To comply with the requirements of the NHS Standard Contract for ToC, organisations need to ensure they are sending messages:
The FHIR profiles created by INTEROPen members reflect UK standards. However, it is important to understand the curation process used is there to only extend the profiles where necessary to fit local requirements. The curation process takes the FHIR STU3 resource definitions from HL7 International and reviews them to understand where they need to be changed to reflect NHS requirements in England.
The GDE’s, Fast Followers and LHCRE contracts stipulate the use of FHIR standards as does the NHS Standard Contract. This contractual and funded route covers approximately 60% of frontline NHS organisations.
Priority profiles are already under discussion by various groups within INTEROPen/NHS England/NHS Digital/ PRSB/TechUK and the CCIO/CIO Networks. INTEROPen is acting as a community where these priorities can be defined together.
The Global Digital Exemplars (GDEs), Fast Followers and Local Health and Care Record Exemplar (LHCRE) contracts stipulate the use of FHIR standards as does the NHS Standard Contract. This contractual and funded route covers approximately 60% of frontline NHS organisations.
The two target dates are different but we are looking at Trusts to at least have plans in place to implement FHIR based Transfer of Care messages and Open (CareConnect) APIs.
GPConnect profiles and key national profiles should all be reviewed by the INTEROPen community, as it is essential for vendors who are implementing them on a national scale to influence the design and ensure there is consistency. However, because the Level 2 CareConnect profiles and CareConnect APIs have a basic set of constraints and operations to support UK interoperability, we hope that they can be taken and used by many local areas, vendors and innovative projects to develop new models of care in a way that doesn’t hold back innovation. We expect these projects will share their learning and specifications, and as they develop and scale, we envisage certain rules and patterns and other profiles emerging that may need to be plugged into a curation process so that other regions can pick them up with a degree of confidence that their design has been technically and clinically validated. Some regions may specifically come to INTEROPen for curation first, as they wish to gain further guidance. We will need to support both approaches.
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.