INTEROPen is UK nation agnostic. As a growing action group, with funding provided as resource and support in kind, we have focused on where we can make a difference with the engagement we have. Initially, this was focused by working with NHS Digital and NHS England to build national CareConnect profiles to support GPConnect and Transfers of Care, whilst creating a basic set of National FHIR capabilities to support other care organisations and vendors who wish to develop interfaces for data exchange.
NHS Scotland and NHS Wales have recently shown interest in engaging with this work and discussing the profiles we are developing. Importantly, the many vendors in INTEROPen cover the 4 nations and, as implementers, play an important part in helping to ensure consistency in the design of the CareConnect specifications.
Has the recently published KLAS report been reviewed by INTEROPen? Would the INTEROPen Interoperability Survey be a duplication of this?
The KLAS report is essentially a report from a customers’ perspective on their supplier. The INTEROPen Supplier Survey is different; it is an opportunity for suppliers to go offer technical detail as to the capabilities of their products/services, focusing on progress towards the things that they need to develop and how can INTEROPen help. Results from the INTEROPen Supplier Survey will be triangulated with findings from other relevant surveys (including the KLAS report), to create a much more comprehensive and realistic representation of where suppliers are at, what needs to be done and where help is needed.
The Code4Health website states, “Code4Health provides a home for the increasing number of open source projects providing software suitable for use in health and care”. INTEROPen was set up as a community to help work with all interoperability stakeholders to create national open standards for interoperability. Naturally there is overlap in these areas and benefits of both initiatives. INTEROPen discussed a partnership with Peter Coates, NHS Digital Nominated Director of the Apperta foundation (“a prime supporter of Code4Health”) at the March 2018 INTEROPen board, minutes here, item 12.
We recognise the synergies between the too and have been in discussions about a more closely linked working partnership. Discussions continue.
I’m a supplier who wants to integrate with my commissioners (the NHS) – how do I engage them to take this forward?
There are two parts to this: first of all, your primary engagement will always need to be with the NHS at a local level – these are your customers and your revenue stream. However, you may also wish to be able to advise your customers with regard to upcoming strategic moves around inter-organisational information exchange, especially with details of how your system(s) can help your customer meet the most recent contractual requirements for Transfer of Care and Open (CareConnect) APIs. I would recommend anyone in your position take an active roll in INTEROPen, where NHS England, NHS Digital, local CIO/CCIOs, other system suppliers, standards bodies etc. work together to develop and adopt open national standards for information exchange.
Is there a plan to open INTEROPen data up beyond only being used for point of care use (for example, allowing a third party to access patient information for intelligent triage purposes)?
INTEROPen doesn’t own any data – it simply defines the standards for information exchange. However, the initial use cases have focussed on direct care. Where an appropriate use case exists it would be possible for a care provider to use the same specifications to access data for intelligent triage purposes. This decision lies with the local data controller.
The use of the CareConnect standards we are working with should be covered by existing contracts that Suppliers are working within, together with their customers. Suppliers should, however, be reviewing these and if they believe they are subject to a CCN, should discuss that with their customers. Their customers may then want to discuss this with NHS England, as the current work being done is to satisfy the NHS Contract.
Without wanting to sound too cliched, Interoperability is as much about the journey as the destination. Whilst it is easy to pull out a definition of Interoperability as being “the ability to exchange information between systems and for the receiving system to be able to process and reason on that data” we have to understand there are dependencies in getting there.
We need a standard information model that covers all the health and care data we want to exchange. FHIR is the first information model that will cover all the data but, as a global standard, it is currently incomplete and only a small part of it has been curated and localised, where necessary, for England.
IT Suppliers need to open up their systems to both generate and consume data based on the standard information model. Again, it is going to take time for IT Suppliers to achieve this as, once it is known what is required, it has to be planned into their roadmaps. In some cases, the contracts they are working to may have to be changed, which will also take time.
What INTEROPen is doing, in working with the NHS England CCIO, NHS England, the Service, Standard Bodies, and Suppliers, is prioritising the FHIR resources to curate and then implement. It will take time to curate even 95% of the data required, but the fact we have started with Transfers of Care and the Patient Summary for CareConnect APIs means we are addressing the most important data first.