2 to FHIR.

IHE Australia Deployment Committee members believe that its efforts to support standardisation of HL7v2 Pathology orders and results messages in use in Australia are important and will, in conjunction with the HL7 International efforts, support smooth and consistent transition to FHIR-based Pathology ordering and reporting in Australia.

The links below are a selection of relevant pages from the HL7 International website.

• 2-To-FHIR Project Pages, HL7 International Orders and Observations - HL7v2 to FHIR Project Pages
• 2-To-FHIR Pages, HL7 International Orders and Observations - HL7v2 to FHIR Pages
• 2-To-FHIR Mapping for OML^O21 (Orders), HL7 International Orders and Observations - HL7v2 to FHIR Mapping for OML^O21 (Orders)
• 2-To-FHIR Mapping for ORU^R01 (Results), HL7 International Orders and Observations - HL7v2 to FHIR Mapping for ORU^R01 (Results)
• 2-To-FHIR Segment Mapping, HL7 International Orders and Observations - HL7v2 to FHIR - Segment Mapping
• 2-To-FHIR v2 Sample Messages, HL7 International Orders and Observations - HL7v2 to FHIR - v2 Sample Messages

HL7 Australia FHIR for Pathology Initiatives

The Sparked project is a collaboration of HL7 Australia, the Australian Digital Health Agency, the Department of Health and Ageing and the CSIRO e-health. The project aims to deliver a core set of FHIR standards, developed by and for the community, for use in Australian settings with specific focus on:.

• An Australian localisation of the international HL7 FHIR Core as an Australian AU Core Data for Interoperability and implementation guide
• FHIR representations of electronic request data for pathology AU eRequesting Data for Interoperability and associated implementation guide
• An Australian localisation of the International Patient Summary via the AU Patient Summary Clinical Focus Group

Integrating the Healthcare Enterprise (IHE) International, Incorporated, is a non-profit 130 organization incorporated under the laws of the State of Illinois, U.S.A. IHE International enables users and developers of information technology for healthcare to achieve interoperability of systems through the precise definition of healthcare tasks, the specification of standards-based communication between systems required to support those tasks and the testing of systems to determine that they conform to the specifications. The work is managed by IHE committees and 135 sponsored by various national and international bodies. The composition of the IHE International Board is published on IHE International web site.

IHE Mission

The goal of IHE is to improve the ability of computer systems in healthcare to share information so that all information relevant to a patient's care is available to the patient and the care provider when required. The driving needs for this work include:

• facilitating the seamless exchange of health information among care providers both within the enterprise and across care settings
• providing interoperability capabilities to support the deployment of electronic health records in their various national and regional contexts
• enabling local, national and regional health information networks
• addressing needs for security and privacy
• improving the efficiency and effectiveness of healthcare workflows, and
• generally removing barriers to safe and optimal patient care

IHE collaboratively engages developers and users of healthcare IT systems to identify and resolve significant interoperability problems facing healthcare. IHE promotes and accelerates the coordinated adoption of established standards by creating and maintaining Technical Documents, including implementation guidelines called IHE Profiles, which are published in a set of documents called the IHE Technical Frameworks. IHE encourages harmonization and global adoption of the guidelines by collaborating with national and regional groups. IHE fosters compatible implementations of the Profiles by organizing testing events and associated educational seminars.

Systems that conform to IHE Profiles communicate more effectively, are more easily implemented, and enable efficient, secure access to relevant health information, both within healthcare delivery organizations and between different care settings and administrative entities.

IHE Organisation

IHE activities fall into two categories and IHE is organised to reflect this:

1. Development activities: the work that leads to publication of the IHE Technical Frameworks that are international in scope; and organised along clinical and operational domains. Typically, within each Domain, a Planning Committee annually selects the use cases and a Technical Committee profiles the use of standards to address the use case, documenting them in Technical Framework documents and their supplements. An overarching Domain Coordination Committee ensures that consistent processes and technical directions are followed.
2. Deployment activities: regional/national testing and demonstrations of the profiles contained in the Technical Frameworks and their supplements, as well as promotional and educational efforts. Testing activities are supported by testing software and related tools. Deployment activities are organised by National and Regional Deployment Committees that are separate entities with a close collaborative relationship with IHE International.

National and Regional Deployment Committees are empowered by the IHE Board to conduct testing, demonstrations, educational events and other deployment activities within their geographic area. They also develop National Extensions to the IHE Technical Frameworks to address local variations in care delivery. They develop their own governance rules and business models but adhere to the general principles expressed in the IHE international governance document and the guidelines

IHE Australia improves the healthcare of the Australian community by promoting the adoption and use of IHE and other world-class standards, tools, and services to enable healthcare information systems. IHE Australia engages public and private sector participants to test, implement, and use standards-based solutions for all health information needs. IHE Australia is a not for profit organisation founded in 2009 that operates the national deployment committee of IHE International® in Australia. We have a local organisation and our own governance rules and business model that adhere to the IHE Principles of Governance, with the flexibility to meet the needs of our local members, stakeholders and Australian interoperability priorities.

IHE Australia Deployment Committee Leadership Team members represent Australia on the IHE International Board and actively participate in its deliberations.

IHE Australia Deployment Committee is focused on engagement with Australian stakeholders, including Clinicians, Vendors, Industry Groups and Governments at all levels, with the view to assist with:

• Determination of applicability of IHE Profiles to Australian initiatives
• Guidance on the application of IHE Profiles to specific business cases
• Collaboration in planning and implementation of Australian initiatives that employ IHE Profiles
• Organisation and oversight of local IHE Connectathons and IHE Showcases
• Education sessions and workshops focussed on IHE Profiles and Frameworks
• Engagements with international IHE community