With new models of care emerging and evolving, there is a clear need for more effective information sharing between care settings, organisations and geographies, as well as between professionals and citizens, to optimise patient outcomes and quality of care. This is reliant on the ability of IT systems across health and care to be interoperable with one another, and is key to the delivery of the future vision of care in England.

More integrated ways of working across health and care are necessary to enabling care professionals and citizens to better manage care.  Working with organisations such as those delivering new models of care and initiatives being driving by integrated care systems.

Our system-wide move towards interoperability focuses upon the following areas:

  • Working with services to identify their strategic business needs in relation to interoperability to inform development of required solutions
  • Development of priority use cases for interoperability to provide business justification for local investment and development of supporting systems and products nationally
  • Supporting local organisations with tools and guidance to enable them to develop effective solutions to interoperability problems
  • Developing standards to support the move from paper to electronic transfers of care for:
    • Discharge from inpatient care
    • Discharge from mental health
    • A&E attendance
    • Outpatient clinic letters
  • Developing standards to support the move to systems enabling access to patient information through open interfaces (CareConnect APIs)
  • Commissioning NHS Digital in the delivery of interoperability standards
  • Work with INTEROPen in the adoption of interoperability.

The adoption of interoperability

The Chief Clinical Information Officer for health and care in England has outlined seven priority areas:

  1. NHS number/Citizen ID – real-time access to the NHS Number at the point of care across the service, ensuring that the NHS Number is associated with care record elements e.g. lab tests
  2. Medications – all medication messages in the NHS to be interoperable and machine readable across the service
  3. Staff ID – ensuring that there is a consistent way to identify and authenticate staff across the service
  4. Dates and scheduling – a consistent set of interoperability standards for dates and scheduling information  that enables a consistent approach to appointment booking across venues of care and the creation of historic and forward views of appointments
  5. Basic observations – a consistent set of interoperability standards for the sharing of a core set of structured observations
  6. Basic pathology – a consistent set of interoperability standards for the sharing of a core set of pathology tests
  7. Diagnostic coding – implementation of SNOMED CT across the wider service.

Guidance on the NHS Standard Contract requirements on discharge summaries and clinic letters and on interoperability of clinical IT systems

The NHS Standard Contract has required organisations to align their inpatient, emergency care and mental health discharges and also their outpatient letters to nationally published specifications by 1 October 2018.

Organisations are also expected, by 31 December 2018, to have Open APIs in place in line with nationally published specifications.

In both cases, organisations would be expected to have implemented these requirements and/or have clearly agreed local plans in place for their delivery.

This guidance provides further support to commissioners on the interoperability specifications to be adopted by their providers.

Roadmap for new work commission development

Available now 2018

  • Emergency Care discharge summaries
  • Acute inpatient and day case discharge summaries
  • Mental Health discharge summaries
  • Outpatient clinic letters
  • CareConnect Profiles
    • Clinical content
    • Administrative content
  • Learning Disability and generic flagging
  • End of Life (EoL)
  • Structured meds and allergies

In development (April – June 2018)

  • Sharing of  key observations
  • Ambulance handovers
  • Open API content
  • Sharing of Pathology information
  • Medications – stock control management
  • Maternity FHIR requirements
  • Maternity Record Registry
  • Maternity Record Repository
  • Maternity Events

Future developments (June – September 2018)

  • Integrated Care Planning
  • Appointments and scheduling
  • NRLS Phase 2 – discovery for shared care record flows
  • Care setting specific records
  • PHR – patient provided data
  • PHR – patient preferences
  • Continuing Healthcare – assessments

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