Table of Contents

Table of Contents 3
Executive Summary 6
1   Introduction                                                              8
1.1      Background                                                           8
1.3      References                                                           9
2.  PaGSIP Trials Outline                                                     10
2.1      Quality Use of Pathology Program                                     10
2.2      Project Scope                                                        10
2.2.1        Risk Identification                                              10
2.2.2        Timing                                                           11
2.2.3        Issues Log and Evaluation                                        11
3.  Fundamental Design Principles, Decisions and Rationale                    12
3.1      Approach and Methodology                                             12
3.2      Model Overview                                                       14
3.3      Baseline Data                                                        14
3.4      Implementation and Continuance                                       15
3.5      Clinical Perceptions                                                 15
3.6      The CCeH Team                                                        16
4.  HL7 Compliant Messaging                                                   17
4.1      Minimum Security Requirements                                        17
4.2      Messaging Focus                                                      17
4.2.1        Current use of Pathology Messaging                               17
4.2.2        Standards - PIT, HL7 and Clinical Code-set                       18
4.2.3        HL7 Messaging Implementation                                     18
4.2.4        Compatibility with Messaging Standards                           19
5.  Trial Environment                                                         20
5.1      Principles, Decisions and Rationale                                  20
5.1.1        Practice - Pathology Message Diversity                           20
5.1.2        Pre-Trial Data Analysis                                          21
5.1.3        Trial Data Analysis                                              21
5.2      Stakeholder Participants                                             22
5.2.1        Ballarat & District Division of General Practice                 22
5.2.2        St John of God Pathology                                         22
5.2.3        Top End Division of General Practice                             22
5.2.4        Queensland Medical Laboratory                                    22
5.3      Timelines                                                            23
5.4      Expected Transaction Volumes                                         24
6.  Trial Preparation & Installation                                          25
6.1      Interface Software                                                   25
6.1.1        Software Application Program Interface (API)                     25
6.1.2        Medical Director                                                 25
6.1.3        Locum 3                                                          25
6.1.4        MedTech 32                                                       26
6.1.5 Queensland Medical Laboratory                                           26
6.1.6        St John of God Pathology                                         27
6.2      Argus Messaging Infrastructure                                       27
6.3      Open Source Restrictions                                             28
6.4      Procedural Implementation Issues                                     28
6.5      Messaging Trials                                                     28
7   Implementation Considerations                                             29
7.1      Risk Mitigation Measures                                             29
7.2      Business Issues                                                      29
7.3      Technical Issues                                                     30
7.4      Workflow Issues                                                      30
7.5      Platform Issues                                                      30
8   Findings                                                                  31
8.1      General                                                              31
8.2      Practice Management Workflow                                         31
8.3      Improved Safety                                                      32
8.4      Use of Messaging 'Middleware' (Argus)                                32
8.4.1        Medical Director/Locum                                           32
8.4.2        LabTrak/QML                                                      33
8.4.3        HL7 Compliance                                                   33
8.5      Project Management Issues                                            34
8.5.1        Timing                                                           34
8.5.2        Cooperation with Software Companies                              35
8.5.3        GP Practice Issues                                               35
8.6      PKI Security                                                         36
8.7      Benefits of HL7                                                      37
8.7.1        Atomised Report Data                                             37
8.7.2        Guaranteed Delivery                                              37
8.7.3        HL7/PIT Combination                                              37
9   Recommendations                                                           39
Appendix A - Procedural Trial Management Logs 42
A.1      Risk Identification                                                  42
A.2      Risk Mitigation Measures Implemented                                 45
A.3      QML Statement of Takeover                                            45
Appendix B - Trial Implementation Data 46
B.1      Baseline Data                                                        46
B.2      Application Architecture                                             46
B.3      Key Features                                                         47
B.4      Technical Messaging Interface Architecture                           48
Appendix C - Project Materials Catalogue 50
C.1      Project Materials                                                    50
C.2      Intellectual Property                                                50
C.3      Key Contributors                                                     50
C.4      Moral Rights Schedule                                                50
Appendix D - Contractual Requirements to Provide Material Submissions to Standards Australia 52

D.1      Contract of Services, Schedule Item A.5: Draft Revisions to 'The Handbook' identifying and addressing the variants encountered when implementing electronic orders and results messages in a manner suitable for consideration by the Standards Australia working group responsible for 'The Handbook' (IT-14-6-5) 52

D.2      Schedule Item B.6: Presentations that summarise the findings identified in the Final Project and Evaluation Report suitable for Presentation to the following organisations: 53

Standards Australia - HL7 Australia Working Group                             53
Quality Use of Pathology Committee                                            53