Services Description
GPSoC Service Name
Healthcare Gateway Ltd – MIG – Specialist Data Sets
GPSoC Service ID
Service Overview
HGL-SDATA
The Healthcare Gateway (HGL) Specialist Data Set Service (SDATA) enables
clinicians to share a rich array of patient data as either structured data sets
(OpenHR) or as tailored views according to specific health conditions.
With a variety of different data sets for specific long term conditions and end of
life services, Specialist Data Sets ensure healthcare professionals have access to
the real time relevant medical information for the patient.
Consuming systems also have the ability to check if there is a particular data set
available for a patient, averting the need for a standalone data repository.
The current Specialist Data Sets available are for:










COPD
Supportive Care (Inc. Advanced Care Planning)
EMIS Web Community Views
Care Plans
End Of Life National Data Set
End Of Life Enhanced Data Set
End of Life Enhanced Data Set Plus Frailty
End Of Life for Ambulance Services
Special Patient Notes
Medications and Allergies
Additional data sets will be added to the service when available.
The Specialist Data Set service has the same audit capability as the DCR V2
service. This includes:






Case Studies
Name of the clinician who has viewed the patient’s record
The viewing organisation
Date and time the record was accessed
The viewing organisation department
Consent status – Given, Refused, Emergency (including reason for
emergency access)
The sharing agreement used (content model)
End of Life care in University Hospitals of Morecambe Bay and across NHS
Lancashire North CCG
There’s been a strong history of good palliative care in the North West. The
ambition is to provide gold standard end of life care to patients wherever they
present but there was a fundamental problem that the necessary information was
stuck in the GP record; the hospitals were not getting the information they
needed.
A joint project across the Hospital, the CCG with Healthcare Gateway was the
answer. Healthcare Gateway’s Detailed Care Record V2 and Specialist Datasets
shares the Electronic Palliative Care Co-ordination Systems (EPaCCS) record
with the hospital.
The MIG shows relevant End of Life (EoL) information from the GP practices as a
view inside Lorenzo, the hospital’s clinical system. The interoperability the MIG
offers means the hospital didn’t have to replace their current software to have
access to the information; it was integrated straight into the current system from
the GP records.
Tim Reynard, GP clinical lead for Health Informatics at Lancashire North CCG,
believes there are three main benefits;
1.
Automatic alerts
The patient’s supportive care record is automatically shown as an alert; if there is
one present. As only about 1% of patients coming into hospital have a palliative
care record, doctors might not have checked whether one is present as a matter of
course.
2.
Delicate handling of sensitive information
Having access to a patient’s preferences enhances the patient experience by
making healthcare professionals aware of what EoL care has been decided upon.
It can be distressing for patients to repeat what their preferences are.
Also if the patient has deteriorated and is not able to state their preference, there
is break glass functionally in the MIG, which means that consent couldn’t be
given but a reason for accessing the record can be provided for an audit.
3.
Spend more time with patients
Healthcare professionals having access to the same information for palliative
care means that there is less duplication in data entry and will free up staff time to
spend more time with patients.
Tim goes onto say “the nurses and team absolutely love it, it is extremely useful.
Having this information available to colleagues undoubtingly empowers the
patient.”
The roll out of the project is led by the palliative care team who will train the
other teams in the hospital.
A&E and acute care are using the information at the moment but there is an
ambition to share more widely across healthcare teams, such as out of hours
(OOH) and in the wider network of any team providing care.
Support
The Healthcare Gateway Limited (HGL) support team provides first point of
contact and own all issues with client support underpinned by robust service level
agreements ensuring service incidents are fully managed and handled swiftly.
Calls are logged through the HGL Service Desk who liaise with all customer and
suppliers until resolution. Clients have a Customer Operational Service
Agreement which outlines contact details, service levels, availability, priority
guidelines and escalation paths for contacting support. Regular service review
meetings are held at project board level between the HGL relationship manager
and clients to ensure effective service delivery is being achieved.
HGL also hold Operational Service Agreements between HGL and its data
providers which details the contact points, issue handling and responses, service
levels, availability, downtime procedures and escalation points. Evidence of the
overall service regime can also be demonstrated by the fact that the service is
certified to ISO 20000.
Service Availability
HGL provide a minimum 99% uptime service availability level during Standard
Support Hours.
Change Management
HGL have permitted downtime periods for the purpose of system administration
and maintenance. Permitted downtime is granted and controlled within our
change management process. We reserve the right to use this at our discretion,
provided that appropriate change controls are utilised and changes are subject to
approval by our change advisory board (CAB). Changes are implemented
utilising pre-determined change windows, these are available to review on
request. HGL will inform clients of any changes via the nominated contacts
within each client organisation.
Annual Permitted downtime allowance
An annual allowance of 12 hours of downtime is available for use in the provision
of major upgrades and service continuity testing and is subject to five working
days’ notice to clients when utilised. This allowance is only available for use
within the calendar year and cannot be rolled over to subsequent years, if unused.
Helpdesk Arrangements
The HGL Healthcare Gateway helpline has standard support hours of:
Monday to Friday
Saturday
Sunday/Bank Holidays
08:00 to 18:00
09:00 to 13:00
Closed
Priority 1 Incidents are classed as a MIG service major incident which causes
significant business impact and prevents the user from providing a normal
service. These would typically be incidents which:



