Tony Yates Digital SME

NHS England

Interoperability

High Level Architecture

Over 3 million ambulanceshave been dispatchedelectronically

Over

have been sentelectronically

10 million OOH messages

Most

has been sentelectronically

GP correspondence

All calls

right from thebeginning

traced against PDS

There is more to do!

MUCH MORE!

What isInteroperability?

Interoperability

Source: https://en.wikipedia.org/wiki/Conceptual_interoperability

• Not to be seen as just a “techie” concept• Its about how we get

• To achieve this, need to think on how we “deliver this in the service”

• Professional buy-in and prioritisation• Improving patient experience• System/vendor functionality• Levers and incentives

• Aligning with the wider NIB Interoperability strategy on enabling information sharing through open interfaces

the pertinent information tothe professional at the point of care where it adds value

Supporting the maturity of the estate

Source: https://en.wikipedia.org/wiki/Conceptual_interoperability

Structured APIs using

strategic terminology

(SNOMED and dm+d)

• View information

Structured APIs with existing coded

information

HTML View

• Automated prompting and alerting in all cases

• Automated clinical decision-support

• Consolidate information

• Pertinent information displayed

Sending System Receiving System

Sending systems moving up the maturity of information sharing

-> means that systems using this information can still move at different speeds without constraining innovation

Structured APIs using

strategic terminology

(SNOMED and dm+d)

Structured APIs with existing coded

information

HTML View

Interoperability Layers

Level 1•Technical Interoperability, means we have a way of electronic communication

•e.g. sms, messenger, skype etc.

Level 2•Syntactic Interoperability, common data structures are in place

•e.g. Email, Twitter API, Facebook etc.

Level 3• Semantic

Interoperability, the meaning of the data is shared

• e.g. Flight bookings, banking transactions etc.

Source: https://en.wikipedia.org/wiki/Conceptual_interoperability

Same at both sides? Not always!

Source: https://en.wikipedia.org/wiki/Conceptual_interoperability

Senders

•Semantic Senders (almost)

•Ensure we send the right thing

•Check the structure &

•Check the conformance

Receivers

• Syntactic Receivers

• Check the structure (CDA)

• Accept or reject

• Upgrades are value driven when they are needed

The Requirements• Sort out the PEM• Access to Records• Support clinical hub workflow across a range of skills• Open up repeat caller to 999, OOH, Clinical Hubs• Provide semantic codes flagged on SCR• Make the DOS API more flexible• Support other clinical content sets in ITK• Enable 999 to send into 111• NHS Number Tagging• Inter Clinical Hub transfers• Endpoint registry not dependent on the DOS• OOH Ambulance Dispatch• Booking In Hours, Out of Hours, Out of Area

Interoperability

Source: https://en.wikipedia.org/wiki/Conceptual_interoperability

Thinking about what this means for the patient

Start with the users

Observe what people do

Not what theysay

It’s not alwaysabout standards

How do we do this?

Together!