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NPfIT Interoperability The Role of HL7 v3

NPfIT Interoperability The Role of HL7 v3. Dr. Tim Jones Enterprise Architect NPfIT Programme Director Communications and Messaging Programme Manager National Clinical Advisory Board. Agenda. NPfIT objectives Why HL7 v3? Development approach Building and equipping the teams

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NPfIT Interoperability The Role of HL7 v3

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  1. NPfIT InteroperabilityThe Role of HL7 v3 Dr. Tim Jones Enterprise Architect NPfIT Programme Director Communications and Messaging Programme Manager National Clinical Advisory Board

  2. Agenda • NPfIT objectives • Why HL7 v3? • Development approach • Building and equipping the teams • Clinical Engagement • Collaboration with other groups • Engagement with HL7 UK and Inc. • Scope and timescales of work • Invitation to become involved

  3. Comms & Messaging Goals • Establish consistent approach to communications & messaging across the NHS • compliant with National Programme Architecture • Deliver messaging specifications in support of NP Delivery Objectives • Develop and iterative refinement of common information models underpinning all NHS developments

  4. Pointers to Patient Information Tracing Core National Services The Data Spine Transaction Management, Validation and Routing HealthSpace ‘Local’ ‘Local’ Domains Domains Local Local Applications Applications Simplified Conceptual Architecture Personal Demographics Service Security Security Core National National Workflow & Rules Workflow/ National Services Services Rules Services Broker Broker E - Booking/ E - Booking/ ETP ETP Personal Spine Information Services Transaction and Messaging Spine Transaction and Messaging Spine Transaction Management, Validation and Routing Other Other National National Services Services Secondary Uses Network Infrastructure Non - - secure domain Non Non - - secure domain secure domain Integration Layer Event Engine Integration Layer Event Engine Event Engine Event Engine Event Engine Browser Browser based based Local Local Local Local Local Local access access Application Application Application Application Application Application Patient Centric Systems Other participants NHS local applications

  5. Why HL7 v3? • Met fundamental requirements: • Can meet the evolving needs of the NHS • Designed to support granular clinical information exchange • Promise of plug and play interoperability • Widespread support • by users, policy makers and suppliers • International open standard • UK and Europe contribution to its development • NHS can take leading role to ensure fitness for purpose • Economies for NHS and its suppliers • Robust approach to development • Model-based • Standard development approach • Established international collaboration and balloting procedures

  6. What needed to be addressed? • Development approach to meet NPfIT delivery objectives • Trained and equipped standards’ development teams • Clinical involvement throughout • Collaboration with other organisations • Mode of engagement with HL7

  7. Changes in approach • Move NHS messaging into an international collaborative environment • NHS takes leading role in driving HL7 v3 standards development to meet evolving NHS needs • Employ iterative spiral rather than traditional waterfall approach • Change development approach to enable greater collaboration & reuse • Integrate into NPfIT

  8. Iterative Spiral Process Benefits Review Business Review Requirements Review Technical Review Analysis Review HL7 Review Information Impact Review

  9. CMP Workstreams • Manage overall delivery in a domain • Led by workstream manager • Business analysts in shared core team • Domain experts drawn from all groups • Collaboration through HL7 processes • Business Analysis Deliverables: • Requirements statement • Storyboards / scenarios • Use Cases • Flowcharts / activity diagrams • Application roles • Logical Data models (where applicable)

  10. Core Technical Team • Produce HL7 domain models by analysing workstream deliverables • Collaborate through HL7 processes • Reconcile HL7 and Data dictionary issues • Generate NHS common object model and mappings • Produce message and document definitions • Produce XML schemas • Produce Implementation Guides • Produce technical and HL7 ballot documentation

  11. HL7 Training • In-house custom bootcamp • Series of training sessions a nd hands-on workshops • Joint and separate business and technical • Contributors, national and international • Mentor supported development • Team working on real problems • Supported by experts • Non-critical path activities

  12. Tools support • Require enterprise strength tools to support collaborative development • Worked with international tools developers • Integration of existing tools into common development environment • Distributed repository access • Version and configuration management • MIF integration • Next step – integration of business analysis tools and deliverables

  13. Vocabulary Team • Provide guidance on terminology issues • e.g. SNOMED CT migration • Leads development of terminologies required by messaging • e.g. Radiology bounded set, DMD&D • Help determine appropriate split between terminology and record structures • Represents NHS interests in HL7 vocabulary workstream and SNOMED CT development

  14. Roles of other teams • HL7 • UK affiliate of HL7 Inc. (International) • Provide supplier neutral input into standards development process • NDA Assurance • Ensure that the deliverables produced are fit for their business purpose. • NDA Sandpit • Technical testing of application roles and messages produced by the CM programme • NASP, LSP Implementation Teams • Pilot Interactions in Model Communities • Draw up draft/full ISB submissions • Perform post-implementation review • National Clinical Advisory Board • Provide authoritative clinical perspective: • Ensure that the work of the workstreams is prioritised according to clinical ROI • Highlight clinical issues, including change management, training and professional practice, setting up working groups where necessary • Sign off scope and business analyses

