HL7 UK
NHS Implementers Group
Integration Engine Stream
Philip Firth
IM&T Strategy Implementation Manager
Background
• NPfIT is stepping into gear
• Replacement of NHS IT systems will not happen
overnight in Acute Hospital Trusts
• Key existing departmental systems may not even
be replaced before 2010
• Systems integration is therefore a key issue for
Acute Hospital Trusts
Integration strategy
• Integration Engine on its own is not enough!
• Need Master Patient Index for validation
• Need highly skilled IT resources (R&R issues)
• Need money to invest in integration (not a given)
• Need to adhere to LSP advice and guidance
• … WWL is therefore evaluating a range of options
Current status at WWL
• A systems integration architecture was needed to
support the implementation of a web-based EPR
• WWL EPR built on an XML data repository (CSW)
• An architecture for systems integration was
developed in-house using
– Microsoft .NET
– Microsoft SQL Server
– XML technologies – XML, Schemas, XSLT, Stylesheets
WWL Integration Architecture
Requirements for NPfIT
• LSP advice (CSCA):
– The choice of software, hardware and the
maintenance of the Trust Integration Engine
is entirely the NHS Trust’s decision and
responsibility.
Required architecture
• Trust Interface Engine (TIE)
– Trust IE needed to link existing systems in the
Trust to the LSP Data Centre
• Existing System Interface Engine (ESIE)
– LSP IE needed to channel data from the reference
PAS to/from Trust existing systems
• Emergency Bundle Interface Engine (EBIE)
– LSP IE needed to channel data from emergency
bundles to/from Trust existing systems
LSP Existing System Architecture
CSC Data Centre Hosted and Maintained
P1R1 Emergency Bundles
Maternity
Theatres
Results
A&E
2a
1a
P1R1 PAS
2
Emergency Bundle Interface
Engine
(EBIE)
1
Existing System Interface
Engine
(ESIE)
Trust A Hosted and Maintained
2b
1b
Trust Interfacing Engine - A (TIE-A)
Existing Systems
(ES)
What this means for WWL
Messaging standards
• LSP and NPfIT have agreed to base existing systems
integration on HL7 v2
• NOTE: HL7v3 predominantly for NASP integration
• HL7 version 2.3 for EBIE (emergency bundles)
• HL7 version 2.4 for ESIE (reference PAS)
Networking and Security
• Secure delivery of messages sent over the
NHS/N3 network using industry standard SSL
encryption
• HTTPS (Hypertext Transfer Protocol over
Secure Socket Layer)
• SSL V3 encryption
Choices of Integration Engine
• Seebeyond (aka Datagate)
– Used by LSP
• Microsoft BizTalk
– BizTalk 2004 well worth a look?
• Clearspan Server (aka Neon, Microscript)
– A lot of Microscript interfaces in the NHS
• New kids on the block
– WCI, WRQ, Intersystems ... (potentially a lucrative market)
Options
• Buy an integration engine
• Buy in a managed service
• Entirely in-house development
Constraints
• Money
– Local funding is non-existent after 3 years CIP
– LDP funding just hasn’t materialised
• Time
– 101 other things to do
• Resources
– Recruitment and retention is a major issue
– Skills needed are in short supply (.NET, XML, SQL etc)
– NHS wages cannot compete with private sector
• Local considerations
– Need to maintain existing interfaces, not break them
Way forward for WWL
• Money (lack of it …)
– Favours an in-house approach
• Time
– Favours a managed service approach
• Resources
– Favours a managed service approach
• Local considerations
– Favours an in-house approach and
– Favours an integration engine approach
Conclusion
• Balancing all options and constraints it is not easy
to decide on a way forward !!!
• Lucky to have a good in-house integration
architecture – this is our fall-back position
• Knowing we need to satisfy stringent LSP and
NPfIT requirements we will evaluate integration
engines
• Looking to HL7UK and NPfIT / Cluster wide
events/forums for sharing best practice and ideas