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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. Quick recap on NHS National Programme for IT Delivery channels: LSP & ESP

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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

[email protected]

07834 602768


Agenda

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

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

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: 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


Spine compliance

“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)


Spine compliance vs lsp compliance

“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


How we progresses work with esps

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


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

“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


Being spine compliant 2 2 current functionality

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)


Being spine compliant 3 3 in pilot

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


Learning points

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

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 billion1

HL7 – Thanks a Billion!

Questions?

Peter Dyke,

Head of Industry Liaison

NHS Connecting for Health

[email protected]

07834 602768


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