hl7 – thanks a billion! what’s been achieved with spine compliance and our first billion hl7 v3...

HL7 – Thanks a Billion!

What’s been achieved with Spine Compliance and our first billion HL7 V3 messages….

Peter Dyke, Head of Industry LiaisonNHS Connecting for [email protected] 602768

mailto:[email protected]

Agenda

• Quick recap on NHS National Programme for IT• Delivery channels: LSP & ESP• “Spine Compliance” & “LSP Compliance”• How NHS CFH works with ESPs• Learning points & looking forward• Questions

National Programme for IT (NPfIT)

£12.7bn programme initiated in 2001(NHS Annual Budget = £95bn-ish)

Provides new services for the NHS in England• Choose and Book (CAB) 13,472,739 bookings made (33k per day, c. 50%)• Electronic Prescriptions Service (EPS) 168,881,954 prescription

messages issued (c 24%)• GP2GP records transfer: 5,205 practices live, 475,248 records transferred

• Summary Care Record live: 240,040 records live on the spine• New National Network (N3) >32,000 connections• NHSmail almost 400,000 users, 983,142 average messages per day• National Care Records Service “Spine” 569,581 smartcard users• PACS 127 sites live • Local Care Records Services (Local Service Providers – LSP)

Data as of 22/2/09

Delivering NPfIT

Delivered via two main routes (since 2004):

• Prime Contractors to NHS CFH – National Application Service Providers (NASPs) and Local Service Providers (LSPs)

• Via Existing Systems Providers (ESPs) with contracts already in place with NHS Trusts, PCTs or other care provider organisations

..If a supplier hasn’t built it, a customer can’t use it..

NPfIT is delivered to users by LSPs and ESPs

ESPs: The fragmented existing systems and supplier base will consolidate in the various market niches. A degree of integration withNPfIT will be required and enabled for these systems(e.g. CAB). A number of systems will cease to be supported within the NHSmarket

ESPs: A number of existing systems will continue in use in the NHS market for a prolonged period or in niche and specialist areas. Users will require that these systems are integrated with NPfIT to the maximum extent possible e.g. GP Systems of Choice (GPSoC)

LSP Services are deployed, in some cases incorporating former existing systems as part of their portfolio.

20040%

100% of NHSClinical IT SystemsMarket

ESPs: Care is delivered outside the traditional NHS boundary. Aligned specialist IT system markets exist: Social Care, Independent Sector, Community Pharmacy, Dentistry, Opticians etc. These areserviced by non-LSP suppliers whose integration with NPfIT maybe enabled and optimised in support of improved patient care.

“Today”

“Spine Compliance”

“Spine”(NASP - BT)

SSBSpine

SecurityBroker

PDSPersonal

Demographics Service

PSISPersonal Spine

Information Service

SUSSecondary

Uses Service

SDSSpine

Directory Service

North, Midlands & Eastern (NME)LSP(CSC)

London LSP(BT)

SouthernLSP(TBC)

Agfa PACS (NE, E)

Lorenzo

GE PACS (NWWM)

Millennium CRS

Philips PACS

Millennium CRS

GE PACS

“Local Service Providers” (LSPs)

CABChoose and Book

(NASP - Atos/Cerner)

IndependentSector

(CAB, SUS, PDS)

Existing NHS PAS

(CAB, PDS)

CommunityPharmacy

(EPS)

GP Systems of Choice (GPSoC)

(CAB, EPS, GP2GP, Summary Record)

Social Care

(PDS, CAF)

“Existing System Providers” (66 suppliers, 80 systems, >20,000 sites)

OthersUrgent Care,

Screening, ONSPACS etc

2004 2005 2006 2007+

Transaction Messaging Service (TMS) “Summary Care Record”

Spine Compliancevs.“LSP Compliance”

NHS Care Records Service Spine

CSC LSP BT LSP

iSOFT (Lorenzo) Cerner (Millennium)

System A

System C

System B

Specialist 1..n

System X

System Z

System Y

Specialist or departmental functionality included within core Lorenzo/Millenium clinical application

LSP provided specialist or departmental system from other supplier

Existing Specialist or departmental system interfacing with LSP solution

Direct spineconnection for certain ESP systems

System G

“Spine Compliance”

“LSP Compliance”

“LSP Compliance”

Specialist 1..n

How we progresseswork with ESPs..

NHS CFHProgramme

teamsdrive

delivery

Trusts PCTsUsers

Benefit..

Existing System Providers (ESPs)

GPs LSPsNon-NHS

ESPs deliver newservices to

one to 000’s of customer sites

..or don’t..

EPSPACSCAB GP SCR

NHS Connecting for Health

Choose and Book

PictureArchiving

ElectronicPrescriptions

SystemsOf Choice

SCPEA

Social Care PDS EarlyAdopters

PDSPDS Birth

Notifications

NHS CFH ESPteam work with ESPs

DeploymentLive

ServiceDesign, Build,

TestDefine

Requirements

“Common Assurance Process” (CAP)

Summary Care

Record

SUSSecondary

UsesService

Described in “Compliance Baseline Index” in “FileCM”PDS = Document NPFIT-FNT-TO-TIN-1023 (EXT PDS Folder)IG = Document NPFIT-FNT-TO-TIN-1031 (EXT IG Folder)

Being “Spine Compliant”1. PDS/IG “Foundation” Compliance

Basic Connectivity (N3) Install link to NPfIT services, configure firewalls/routers to access Spine

Patient Demographics Service (PDS) Access/Update

“PDS Compliance”Ability for system & individual to access/update patient demographics – validate against NHS Number

Ability to interact with TMS via EBXML/HL7V3/MIM with SpineTransaction Messaging (TMS)

Access Control Framework (SDS, SSB)

“IG Compliance” Ability for system, site and individual in their role to authenticate against andaccess the spine.

Being “Spine Compliant” (2)2. Current Functionality

PDS/IG Compliance(PDS = NPFIT-FNT-TO-TIN-1023, IG = NPFIT-FNT-TO-TIN-1031)

Choose and Book (CAB)

NPFIT-FNT-TO-TIN-1032

Electronic Prescriptions NPFIT-FNT-TO-TIN-1050

GP2GP Transfer


Summary Record


GP System

Choose and Book (CAB)


NHS Acute/ Community/

Mental Health or ISTC

EPR/PAS

Electronic Prescriptions NPFIT-FNT-TO-TIN-1050

CommunityPharmacy

Summary Record


Urgent Care

Being “Spine Compliant” (3)3. In pilot..

PACS Cluster Store

Common Assessment Framework

Birth Notifications

PACS Social CareBirth

Notifications

Pathology, Telehealth etc

Note: Dotted line boxes indicate detailed Compliance Baseline is draft or not published

PDS/IG Compliance(PDS = NPFIT-FNT-TO-TIN-1023, IG = NPFIT-FNT-TO-TIN-1031)

Others

Learning Points

• Interoperability is achievable at scale• Needs market-wide configuration control• Mind the (vast) knowledge gaps• Attend to basic governance structures• Communication skills• Foster a culture of mutual respect• Understanding that LSP and ESP is “OK”• Align supplier motivation & commercials• End user engagement

Future Opportunities

• Even greater scale (double)• Even greater clinical complexity• Taking cost out across the value chain• Users taking greater ownership• Product Portfolio Discipline• Education, Education, Education

HL7 – Thanks a Billion!

Questions?

Peter Dyke, Head of Industry LiaisonNHS Connecting for [email protected] 602768

mailto:[email protected]

hl7 – thanks a billion! what’s been achieved with spine compliance and our first billion hl7 v3...

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