Cause unavailability of the entire service, a key module or major function
Or cause incorrect processing of data or errors in a major system
function
And affect all users at multiple organisations
Priority 2 Incidents are classed as MIG service incidents which cause localised
business impact and limit the ability of the user to provide a normal service.
These would typically be incidents which:
 Cause unavailability of individual organisations, a key module or major
function
 Or cause incorrect processing of data or errors in a major system
function
 And affect some users at multiple sites or all users at a single site.
[Note that the response times for Major incidents can be the same as for critical
incidents, and can be dealt with in the same way]
Priority 3 Incidents are classed as MIG service incidents which cause minor
business impact and affect non-critical functions. These would typically be
incidents which:
 cause minor disruption of services
 And leave most functions available but restrict performance, causing
inconvenience
Priority 4/5 Incidents are classed as Service incidents which cause negligible
business impact, and do not prevent the use of system functions.
Incident Procedure
In the event of a failure with the service, the source organisation should contact
their normal 3rd party system supplier as per existing processes and agreements
to enable 3rd Party Supplier to perform their preliminary investigations and
resolves any issues within their control.
Once satisfied that the 3rd Party Supplier application have been eliminated as
possible cause of the service failure, the source organisation will be responsible
for reporting the incident to HGL support in order raise a new incident with them.
The HGL support team will record the incident, assigning it an appropriate
priority level based upon the impact and urgency of the incident. Once the
incident record has been created and all necessary details provided, HGL support
will assume incident ownership and responsibility for resolution within the target
time determined by the chosen priority level. HGL will keep track of incident
progress with all resolving parties (e.g. GP system suppliers) and provide updates
to the Source Organisation.
Major Incidents
Priority 1 incidents will be treated as Major Incidents. These follow the standard
process in terms of recording and resolution, but with the addition of an
escalation/communication process to involve all relevant resolving parties at the
earliest opportunity after opening the incident. In the first instance, invocation of
a major incident will be notified to all contacts supplied by the customer and
relevant GP supplier stakeholders. Subsequent updates provided every 2 hours or
as advised. Where co-ordination of investigation activities is required across
different stakeholders, HGL will chair a meeting with the major incident group via
a teleconference to agree next steps in investigation to ensure all relevant actions
are covered.
Service Levels
An incident log created by Healthcare Gateway support will be given a priority
which will dictate the target resolution time. The priority is derived from the
assessment of the impact and urgency of the reported issue (see above). The
priority levels and target times are as follows:
Service Level Priority & Resolution targets
Priority Level
Target Resolution Hours
1
4
2
8
3
16
4
48
5
144
Resolution times operate within support hours only and apply to MIG errors only.
Where incidents are referred to another party Healthcare Gateway support is not
responsible for the resolution time and the Service Level Agreement (SLA) will be
placed on hold at the point of handover to the supplier.
Escalation
An incident can be escalated in the following scenarios:





