D

Core Requirement

Alpha

V3.0 - March 2023

D-01.1 - Request Consultations

D-02.1 - Consultation Results

D-03.1 - Request Diagnostic Tests

D-04.1 - Diagnostic Test Results

D-05.1- Integration of Diagnostics into Workflow

D-06.1 - Historic Diagnostic Results and Images

D-06.2 - Diagnostic Results filtering

D-06.3 - Diagnostic Results verification

D-07.1 - Diagnostic Order Progress

D-08.1 - Diagnostic Time Stamps

D-09.1 - Single User Interface for Tests and Diagnostics

D-10.1 - Urgent Diagnostic Results

EPR MDF Core Capability

D-01.1 - Request Consultations

As a Clinical Professional,

I want, the ability to digitally request consultations with other clinical professionals,

So that, I can get additional diagnosis support.

Acceptance criteria 1:

Given I have the system access to request a consultation,

When I request a consultation,

Then the request for a consultation is sent to the chosen clinical professional.

Acceptance Criteria 2:

Given that I have requested a consultation,

When the consultation is performed and the patient record is updated with the consultation findings or clinical opinion,

Then I get notified that the consultation has been completed and I can then view the result in the patient record.

Application Function

Description

AF338 Digitally Request Consultation

Request a consultation digitally and have the consultation and its results automatically recorded in the patient record

EPR MDF Core Capability

D-02.1 - Consultation Results

As a Clinical Professional,

I want to be notified that the consultation that I requested has been completed

and I want to be able to see these findings or clinical opinion in the patient record,

So that I can take the appropriate course of action.

Acceptance Criteria 1

Given I have requested a consultation,

When the consultation is completed and the findings or clinical opinions are added to the patient record,

Then I should be notified that the results are published.

Acceptance Criteria 2

Given a consultation has been completed,

When the consultation is completed and the findings or clinical opinion have been added to the patient record,

Then I am able to view the findings or clinical opinion of the consultation.

Application Function

Description

AF339 Send Results Notification 

The ability of an application to send a notification to the clinician who ordered a consultation

EPR MDF Core Capability

D-03.1 - Request Diagnostic Tests

As a Clinical Professional,

I want the ability to digitally request diagnostic tests,

So that I can get accurate diagnosis results.

Acceptance criteria 1:

Given I have the system access to request diagnostic tests,

When I request a diagnostic test,

Then the request for a diagnostic test is sent to the chosen diagnostic service.

Acceptance Criteria 2:

Given that I have requested a diagnostic test,

When the diagnostic test is performed and the patient record is updated with the test results,

Then I get notified that the test has been completed and I can then view the result in the patient record.

Application Function

Description

AF217 Place Test/Investigations Order

The ability to engage testing services in real time and record the action that a request has been made on the patient record.
Scope includes:

• Imaging/Scans

• MRI

• Lab (samples)

• Blood Product Ordering

The application must be able to support the following:

• Adding relevant patient data to the order

• Accurate annotation of body maps to accompany orders

• Appending images to orders

• STD069 Pathology Test and Results Standard - DAPB4017 Guidance (NHS Digital)

EPR MDF Core Capability

D-04.1 - Diagnostic Test Results

As a Clinical Professional,

I want to be notified that the diagnostic tests that I requested have been completed,

and I want to be able to see these results in the patient record, within appropriate prescribing pathways

So that I can take the appropriate course of action.

Acceptance Criteria 1

Given I have requested a diagnostic test,

When the test is completed and the results are added to the patient record,

Then I should be notified that the results are published.

Acceptance Criteria 2

Given a diagnostic test has been completed,

When the test is completed and the results have been added to the patient record,

Then I am able to view the results of the test.

Acceptance Criteria 3

Given the need to record test results

When results are added to the patient record

Then they should be recorded in compliance with any relevant test result standard

Application Function

Description

AF173 Generate clinical alerts

The ability of an application to run algorithms based upon patient data (observations, conditions, test results etc.) to proactively identify conditions or deterioration in conditions and generate clinical alerts where issues are identified (scores are beyond defined thresholds).

AF184 Send Results Notification 

The ability of an application to send a notification to the clinician who ordered a test and concerned clinical groups where a test result indicates that a patient has an urgent health need.

