HL7 UK NHS Implementers GroupIntegration Engine Stream

Philip Firth

IM&T Strategy Implementation Manager

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

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

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

WWL Integration Architecture

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.

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

Trust A Hosted and Maintained

Trust Interfacing Engine - A (TIE-A)

Existing Systems(ES)

CSC Data Centre Hosted and Maintained

Existing System InterfaceEngine(ESIE)

Emergency Bundle InterfaceEngine(EBIE)

P1R1 PAS

P1R1 Emergency Bundles

TheatresMaternity

Results A&E

1a 2a

1 2

1b 2b

LSP Existing System Architecture

What this means for WWL

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)

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

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)

Options

• Buy an integration engine

• Buy in a managed service

• Entirely in-house development

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

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

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