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Implementing Integration Strategy in NHS: Challenges and Solutions

Explore the complexities of integrating IT systems in Acute Hospital Trusts, with a focus on the NHS NPfIT program. Learn about key issues, architecture requirements, networking standards, and integration engine options. Discover the constraints, considerations, and possible ways forward for successful implementation.

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Implementing Integration Strategy in NHS: Challenges and Solutions

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  1. HL7 UK NHS Implementers GroupIntegration Engine Stream Philip Firth IM&T Strategy Implementation Manager

  2. Background • NPfIT is stepping into gear • Replacement of NHS IT systems will not happen overnight in Acute Hospital Trusts • Key existing departmental systems may not even be replaced before 2010 • Systems integration is therefore a key issue for Acute Hospital Trusts

  3. Integration strategy • Integration Engine on its own is not enough! • Need Master Patient Index for validation • Need highly skilled IT resources (R&R issues) • Need money to invest in integration (not a given) • Need to adhere to LSP advice and guidance • … WWL is therefore evaluating a range of options

  4. Current status at WWL • A systems integration architecture was needed to support the implementation of a web-based EPR • WWL EPR built on an XML data repository (CSW) • An architecture for systems integration was developed in-house using • Microsoft .NET • Microsoft SQL Server • XML technologies – XML, Schemas, XSLT, Stylesheets

  5. WWL Integration Architecture

  6. Requirements for NPfIT • LSP advice (CSCA): • The choice of software, hardware and the maintenance of the Trust Integration Engine is entirely the NHS Trust’s decision and responsibility.

  7. Required architecture • Trust Interface Engine (TIE) • Trust IE needed to link existing systems in the Trust to the LSP Data Centre • Existing System Interface Engine (ESIE) • LSP IE needed to channel data from the reference PAS to/from Trust existing systems • Emergency Bundle Interface Engine (EBIE) • LSP IE needed to channel data from emergency bundles to/from Trust existing systems

  8. LSP Existing System Architecture

  9. What this means for WWL

  10. Messaging standards • LSP and NPfIT have agreed to base existing systems integration on HL7 v2 • NOTE: HL7v3 predominantly for NASP integration • HL7 version 2.3 for EBIE (emergency bundles) • HL7 version 2.4 for ESIE (reference PAS)

  11. Networking and Security • Secure delivery of messages sent over the NHS/N3 network using industry standard SSL encryption • HTTPS (Hypertext Transfer Protocol over Secure Socket Layer) • SSL V3 encryption

  12. Choices of Integration Engine • Seebeyond (aka Datagate) • Used by LSP • Microsoft BizTalk • BizTalk 2004 well worth a look? • Clearspan Server (aka Neon, Microscript) • A lot of Microscript interfaces in the NHS • New kids on the block • WCI, WRQ, Intersystems ... (potentially a lucrative market)

  13. Options • Buy an integration engine • Buy in a managed service • Entirely in-house development

  14. Constraints • Money • Local funding is non-existent after 3 years CIP • LDP funding just hasn’t materialised • Time • 101 other things to do • 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 • Local considerations • Need to maintain existing interfaces, not break them

  15. Way forward for WWL • Money (lack of it …) • Favours an in-house approach • Time • Favours a managed service approach • Resources • Favours a managed service approach • Local considerations • Favours an in-house approach and • Favours an integration engine approach

  16. Conclusion • Balancing all options and constraints it is not easy to decide on a way forward !!! • Lucky to have a good in-house integration architecture – this is our fall-back position • Knowing we need to satisfy stringent LSP and NPfIT requirements we will evaluate integration engines • Looking to HL7UK and NPfIT / Cluster wide events/forums for sharing best practice and ideas

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