AF185 Results Acknowledgement

The ability of an application to request an acknowledgement from a clinician that results have been viewed and actioned where the results fall outside normal parameters for the specific clinical speciality of the requesting clinician.

AF231 Visualise Test/Investigation results

The ability to visualise a set of corresponding results, e.g. via time-series graphs.

This should include the ability to overlap significant events onto views, e.g. interventions, procedures

AF229 View Test/Investigation Results

The ability to view the results of all tests/investigations carried out on behalf of a patient including any associated artefacts (images etc.) captured via the testing application.

AF228 Receive and Process Test Results

The ability of an application to be able to receive and process results received from diagnostic results systems (including correlating results with requests).

Standards Compliance

• STD069 Pathology Test and Results Standard - DAPB4017 Guidance (NHS Digital)

EPR MDF Core Capability

D-05.1- Integration of Diagnostics into Workflow

As a Clinical Professional ,

I want automated alerts when ordering diagnostic tests and consultations including but not limited to duplication, inconsistent or conflicting test requests,

So that I am aware of any issues with the request I am making while I am within the workflow.

Acceptance Criteria 1:

Given I have requested a diagnostic test or consultation,

When the request I make triggers an alert within the diagnostic system (LIMS (Laboratory Management System) or RIS (Radiology Information Management)),

Then I will see that alert within the workflow.

Acceptance Criteria 2:

Given I have requested a diagnostic test or consultation,

When the request I make triggers an alert within the diagnostic system (e.g LIMS or RIS)

Then I will be able to accept or override the alert,

And this decision will be recorded for audit purposes.

Application Function

Description

AF315 Configure Workflow rules

The ability to configure automated workflows consisting of sequences of tasks, data flows (messages), notifications and alerts which can be triggered via events (system or manually generated).

EPR MDF Core Capability

D-06.1 - Historic Diagnostic Results and Images

As a Clinical Professional,

I want to be able to view the patient’s historic diagnostic results and images in a structured format,

So that I can make clinical decisions with accurate data.

Acceptance Criteria 1

Given I am viewing a patient record,

When I view results,

Then I should have the option to view historic results.

Acceptance Criteria 2

Given the need to present historic diagnostic results

When displaying the results from the patient record

Then these should be presented in compliance with any relevant test standards

Acceptance Criteria 3

Given the need to include images in results presented

When including images in the patient record

Then the system should comply with relevant medical imaging standards

Application Function

Description

AF215 Order History - Patient

The ability to view a record of order requests made on behalf of a patient including:

• All orders/investigations

• The current status of any outstanding/incomplete requests

• The results of completed tests

• Verification data (e.g. patient identifying information, barcoding)

This should be for current and/or historic care episodes

Standards Compliance

• STD028 Diagnostic Imaging Data Set - SCCI1577 Guidance (NHS Digital)

• STD030 Digital Imaging and Communications in Medicine (DICOM) - ISB 1556 Guidance

• STD069 Pathology Test and Results Standard - DAPB4017 Guidance (NHS Digital)

Addition Information - STD028 - Diagnostic Imaging Data Set

This is an information standard and therefore the trust will have to provide this data to the NHS on a monthly basis

The data set captures information about referral source and patient type, details of the test (imaging code which can be mapped to useful information such as type of test and body site post collection), demographic information such as GP registered practice, patient postcode, ethnicity, gender and date of birth, plus key dates for events in the imaging process to allow derivation of information about waiting times for each diagnostic imaging event, from time of test request through to time of reporting. The data set is coll

EPR MDF Core Capability

D-06.2 - Diagnostic Results filtering

As a Clinical Professional,

I want to be able to filter historic results and images,

So that I can find the results I am looking for quickly.

Acceptance Criteria 1:

Given I am viewing a patient record,

When I view historic results,

Then I should have the option to apply filters to the results

And the applied filters should limit the visible results.

Application Function

Description

AF215 Order History - Patient

The ability to view a record of order requests made on behalf of a patient including:

• All orders/investigations

• The current status of any outstanding/incomplete requests

• The results of completed tests

• Verification data (e.g. patient identifying information, barcoding)

This should be for current and/or historic care episodes

EPR MDF Core Capability

D-06.3 - Diagnostic Results verification

As a clinical professional,

I want the results displayed to include verification e.g. patient identifying information, barcoding,

So that I can ensure that the results I am viewing match the patient I am treating.

