Diagnostic ordering, results and imaging
At a glance
Treat a diagnostic pathway as linked but distinct legs: request or order, acknowledgement and status, report or result, and—where applicable—imaging discovery or retrieval. Authority and standards for one leg do not automatically govern the others.
Return to the Out-of-PHC row or Into-PHC row.
Scope and boundaries
This family covers pathology and other diagnostic requests, the necessary patient/requester/specimen or procedure context, acknowledgements, cancellation and status, final reports or results, and approved retrieval of prior imaging. Name the exact order-communications, laboratory, radiology or imaging service.
DAPB4101 applies to its scoped laboratory-to-requesting-GP pathology-reporting leg; it is not the outward test order or every result workflow. The National Imaging Registry (NIR) is a conditional direct-care service/API for approved imaging discovery and retrieval; it is not DAPB4101, an information standard or a universal PHC entitlement. CLM-053 CLM-055
Out of primary healthcare
PHC sends the request, patient and recipient identifiers, requester details and the minimum clinical context needed to perform and interpret the test. Acknowledgement, amendment, cancellation and later report must remain correlated without treating the outbound order as proof that the result was received or acted upon.
Into primary healthcare
For a result or report, PHC must verify the patient, request, source, codes, units, abnormal or provisional status and clinical owner. It needs defined workflows for review, acknowledgement, correction, duplicate or partial results, late arrival and downtime.
For NIR, an eligible onboarded consumer may discover and retrieve imaging metadata, reports or images for an accepted direct-care use case. Current integration uses IHE XCA/XCA-I; MHD/FHIR R4 remains roadmap capability. Local matching, review, safety, access, audit and fallback responsibilities remain. SRC-077
How the requirement layers apply
| Layer | Workflow-specific position |
|---|---|
| Legislation | UK GDPR and DPA 2018 apply to the request and result. A Section 251B duty may apply to an in-scope direct-care sender but does not replace necessity or confidentiality. |
| Regulations | No universal diagnostic-order regulation is identified here. Apply the exact test, service, contract and any specialist regime. The information-standards procedure regulations do not authorise the clinical flow. |
| Standards | Apply NHS Number, SNOMED CT, UK Core FHIR, DCB0129, DCB0160 and DSPT when scoped. DAPB4101 is limited to its pathology-reporting leg. IHE XCA/XCA-I supports current NIR discovery/retrieval; NIR itself remains a service/control. |
| Confidentiality and other controls | Apply common-law confidentiality, Caldicott, matching, sender/requester identity, provenance, codes and units, abnormal-result handling, clinical ownership, correction, audit and downtime. NIR additionally requires accepted use case, onboarding and organisational agreements. |
Minimum, conditional and higher assurance
- Required floor: the minimum correct request or report content plus matching, meaning, confidentiality, safety, acknowledgement, ownership and failure controls.
- Conditional envelope: use only the request context, result or imaging content necessary for the current care purpose and authorised role.
- Higher-assurance ceiling: end-to-end correlation, structured terminology and units, explicit status, dependable acknowledgement, actionable abnormal-result routing, correction feedback and safe fallback.
Failure states and ownership
Test mismatched patients or requests, lost acknowledgements, duplicate orders, cancellation races, amended or partial reports, abnormal results without ownership, unit/code loss, inaccessible imaging, unavailable external networks and ambiguity between “delivered”, “viewed” and “clinically actioned”.
Evidence and open checks
Maintained evidence: SRC-016, SRC-017, SRC-019, SRC-020, SRC-022, SRC-028, SRC-040, SRC-077. Current date/status conflicts and implementation checks are tracked in VAL-028 and VAL-030.
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