PKB accepts coded data sent via HL7 in ADT A28 and ADT A31 messages and from the EMIS extract service for allergies, diagnoses and medications.
All local codes may be sent as a 'code' and 'code system' pair. Where provided PKB displays the code and the coding system on screen as additional details with the allergy, diagnosis or medication. We will display 'code' value if no 'code system' provided, but if no 'code' provided then the 'code system' will not display.
All code systems are supported for receipt and display, including SNOMED CT, Read v2, and Dm+D.
PKB maps each coded data to a pre-set default privacy label. Code to privacy mappings are only currently available for Read V2 codes with SNOMED CT mappings to come in 2019.
If you would like to send Read V2 codes to PKB for allergies and diagnoses:
The "code system" must be sent as "Read V2". Any other variation on this will be accepted and displayed on screen but the privacy label look-up will only work if the code system is sent exactly as specified.
The Read V2 code must have 5 characters.
PKB will show the term as sent. The Read code look-up will not select a term only a privacy label and datatype.
For HL7 messages with a Read V2 code PKB maps using the Read V2 codes mapping table. PKB does not yet have a Snomed code mapping.
For unmapped codes, PKB defaults to the 'General Health' privacy label.
Each EMIS data point has a Read V2 code or EMIS proprietary code. PKB maps these to privacy labels using the Read V2 codes mapping table or the EMIS proprietary codes mapping table.
As PKB is moving toward supporting privacy label mapping for SNOMED CT codes, the SNOMED CT concept ids are included in these tables. If you have any feedback or suggestions on the mapping tables please contact the PKB team.
The principles we've followed in determining these mappings for diagnoses are:
Mental - all items in Chapter E of Read V2 (Mental disorders) EXCEPT those falling under Sexual
mental health symptoms and conditions
substance dependence
mental development disorders
dementia
autism
Sexual
sexually transmitted infections incl. neonatal e.g. chlamydia, gonorrhoea, trichomonas, HIV
fertility related (K26.., K5B..) e.g. IVF, sperm motility issues
sexual disorders e.g. dyspareunia
female genital mutilation
termination of pregnancy
gender identity related
sexual preference related
NOT pregnancy, miscarriage or childbirth related (general)
Social
non-accidental injury / abuse
General - everything else including
alcohol related organic illness (e.g. cirrhosis)
poisoning - any chemical, drug or medication
cancer
any allergy or adverse event
All medications and allergies are assigned 'General' privacy label. The patient can modify this if preferred manually in PKB.
More information on how privacy labels are applied can be found on our developer wiki page.
This currently only applies to data received from the EMIS extract service. For HL7 the datatype is implied by the segment, for consistency we recommend matching the PKB datatype mappings.
PKB stores data received via HL7 according to the mappings specified in the HL7 message.
For Read V2 codes PKB mapped datatype using these principles:
'diagnosis' for Read V2 codes A-S
'allergy' for EmisCodeCategoryDescription is one of
Allergy and adverse drug reactions
Allergy and adverse reactions
'unmapped' for all other Read V2 codes. These are not processed or stored.
For EMIS proprietary codes PKB mapped using these principles
Allergy for EmisCodeCategoryDescription is one of
Allergy and adverse drug reactions
Allergy and adverse reactions
Diagnosis where EmisCodeCategoryDescription is a diagnosis in one of these categories
Conditions, operations and procedures
KC60
Obstetrics and birth
The Read V2 codes which are 'unmapped' and thus not currently processed or stored are those where EmisCodeCategoryDescription is one of:
Administration, documents and attachments
Biochemistry
Biological values
Body structure
Care episode outcome
Cytology/Histology
Dental disorder
Dental finding
Dental procedure
Diagnostics
Discharged from service
EMIS qualifier
Ethnicity
Family history
Haematology
Health management, screening and monitoring
HMP
Immunisations
Immunology
Intervention category
Intervention target
Investigation requests
Marital status
Microbiology
Nationality
Nursing problem
Nursing problem domain
Pathology specimen
Personal health and social
Planned dental intervention
Problem rating scale for outcomes
Procedure code
Radiology
Reason for care
Referral
Referral activity
Referral rejected
Referral withdrawn
Regiment
Religion
Symptoms and findings
Trade/branch
Unset (drugs and devices)
Observation types that are not being processed in the initial integration will be added in subsequent phases.
Diagnoses and allergies are grouped at display time in the PKB GUI if they have all of these the same
code (if present)
description (if present)
source
route
The episode information will be expanded by default for professionals and collapsed for patients.
<In development>
The title line of a group will display with description and the following dates:
Allergies: last noted date (recommended by NHS digital)
Current diagnoses: date first reported
Past diagnoses: date ended.
EMIS does not send Summary Code Record sensitive Read V2 codes to PKB.
PKB discards additional sensitive Read V2 codes and EMIS proprietary codes, when received by HL7 or in the EMIS extract service. These data points will not be stored in the patient's record. This is set of Read v2 and EMIS codes our customers favoured excluding.