Dependencies
An incident is nearing, or has breached its target resolution time or is at
risk of breaching
The circumstances, impact or urgency of the incident has changed
suddenly
A progress update has not been received or contains insufficient
information
The resolution provided was not sufficient
In all cases an escalation can only apply to an existing incident record.
Healthcare Gateway Limited publishes a list of escalation contacts available to all
customers with names, telephone numbers and email addresses.
Service Dependencies
The HGL Specialist Data Set service is designed to connect existing and trusted
systems together within a locality; therefore there is no additional requirement for
hardware or software license. Third party suppliers consuming or providing data
through the MIG will be required to be MIG compliant. There are already many
MIG enabled system suppliers, however for those not compliant; these systems
will be required to progress through the MIG supplier accreditation process. HGL
provide a MIG software development kit, technical specifications, test harnesses
and sample messages to support this process, including access to the MIG
technical integration team. This complete service is free of charge.
Third Party Dependencies

GP Systems providing data must currently be EMIS

GP Practices must have enabled data streaming to EMIS Web

Sharing Agreements must be in place with GP Practices as per the HGL
content model
Third Party Supplier Engagement
Before the actual service goes live, HGL will check that it has gone through full
user acceptance testing ensuring it meets the customer needs. HGL have
developed test plans to be used for acceptance testing of all MIG services, these
test plans can be adapted or incorporated into the customers’ acceptance criteria,
if the MIG service forms part of a wider project scope or the customer wishes to
expand on the acceptance criteria.
The Testing Phase will include a pipe cleaning exercise to ensure all security
certificates have been successfully installed and all firewalls have been opened.
Following a successful pipe-cleaning exercise a date will be agreed with all
stakeholders to go through full end to end testing as per the agreed test plans and
criteria.
Infrastructure Dependencies
The Specialist Data Sets Service requires no specific hardware or software to be
used. The only infrastructure dependency is that the customer must use N3 to
access the Service.
Local Personnel Dependencies
All organisations either consuming or providing data must have signed a data
sharing agreement and clients must have allocated local project management
resource during the implementation phase before the service can be made live.
To ensure a smooth implementation, there is a requirement for dedicated project
management resource from the customer side. This is typically required to support
stakeholder engagement, information governance and data sharing agreement
sign off and supplier integration.
Sub-Contractor(s)
N/A
Pricing Information
Implementation Charges
The HGL Specialist Data Sets are charged on a managed service model which
reflects the discreet nature of the specific data sharing exchange. As a managed
service, Healthcare Gateway Limited (HGL) provides all the required technology
to broker and route data from end to end, including the necessary hosted
infrastructure, configuration, and system support. This is complimented by
implementation services to project manage the deployment, during which we will
work with all stakeholders and suppliers. This approach provides customers with
flexibility and scalability to adapt to changing conditions and improves security,
business resilience and overhead and risk. New MIG services can be incrementally
added and can benefit from reduced charges based on volumes.
HGL separate the service implementation charges into two components, Project
Initiation and Implementation.
Project Initiation
On contract signature, HGL will request that a Projection Initiation meeting takes
place (normally within 7 working days) with all stakeholders. This meeting will
initiate a phase of work to confirm and agree:
Project scope, commercials and deliverables for the project
Project dependencies such as supplier accreditation and information
governance/sharing agreements
Customer and HGL responsibilities
Support procedures and issue reporting handovers
Training requirements
Implementation process
Test Plans and acceptance criteria
Project plan
