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Histology Lab Device Automation using HL7 version 2

Publication date: Jul 23, 2013

How does one use HL7 chapter 13 in a Histology lab device ?

Last week I had a lengthy discussion with a Dutch reseller of a slide stainer - a lab device used to automate the process of staining. Now I must admit that when it comes to my knowledge of Lab processes it's pretty much limited to some aspects of Clinical Pathology (Clinical Chemistry, Hematology, Clinical Microbiology) - that is, up to this particular discussion. Histology (according to Wikipedia) is the study of the microscopic anatomy of cells and tissues. It is commonly performed by examining cells and tissues by sectioning and staining, followed by examination under a light microscope or electron microscope.

Specimen Container

They had a requirement to support a couple of messages from HL7 v2 - chapter 13 "Clicical Laboratory Automation". I'd only ever seen one message used, U03 (SSU/ACK - SPECIMEN STATUS UPDATE (EVENT U03)) which is basically used to track (from a logistics perspective) the specimen location as it is processed by various pieces of laboratory equipment. U03 is also used as part of the IHE LDA (Lab Device Automation) workflow, which is why I was already aware of it. The core of the U03 message is formed by the SAC segment (specimen container). The name of the segment already shows us the origin of its definition: clinical chemistry.

Test tube carrier .. Slide rack

SAC defines containers (whereas a slide doesn't 'contain' anything), and the volume of containers. Still, if we define a slide to be a 'container' the segment and the message can be used. It was noted that the unit of processing and status management (for this lab device) is a 'rack of slides', and not an individual slide. When we simply copy the status of the rack to the status field of the individual slides (in SAC parlance: the container) all will probably work just fine.

Equipment Control and Status

The other messages in chapter 13 are all about equipment status (notably ESU/ACK - AUTOMATED EQUIPMENT STATUS UPDATE (EVENT U01)). The status can be (e.g.) Powered Up, Initializing, Idle, Normal Operation, Clearing, Paused and Stopped.

Another key message in this case is U05 (INU/ACK – AUTOMATED EQUIPMENT INVENTORY UPDATE (EVENT U05)) - the process of staining uses a number of reagents, so one has to continuously monitor the level of reagents.

Digital Pathology

It's interesting to have to focus on an area of HL7 version 2 that has been around for ages - but that I hadn't come accross yet. The sizable increase in the use of Digital Pathology, and the use of these HL7 v2 messages in this particular project, do show us that this is an area of growth when it comes to application and device interfaces. HL7 may have to initiate a workitem to ensure that the current SAC/SPM segments can also be used for Histology oriented lab devices.

-Rene

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