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HL7 – Thanks a Billion!

HL7 – Thanks a Billion!. What’s been achieved with Spine Compliance and our first billion HL7 V3 messages…. Peter Dyke, Head of Industry Liaison NHS Connecting for Health peter.dyke@nhs.net 07834 602768. Agenda. Quick recap on NHS National Programme for IT Delivery channels: LSP & ESP

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HL7 – Thanks a Billion!

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  1. HL7 – Thanks a Billion! What’s been achieved with Spine Compliance and our first billion HL7 V3 messages…. Peter Dyke, Head of Industry Liaison NHS Connecting for Health peter.dyke@nhs.net 07834 602768

  2. 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

  3. 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

  4. 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..

  5. 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) “Today” 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 are serviced by non-LSP suppliers whose integration with NPfIT may be enabled and optimised in support of improved patient care. NPfIT is delivered to users by LSPs and ESPs 100% of NHS Clinical IT Systems Market ESPs: The fragmented existing systems and supplier base will consolidate in the various market niches. A degree of integration with NPfIT will be required and enabled for these systems (e.g. CAB). A number of systems will cease to be supported within the NHS market LSP Services are deployed, in some cases incorporating former existing systems as part of their portfolio. 0% 2004

  6. “Existing System Providers” (66 suppliers, 80 systems, >20,000 sites) Independent Sector (CAB, SUS, PDS) Existing NHS PAS (CAB, PDS) GP Systems of Choice (GPSoC) (CAB, EPS, GP2GP, Summary Record) Others Urgent Care, Screening, ONS PACS etc Social Care (PDS, CAF) Community Pharmacy (EPS) “Summary Care Record” North, Midlands & Eastern (NME) LSP (CSC) London LSP (BT) Southern LSP (TBC) “Local Service Providers” (LSPs) Lorenzo Millennium CRS Millennium CRS Agfa PACS (NE, E) GE PACS (NWWM) Philips PACS GE PACS 2004200520062007+ “Spine Compliance” “Spine” (NASP - BT) CAB Choose and Book (NASP - Atos/Cerner) SDS Spine Directory Service SSB Spine Security Broker SUS Secondary Uses Service PDS Personal Demographics Service PSIS Personal Spine Information Service Transaction Messaging Service (TMS)

  7. “LSP Compliance” “LSP Compliance” NHS Care Records Service Spine Spine Compliancevs.“LSP Compliance” Direct spine connection for certain ESP systems CSC LSP BT LSP System G “Spine Compliance” iSOFT (Lorenzo) Cerner (Millennium) Specialist or departmental functionality included within core Lorenzo/Millenium clinical application Specialist 1..n Specialist 1..n System X System A LSP provided specialist or departmental system from other supplier System Y System B System Z System C Existing Specialist or departmental system interfacing with LSP solution

  8. EPS SUS SCR GP CAB PACS PDS “Common Assurance Process” (CAP) Define Requirements Design, Build, Test NHS CFH ESP team work with ESPs Live Service Deployment ESPs deliver new services to one to 000’s of customer sites Existing System Providers (ESPs) Users Benefit.. Trusts PCTs GPs Non-NHS LSPs ..or don’t.. NHS Connecting for Health How we progresseswork with ESPs.. NHS CFH Programme teams drive delivery SCPEA Social Care PDS Early Adopters Summary Care Record Secondary Uses Service Systems Of Choice Electronic Prescriptions Choose and Book Picture Archiving PDS Birth Notifications

  9. 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) Patient Demographics Service (PDS) Access/Update “PDS Compliance” Ability for system & individual to access/update patient demographics – validate against NHS Number Access Control Framework (SDS, SSB) “IG Compliance” Ability for system, site and individual in their role to authenticate against and access the spine. Ability to interact with TMS via EBXML/HL7V3/MIM with Spine Transaction Messaging (TMS) Basic Connectivity (N3) Install link to NPfIT services, configure firewalls/routers to access Spine Being “Spine Compliant”1. PDS/IG “Foundation” Compliance

  10. NHS Acute/ Community/ Mental Health or ISTC EPR/PAS Community Pharmacy Urgent Care Choose and Book (CAB) NPFIT-FNT-TO-TIN-1032 Electronic Prescriptions NPFIT-FNT-TO-TIN-1050 Summary Record NPFIT-FNT-TO-TIN-0830 GP System Being “Spine Compliant” (2)2. Current Functionality Summary Record NPFIT-FNT-TO-TIN-0830 GP2GP Transfer NPFIT-FNT-TO-TIN-0402 Electronic Prescriptions NPFIT-FNT-TO-TIN-1050 Choose and Book (CAB) NPFIT-FNT-TO-TIN-1032 PDS/IG Compliance (PDS = NPFIT-FNT-TO-TIN-1023, IG = NPFIT-FNT-TO-TIN-1031)

  11. Being “Spine Compliant” (3)3. In pilot.. Birth Notifications PACS Social Care Others PACS Cluster Store Common Assessment Framework Birth Notifications Pathology, Telehealth etc PDS/IG Compliance (PDS = NPFIT-FNT-TO-TIN-1023, IG = NPFIT-FNT-TO-TIN-1031) Note: Dotted line boxes indicate detailed Compliance Baseline is draft or not published

  12. 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

  13. 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

  14. HL7 – Thanks a Billion! Questions? Peter Dyke, Head of Industry Liaison NHS Connecting for Health peter.dyke@nhs.net 07834 602768

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