Acceptance Criteria 1

Given I am viewing a patient record,

When I view the detailed results,

Then I should see verification information within the results that matches the patient’s record,

And I should be able to flag if the results don’t match the patient.

Acceptance Criteria 2

Given the need to present diagnostic results

When displaying the results from the patient record

Then these should be presented in compliance with any relevant test standards

Acceptance Criteria 3

Given the use of patient barcodes to identify the patient

When displaying the barcode as part of the results

Then follow the guidance in the AIDC standard for patient barcodes

Application Function

Description

AF215 Order History - Patient

The ability to view a record of order requests made on behalf of a patient including:

• All orders/investigations

• The current status of any outstanding/incomplete requests

• The results of completed tests

• Verification data (e.g. patient identifying information, barcoding)

This should be for current and/or historic care episodes

Standards Compliance

• STD069 Pathology Test and Results Standard - DAPB4017 Guidance (NHS Digital)

• STD003 AIDC for Patient Identification - DCB1077 Guidance (NHS Digital)

EPR MDF Transformation & Innovation Capability

D-07.1 - Diagnostic Order Progress

As a Clinical Professional,

I want to view the progress of my order,

So that I am assured that my order has not been overlooked.

Acceptance Criteria 1:

Given the need to create a new order

When my order is opened

Then an view of order progress is available

Application Function

Description

AF360 Order acknowledgement

System issues an acknowledgement when an order is opened. When placing order clinician may request acknowledgement via an alert

EPR MDF Transformation & Innovation Capability

D-08.1 - Diagnostic Time Stamps

As a Clinical Professional,

I want any investigation notes to be visibly time stamped

So that, I can see which notes are current, and the timeline of notes

Acceptance Criteria 1

Given the need to keep up to date with the patients progress

When reviewing investigation notes

Then notes are all time stamped

Application Function

Description

AF215 Order History - Patient

The ability to view a record of order requests made on behalf of a patient including:

• All orders/investigations

• The current status of any outstanding/incomplete requests

• The results of completed tests

• Verification data (e.g. patient identifying information, barcoding)

This should be for current and/or historic care episodes

Standards Compliance

• STD085 The Core Information Standard - The Core Information Standard

EPR MDF Transformation & Innovation Capability

D-09.1 - Single User Interface for Tests and Diagnostics

As a Clinical Professional,

I want to see test results and diagnostics in a single user interface

So that, I don't have to jump between different user interfaces for all diagnostic information,

Acceptance Criteria 1:

Given the need to review tests and diagnostic results

When reviewing the patients care record

Then both test results and diagnostics are in the same user interface

Application Function

Description

AF215 Order History - Patient

The ability to view a record of order requests made on behalf of a patient including:

• All orders/investigations

• The current status of any outstanding/incomplete requests

• The results of completed tests

This should be for current and/or historic care episodes

EPR MDF Transformation & Innovation Capability

D-10.1 - Urgent Diagnostic Results

As a Clinical Professional,

I want, urgent diagnostic requests that are time-dependent to be flagged

and, I need an alert attached to the time dependency

So that, Urgent requests are prioritised and delivered in a timely manner

Acceptance Criteria 1:

Given the need to see urgent requests

When reviewing the patients care record

Then requests are prioritised and delivered in a timely manner

Application Function

Description

AF226 Order alerts

The ability to generate an alert to the requestor when an order is delayed

AF360 Order acknowledgement

System issues an acknowledgement when an order is opened. When placing order clinician may request acknowledgement via an alert

AF361 Order Prioritisation

The system will allow an urgency to be set when placing an order to ensure that urgent orders receive prioritised attention and an appropriate escalation of alerts to manage the timeliness of order processing

The full list of standards applicable to the secondary care setting are contained at the link below

• Secondary Care Standards

The following standards apply more specifically to the requirements on this page

• STD028 Diagnostic Imaging Data Set - SCCI1577 Guidance (NHS Digital)

• STD030 Digital Imaging and Communications in Medicine (DICOM) - ISB 1556 Guidance

• STD069 Pathology Test and Results Standard - DAPB4017 Guidance (NHS Digital)

⬅️ Patient Tracking & Flow

Requirements Map

Provide Medication ➡️