HealthTech NHS Pathology Results Platform — Integrated Care System

NHS Pathology FHIR R4 Implementation Guide

• DiagnosticReport resource (report header — requesting clinician, specimen, report status), Observation resources (individual test results — LOINC codes, numeric values, reference ranges, abnormal flags).
• HL7 v2 ORU R01 →

FHIR R4 transformation

HAPI FHIR message parser with UK Core profile validation.

Bidirectional

receive results (HL7 v2 in, FHIR R4 out for viewer) and send orders (FHIR R4 ServiceRequest out).

Critical Value Alerting

• Critical values (results outside limits requiring urgent clinical action — e.g., potassium &gt
• 6.0 mmol/L, haemoglobin &lt
• 70 g/L, INR &gt
• 10): automatic alert to requesting clinician within 5 minutes of result receipt.

Alert channel

GOV.UK Notify SMS to clinician mobile + in-app notification.

Acknowledgement required

clinician must acknowledge critical alert within 30 minutes — escalation to duty clinician if no acknowledgement.

DCB0129 hazard

alert not delivered or acknowledged — mitigated by dual-channel plus escalation.

NHS SDS Authentication

NHS Spine Directory Service (SDS): GP clinical system authentication for NHS Spine access.

Smartcard integration

NHS Spine requires Smartcard (RA01/02) authentication for clinical data access.

RBAC

NHS Spine Role Based Access Control — GP sees only results for their registered patients (ODS code matching).

Audit

every result access logged with clinician NHS number and ODS code — NHS DSP Toolkit audit trail requirement.

Pathology results

health data, Article 9 special category.

Basis

Article 9(2)(h) — provision of health care.

Retention

pathology results retained for 8 years (NHS Records Management Code — adults).

Minimum necessary access

clinicians see only results for their registered patients.

Results search

clinician cannot search by diagnosis or result value across population — only patient-level access.