  15. National Clinical Advisory Board • Accountable to: • the Ministerial Task-force and NPfIT Board • Responsible for: • identifying key clinical interest groups and their concerns • advising all NPfIT workstreams on clinical needs, priorities and key customers with whom to consult • ensuring clinical concerns are addressed either within the National Programme or by other key players as necessary • anticipating the effects of the implementation of the objectives of the NPfIT on the clinical staff and their ways of working • keeping the clinical workforce informed about the developments and objectives of NPfIT • obtaining political and policy support from those clinical staff and organisations with national influence • providing through its chairman (and to some extent its members) a champion for and spokesman on the clinical aspects of NPfIT

  16. Comms & Messaging Process

  17. NPfIT engagement with HL7 UK • NPfIT is a Benefactor Member of HL7 UK • NPfIT regularly participates in HL7 UK Technical Committee meetings and has a representative on the HL7 UK Board • HL7 UK is the main forum for open communications from NPfIT about messaging plans and specifications • HL7 UK has a member list server dedicated to NPfIT-specific communications

  18. Communicating Plans • NPfIT posts project documentation on the HL7 UK members website • informing members about planned domains, scopes, and business requirements • inviting informal review and comment

  19. Technical Review and Approval • NPfIT posts draft message specifications to the HL7 UK members website • for review and informal comment • NPfIT intends to • post NHS implementation profiles of HL7 V3 for members • propose UK standard localisations of V3 for HL7 UK approval

  20. Technical Review and Approval (cont) • First planned HL7 ballot • eBooking message suite • first quarter of 2004 • Technical approvals from HL7 UK will be coordinated with NHS ISB approvals • eBooking ISB submission for Draft Standard status planned for Spring 2004

  21. NPfIT and HL7 International • NPfIT is a Benefactor member of HL7, Inc. • NPfIT has developed message design tools suitable for use by HL7 members worldwide • will be presented at HL7’s January meetings in the USA • NPfIT will be working with HL7 UK to influence international HL7 development • through international votes and UK proposals for change • NPfIT regularly participates in HL7, Inc. working group meetings

  22. NPfIT and HL7 International (cont) • NPfIT is working with BSI IST/35 • To encourage further alignment across standards from : • HL7 • ISO • CEN

  23. Messaging Phasing • Tied into ICRS implementation phases • Phase 1 • Release 1 June 2004 • Release 2 December 2004 • Phase 2 • Release 1 June 2005 • Release 2 June 2006 • Phase 3 • Release 1 December 2008

  24. Phase 1 Release 1 Messages • eBooking • All messages to support service • Personal Demographic Service • Create record, trace, retrieval and update demographics, process birth and death notifications • Legitimate Relationships • Create and maintain carer relationships • Central role in access control

  25. Phase 1 Release 2 Messages #1 • Transfer of care • Generic referral • Emergency admission notification • Out of hours & NHS direct reports • Notification of sectioning under MH act • Generic Clinic letter • Generic Discharge letter • ICRS Record • Maintain patient problem list • Allergies and adverse reactions • PMIP pathology results • Diagnostic Imaging results • Single Assessment Process • Care Programme Approach

  26. Phase 1 Release 2 Messages #2 • eTP • Prescription and dispensing • PPA, pharmacist to patient, other prescribers • Other • GP2GP messages • Begin / end episode / encounter / intervention • Clinical spine record • Add patient • Prescribe • Screening • Entry, exit and status change in screening protocols • Record screening result • Terminology service • PDS • Change GP

  27. Phase 2 Release 1 Messages • Secondary uses • Including NWCS flows • Assessment and review messages • Diabetes, Cancer, CHD, children, Renal, and LTMC • Ordering & results • Diagnostic Imaging orders • Pathology orders & results (HL7) • Care pathways • Begin, end, and status change care pathway messages • Other • PDS HealthSpace messages

  28. Phase 2 Release 2 Messages • PSIS Healthspace • Patient access to record • Referrals • Generic tertiary referral • Attendances • Walk in centre • pharmacy

  29. Phase 3 Messages • Orders and results • Remaining modalities • Referral • Generic community • Alerts • Clinical warning from national services • Knowledge Sources • Cochrane • Clinical Evidence • Other information sources

  30. Nascent Standards work • NCAB Cancer group development of standard conceptual model for care pathways / protocols / guidelines ... • To allow unambiguous description of best practice collaborative care • To support creation of interoperable as well as integrated care pathways • System suppliers with varying systems’ models should be able to represent and implement pathways and elements of pathways without degradation of meaning or function • Intended collaboration with HL7 Decision Support and other international groups

  31. If you want to join the party.. • Get involved in message development • Join HL7 UK if not a member • must join HL7 UK to be able to have access to HL7 materials and participate in meetings • Subscribe to the dedicated mailing list • Go to: http://lists.hl7.org.uk/mailman/listinfo/nhsnpfit • Respond to subsequent invitations to express interest in working on workpackages announced via mailing list • Attend analysis & design sessions as appropriate • Participate in HL7 UK and Inc. technical and other meetings

  32. If you a supplier to the NHS… • Get involved with Systems messaging implementation • Contact Phil Sissons • Supplier.Liaison@npfit.nhs.uk • Engage through Intellect • Whether or not an existing Intellect member • Contact Laurence Harrison & Sureyya Cansoy sureyya.cansoy@intellectuk.org • Register which message flows you will be implementing • Attend follow-up message implementation workshops • Receive communications standards • Implement the messages in your systems • Engage with NPfIT for conformance testing in NPfIT sandpit and LSP Model communities • Work with customers and LSPs in planning, migration and roll out

  33. Thank you for your attentionQuestions? tim.jones@npfit.nhs.uk

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