Transcript Document

6th HL7 International Affiliates
Conference Taiwan
HL7 UK and
NHS IT Integration Strategies
Philip Firth
IM&T Strategy Implementation Manager
Wrightington, Wigan & Leigh NHS Trust
[email protected]
HL7 UK
HL7 UK
• HL7 UK membership growing steadily
• 2003
• 2004
• 2005
Organisation
Personal
Benefactor
Total
62
97
91
77
109
118
6
10
9
145
213
218
• Adoption of HL7 as the messaging
standard for the NHS National Programme
for IT has been a major catalyst for growth
HL7 UK – Services to members
• Web services
– Access to important information – eg. NPfIT MIM
– Communication
• Training opportunities – HL7v3 etc
• HL7v3 Primer: approximately 2300 sold
• Technical Committee - regular 2 day meetings
throughout the year (free to members)
• NHS Implementer conferences (free to NHS)
• HL7UK annual conference (next November 2-3)
http://www.hl7.org.uk/
HL7 UK Repository
HL7 UK Website Repository
An important source of
information, particularly the NPfIT
Message Implementation Manual
(MIM)
National
Perspective
What is going on in the UK?
• NHS Connecting for Health (England only)
– National Programme for IT in the NHS
• Mandated to build an information infrastructure to improve patient care
in England
• Covers all NHS organisations in England
– >100K doctors, >380K nurses, 50 million patients
• Represents an investment of £2.3billion (US$ 3.8billion) over the first
3 years, with further funding to end of 10 years >£6billion
NPfIT Key Targets
• NHS Care Records Service (NCRS)
– Every patient's medical and care records will be held
electronically and will eventually be available securely online.
• Choose and Book (electronic booking of hospital
appointments)
• GP2GP
• Electronic Transmission of Prescriptions (ETP)
• New National Network (N3)
• Picture Archiving and Communications Systems
How NCRS will work
• A summary of care and clinical history will be held on a
national database (the ‘Spine’) to ensure that important
patient information is always accessible.
• More in-depth details will be held locally where most care
is delivered.
– records of conditions, medication, operations, tests, X-rays, scans
and other results
• Links to local information will be available from the
summary record
• Key clinical information will also still be stored on Existing
IT Systems – a major integration challenge for the NHS
NPfIT – the role of HL7
• HL7v3 being used predominantly for integration
with the Spine and other National Applications,
eg. eBooking, ETP, GP2GP
• NPfIT is using HL7v3 foundations, and
contributing to the development of domain
models
• NHS V3 message specifications contained in the
Message Implementation Manual (MIM)
• MIM available to HL7UK members via website
• HL7 v2.x for integration with existing systems
GP2GP
• GP2GP a very early V3 adopter
• NHS sponsored / supplier supported
• use RIM / Datatypes / Tools and model
EHR structure
• feedback into CDA and clinical statement
Scope of Clinical Messaging in Phase 1
Medication Updates
Adm
Disch
CPA Summary
ETP
Spine
SAP Encounter
(PoC Care
Event Report)
Mental Health
Full / Partial
Dispense
DI
Encounter
Diagnostic
Imaging
Prescribe
Cancel
DI Report
DI
Report
Adm / Disch /
CPA Summary
Notifications
Pharmacy
DI Requestor
GP2GP
OOH
Encounter **
Spine Query
PoC
Discharge
Report
(Inpatients)
or
PoC
Care Event
Report
(Out Patients)
SAP
PoC
Care Event
Report
(Primary Care)
PoC Disch or Care Event Report
Primary Care
LSP / Existing
Emergency Admission Notification **
A&E Report **
Secondary Care
LSP / Existing
A&E
Encounter **
NHSD
Referral
Choose
& Book
Slots (provide and fill)
NOTE: Flows marked with ** are also sent to Spine but not shown on this diagram for ease of reading
Any Spine / NCRS
Accredited
System
NHS Messaging Standards - MIM
Local
Perspective
Wigan - Background
• IM&T Strategy
– Best of Breed
– Keep departmental systems that work
– Build EPR using web development and systems
integration
• Development 3 yrs down the line …
• Lots of HL7 v2 interfaces
• Project in place to send discharge letters to GPs
using HL7 v3
Wigan – Local issues
• Data quality – a huge issue for the NHS
• Consistent person referencing
– NHS Number, but not all systems/people use it
– Patients rarely know their own NHS Number
• Poor IT literacy skills (major contributor to poor
data)
• Poor IT Infrastructure
Wigan – Local issues
• Availability of funding
– Local funding scarce – major NHS cost pressures
– Just got £100K+ funding to develop a integration
platform for linking existing systems with CfH
• Time
– Lots to do in a limited timescale
• 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
Wigan – Getting ready for CfH
• CfH is stepping into gear,
– Wigan: Theatres 2006, new PAS 2007 …
• Replacement of NHS IT systems will not
happen overnight in Acute Hospital Trusts
• Key existing departmental systems may
not be replaced before 2010
• Existing Systems integration is therefore a
key issue for Acute Hospital Trusts –
which has breathed new life into HL7v2
Bridging the gap
between local
and national
applications
HL7v2 to link
existing systems
to CfH
applications
HL7v3 for
systems
interoperability for
national
applications and
the Spine
Summary
• CfH in full swing
• Major system integration challenges for the NHS
at local and national level
• HL7 UK is providing a key supporting role in the
development of the messaging standards
required for CfH
• HL7 UK making a major contribution to the
development of HL7v3, early adopters etc