Embed Size (px)
Citation preview
NPfIT InteroperabilityThe Role of HL7 v3
Dr. Tim JonesEnterprise Architect NPfIT
Programme DirectorCommunications and Messaging
Programme Manager National Clinical Advisory Board
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
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
Simplified Conceptual Architecture
Event Engine
Workflow/Rules
OtherNationalServices
Transaction Management, Validation and Routing
The DataSpine
NationalServicesBroker
LocalApplication
LocalApplication
Event Engine
CoreNationalServicesE- Booking/
ETP
Transaction and Messaging Spine
Integration Layer
Non-secure domainNon-secure domainNon-secure domain-Network Infrastructure
Workflow& Rules
OtherNationalServices
Transaction Management, Validation and Routing
NationalServicesBroker
LocalApplication
LocalApplications
NHS local applications
LocalApplication
Event Engine
LocalApplication
Event Engine
LocalApplication
Event EngineIntegration Layer
Other participantsPatient Centric Systems
TracingPersonal
DemographicsService
SecuritySecurityPointers to
PatientInformation
CoreNationalServices
‘Local’Domains‘Local’
Domains
PersonalSpine
InformationServices
Browser basedaccess
Browser basedaccess
E- Booking/ETP
Transaction and Messaging Spine
SecondaryUses
HealthSpace
LocalApplications
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
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
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
Iterative Spiral Process
Roll out
Piloting
SandpitTesting
MessageDevelopment
DomainModelling
DomainBusinessAnalysis
RequirementsAnalysis
Technical Review
Business Review
Benefits Review
Analysis Review
Requirements Review
Information Impact Review
HL7 Review
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)
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
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
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
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
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
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
DefineScope
ConsultNCAB
RecruitDomainExperts
UndertakeBusinessAnalysis
BusinessModels
ProcessChangeIssues
ProfessionalIssues
DomainModelling
MessageDevelopment
SandpitTesting
PilotingRollout
ISBRequirement
Standard
ISBDraft/FullStandard
ISBFull
Standard
NCABApproval
ClusterChange
Management
NCABProfessional
Bodies
NDATechnicalReview
Postimplementation
Review
Comms & Messaging Process
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
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
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
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
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
NPfIT and HL7 International (cont)
• NPfIT is working with BSI IST/35– To encourage further alignment
across standards from :• HL7• ISO• CEN
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
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
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
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
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
Phase 2 Release 2 Messages
• PSIS Healthspace– Patient access to record
• Referrals– Generic tertiary referral
• Attendances– Walk in centre– pharmacy
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
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
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
If you a supplier to the NHS…• Get involved with Systems messaging
implementation– Contact Phil Sissons
– Engage through Intellect • Whether or not an existing Intellect member• Contact Laurence Harrison & Sureyya Cansoy
[email protected]• 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
