Introduction to the National
code list of laboratory items (NÄLP in Czech)
When ordering or communicating measured or observed
results, clinical laboratories have to clearly define the quantity to which a
value (a result of measurement or observation) is assigned. In this sense, the
term âquantityâ is meant to indicate a particular characteristic that always
involves information about the measured system and component. A component is
the subject of a measurement or observation (for example glucose as an analyte,
erythrocyte as a cell, synthesis as property, etc.). A system is a bounded part
of a universe, where a particular component can be found (for example
environment, patient, blood, plasma, or urine). The third determining
characteristic is a kind-of-property (for example weight, length, substance
concentration, compatibility, or presence). Kind-of-property determines the
unit of measurement (for example kg, meter, mol/L, katal/L, and their
multiples). A type of procedure complements a more detailed specification of a
quantity (absorption spectrophotometry, microscopy, FPIA, etc.). These five
terms make up the conceptual basics of the NÄLP. Individual laboratory items
are defined by assembling the five above-mentioned elements from predefined
building blocks stored in relevant code lists. Such assembly of five terms is
assigned a unique NÄLP key.
The
National code list of laboratory items is used mainly by clinical laboratories
with a focus on clinical biochemistry, clinical haematology, clinical
immunology, nuclear medicine (in vitro methods), laboratory part of transfusion
medicine, clinical microbiology, serology, and the like. NÄLP is used for
requesting laboratory tests, communicating their results, working with
laboratory tests, archiving laboratory data, and also other activities where
appropriate. Healthcare information systems use it mainly to define items
determined not only by clinical laboratories but by paraclinical fields in
general. It can be further used for data transfers within the Data standard and
to communicate patient data between information systems of healthcare
facilities (in sense of the methodological instructions of the Ministry of
Health).
At the national level, the NÄLP is maintained
centrally in cooperation with the Ministry of Health. This way ensures a
connection to a corresponding version of âData standard for the transfer of
patient data between information systems of healthcare facilitiesâ.
Locally, the application is provided by an
authorised laboratory specialist who, for every measured (and communicated)
laboratory item, selects a corresponding counterpart from NÄLP and thus ensures
an unambiguous mapping (including the addition of other necessary information).
The mapping method depends on a particular
laboratory information system. Due to the highly professional nature of
mapping, it is not recommended to entrust the task to employees of external
organisations (providing for example maintenance of the laboratory information
system). Correct mapping creates a basis for electronic communication between
information systems and it is directly related to the issue of âgood laboratory
practiceâ.