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
[email protected]
07834 602768
Agenda
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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%)
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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: 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.
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)
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
2004
100% of NHS
Clinical IT Systems
Market
LSP Services are
deployed, in some
cases incorporating
former existing systems
as part of their portfolio.
“Today”
0%
“Spine Compliance”
“Existing System Providers” (66 suppliers, 80 systems, >20,000 sites)
2004
2005
2006
Existing GP Systems of Community
(GPSoC) Pharmacy
NHS PAS Choice
(CAB, EPS, GP2GP,
(CAB, PDS)
CAB
Choose and Book
(NASP - Atos/Cerner)
(EPS)
Summary Record)
SDS
SSB
Spine
Directory
Service
Spine
Security
Broker
Independent
Sector
Social
Care
(CAB, SUS, PDS)
(PDS, CAF)
“Spine”
(NASP - BT)
2007+
Others
Urgent Care,
Screening, ONS
PACS etc
SUS
PDS
PSIS
Secondary
Uses
Service
Personal
Demographics
Service
Personal Spine
Information
Service
Transaction Messaging Service (TMS)
“Summary Care Record”
Southern
LSP
North, Midlands & Eastern (NME)
LSP
London
LSP
(CSC)
(BT)
Lorenzo
Millennium CRS
Millennium CRS
Philips PACS
GE PACS
Agfa PACS (NE, E)
GE PACS (NWWM)
(TBC)
“Local
Service
Providers”
(LSPs)
“LSP Compliance”
Spine Compliance
NHS Care Records Service Spine
vs.
“LSP Compliance”
Direct spine
connection
for certain
ESP systems
System G
CSC LSP
BT LSP
iSOFT (Lorenzo)
Cerner (Millennium)
Specialist 1..n
Specialist 1..n
System A
System X
System B
System Y
System C
System Z
“Spine Compliance”
“LSP Compliance”
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
How we progresses
work with ESPs..
NHS Connecting for Health
NHS CFH
Programme
teams
drive
delivery
CAB
PACS
EPS
GP
SCR
SUS
Choose
and Book
Picture
Archiving
Electronic
Prescriptions
Systems
Of Choice
Summary
Care
Record
Secondary
Uses
Service
SCPEA
Social Care
PDS Early
Adopters
PDS
PDS Birth
Notifications
“Common Assurance Process” (CAP)
NHS CFH ESP
team work
with ESPs
Define
Design, Build,
Requirements
Test
ESPs
deliver new
services to
one to 000’s of
customer sites
Users
Benefit..
Deployment
Live
Service
Existing System Providers (ESPs)
Trusts
PCTs
GPs
Non-NHS
LSPs
..or don’t..
Being “Spine Compliant”
1. PDS/IG “Foundation” Compliance
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
Access Control Framework (SDS, SSB)
Transaction Messaging (TMS)
Basic Connectivity (N3)
“PDS Compliance”
Ability for system & individual to
access/update patient demographics
– validate against NHS Number
“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
Install link to NPfIT services, configure
firewalls/routers to access Spine
Being “Spine Compliant” (2)
2. Current Functionality
GP System
Summary
Record
NPFIT-FNT-TO-TIN-0830
NHS Acute/
Community/
Mental Health or
ISTC
EPR/PAS
Community
Pharmacy
Urgent Care
Choose and
Book (CAB)
Choose and
Book (CAB)
Electronic
Prescriptions
Summary
Record
NPFIT-FNT-TO-TIN-1032
NPFIT-FNT-TO-TIN-1032
NPFIT-FNT-TO-TIN-1050
NPFIT-FNT-TO-TIN-0830
GP2GP
Transfer
NPFIT-FNT-TO-TIN-0402
Electronic
Prescriptions
NPFIT-FNT-TO-TIN-1050
PDS/IG Compliance
(PDS = NPFIT-FNT-TO-TIN-1023, IG = NPFIT-FNT-TO-TIN-1031)
Being “Spine Compliant” (3)
3. In pilot..
PACS
PACS Cluster
Store
Social Care
Birth
Notifications
Others
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
Learning Points
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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
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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 Liaison
NHS Connecting for Health
[email protected]
07834 602768