Australian pathology services are provided by public and private laboratories and provide the foundations on which much of the science of medicine is based.
Pathology in the Australian context
Private laboratories are majority funded by the Australian Government via a fee-for-service basis with the Medicare Benefits Schedule (MBS). Public laboratories operating within public hospitals are mainly funded by the state government’s public hospital funding allocation, however hospitals also access MBS where possible.
It has been estimated that pathology investigations feature in up to 70 per cent of medical diagnoses. In Australia, over half of all Australians have a pathology test each year and there are currently about 34 million pathology requests and 100 million pathology reports produced annually. Half of all pathology tests are undertaken on 7 per cent of patients. We can assume that most testing is performed for those with chronic disease.
A number of these pathology tests require multiple reports for different test types and multiple copies are distributed to clinicians. The Pathology Funding Agreement aims to constrain the increase in pathology costs to approximately 5 per cent per annum.
Context in digital health
There are a number of key business flows that occur within digital health in Australia, as outlined in Figure 1 below.
Figure 1: Digital health business flows for pathology
These flows are described below:
1. A requesting clinician sends a referral (frequently in paper form given to the consumer) to the pathology provider. This form (electronic or paper) provides consent and identify information for future use when accessingMy Health Record.
2. The pathology provider will provide the report (and any subsequent updates) to the requesting clinician and any other listed recipient on the request.
2a. Electronic pathology reports can be used to share information about pathology tests via an individual's digital health record. The Pathology Report PDF may contain one or more tests that are uploaded by the pathology provider to the individual's digital health record.
3. Clinicians can retrieve the pathology reports from My Health Record using either their clinical information system or the national provider portal. Results are available in this way as soon as they have been loaded to My Health Record.
4. Consumers can view their pathology reports on My Health Record after 7 days after their test. This delay allows the requesting clinician to review the results and determine if further clinical counselling is required.