This project initiation phase is charged at £1,300
Implementation
Following the project initiation phase, HGL follow the agreed implementation
project plan, which will be updated by HGL as the project progresses. The
appointed HGL project lead will ensure regular check point calls are scheduled
with all stakeholders to discuss progress, raise risks and/or issues and review
progress in line with the implementation. HGL will also ensure that before any
MIG Service can go live, the customer is familiar with the HGL support process as
outlined the HGQM002 MIG Operational Service Agreement and that
communication plans are in place to support the HGL Major Incident Process or
Maintenance Events.
A standard implementation will cost £2600 per consuming system (such as out of
hours) that the customer wishes to connect and this charge covers all work
required by HGL to implement the service to the agreed project plan.
Summary of Implementation Charges
Project Initiation - £1300
Implementation - £2600 (Per consuming system)
Service Charges
Charge Description
Unit Price (exc VAT);
Providing a Specialist Data Set for up to 7p per patient per annum
100,000 Patients
Exit Charges
See volume discounts section for pricing
larger volumes
HGL do not apply any exit charges to customers once a contract has ended. On
contract expiry, HGL will ensure that all sharing agreements and end point
configurations are disabled for that service.
Invoicing Terms
All HGL implementation and service charges will be invoiced in arrears.
Invoice frequency
Project Initiation will be invoiced on the production of the agreed project
implementation plan.
The Implementation charge will be invoiced once the “Commencement of Service”
Milestone has been reached. This is the point at which HGL has completed the
necessary configuration work to enable all end points and that the service is
available for use by the customer. For the avoidance of doubt this does not mean
that the customer needs to have actually commenced use of the service.
Service Charges will be invoiced three months in arrears. The first invoice will be
produced 3 months following the date of the Commencement of Service Milestone.
Invoice delivery period
Invoices will be produced within 5 working days after the completion of the
Project initiation phase, Commencement of Service or a three monthly service
charge period.
Payment Terms
Due date for payment
30 days after receipt of a valid invoice
Details of any early payment discounts
None
Discounts
Volume Discounts
Number of Patients
First 100,000 patients
Next 200,00 patients
(up to 300,000 patients in total)
Next 200,000 patients
(up to 500,00 patients in total)
Above 700,000 patients
Discounted Prices
7p per patient per annum
5p per patient per annum
4p per patient per annum
2p per patient per annum
Worked Pricing Example
Connecting 1 x Consuming System (e.g. Out of Hours Service) and providing them
with 1 x Specialist Data Set for a local population of 280,000 patients:
100,000 patients * 0.07= £ 7,000
180,000 patients * 0.05= £ 9,000
Total Annual charge ---- £16,000 (per annum)
Project Initiation charge ---------------------------- £1,300 (one off)
Implementation charge (1 Consuming System) -- £2,600 (one off)
Existing customers who have already contracted for DCRV1 or DCRV2 are
eligible for existing client discounts which reduces the cost of the Specialist Data
Set Service. Please see below.
Volume Discounts for customers with existing DCRV1 or DCRV2 services
Number of Patients
Discounted Prices
First 100,000 patients
Next 200,00 patients
(up to 300,000 patients in total)
Next 200,000 patients
(up to 500,00 patients in total)
Above 700,000 patients
2.34p per patient per annum
1.98p per patient per annum
1.62p per patient per annum
1.26p per patient per annum
Worked Pricing Example based on customer with existing MIG DCR service
Connecting 1 x Consuming System (e.g. Out of Hours Service) and providing them
with 1 x Specialist Data Set for a local population of 280,000 patients:
100,000 patients * 2.34p = £ 2,340
180,000 patients * 1.98p = £ 3,564
Total Specialist Data Set annual charge ---- £5,904 (per annum)
Project Initiation charge ---------------------------- £1,300 (one off)
Implementation charge (1 Consuming System) -- £2,600 (one off)
Resource Based Pricing
Other Pricing Information
Additional HGL project or technical consultancy days can be purchased for
projects if required by clients. Please see the SFIA rate card for details.