itk technical forum - knowledge.scot.nhs.uk · liberating the nhs & the challenges for system...

ITK Technical ForumWednesday 26th January 2011 12.00pm – 16.30pm

National Motorcycle Museum, West Midlands, B92 0EJ

[email protected]

http://www.connectingforhealth.nhs.uk/systemsandservices/interop

AgendaIntroductions and Objectives Inderjit Singh 12.30 – 12.45

Keynote Speech

•Liberating the NHS & the Challenges for System Vendors & The role

of Technology Office, ITK & the Standards Agenda

Paul Jones 12.45 – 13.15

ITK Background & Overview

•ITK Groups & Relationships & output from NHS User Forum Inderjit Singh 13.15 – 13.45

•The NHS View of ITK Mark England 13.45 – 14.00

•ITK Management Group Direction & Priorities Ben Dunlop 14.00 – 14.15

Coffee and Networking 14.15 – 14.45

Current Priorities

•Accreditation Richard Dobson 14.45 – 15.00

•Technical Design Strawman - Correspondence & Spine Mini

Services

Tim Davey 15.00 – 15.30

•Open Invitation for Involvement Paul Sanderson 15.30 – 15.45

•Questions & Feedback All 15.45 – 16.15

AOB Inderjit Singh 16.15 – 16.30© Crown Copyright 2011

Welcome, Introductions & Objectives

[email protected]


Inderjit SinghLead Technical ArchitectTechnology OfficeDepartment of Health Informatics Directorate

Local NHS Integration

Simplify and standardise on a „NHS code of Connection‟

Provide technical support for „Liberating the NHS‟ strategic objectives

Share best practice solutions and requirements

Engage with industry to adopt common technologies and APIs

Build a viable market around ITK based information sharing

© Crown Copyright 2011

ITK Approach

Specification

• A set of standards and frameworks for vendors to build against

• Either core product or using adaptors

Standards

• Common technical standards

• XML

• Web Services

Infrastructure

• Standardised envelopes and wrappers

• Standard patterns and application behaviours

• Standardised message structures

Operating Model

• NHS Organisations operating considerations

• Provides guidance, processes and governance for use when using the standards

Conformance

• Vendors will be required to attain a conformance certificate for applications claiming to be compatible with ITK

• NHS Organisations should ask for this when procuring systems

Community

• User Forum

• Technical Forum


ITK News

• ITK User Forum established – 97 NHS organisations attended

• ITK NHS led Management Group established – 16 NHS ICT

Directors and Integration Leads

• ITK now has a long list of „topics‟ to address from the forum

• ITK at the heart of the new Information Strategy ....

• More from Paul Jones and the team shortly


Liberating the NHS & the Challenges for

System Vendors & the Role of the

Technology Office, ITK & The Standards

Agenda

[email protected]


Paul JonesChief Technology OfficerTechnology OfficeDepartment of Health Informatics Directorate

Questions

ITK Groups & Relationships & Output

from the NHS User Forum

[email protected]



ITK Community

DHID ITK

Team

NHS ITK User

Forum

ITK Technical

Forum

Vendors

NHS Trusts and

Consortia

Common NHS Business Requirements

Common Technical Specifications

Accredited Systems

ITK Forum Management GroupDHID

SMT

Modelled on „Continua‟ working groups © Crown Copyright 2011

Roles and Objectives

NHS Front line led

ITK Requirements Management Group drawn from this forum

Co-ordinated by DHID ITK Team

Develop and agree common business requirements

Advise of prioritisation of specification development

Share project information and vendor intelligence

Develop business accreditation criteria for solutions

NHS ITK User

Forum



NHS ICT Directors and Senior NHS Representatives

Chairman – John Thornbury (Director of ICT Services Worcestershire)

Represent the NHS User Forum membership and direct priorities for development within ITK

Evangelise ITK to NHS and industry

Ensure sign-off of solution with Requirements Team

ITK Forum

Management Group



NHS ICT Teams, Vendors, Standards Organisations, DHID Technical Team

Co-ordinated by DHID ITK Team

Develop and agree technical specifications to address the business requirements

Develop technical accreditation criteria for solutions

Ensure sign-off of solution with Requirements Group

ITK Technical

Group



Coordinate activity in User and Tech Forum

Publish ITK Specifications

QA standards developed for consistency

Provide accreditation services

Shaping the solution(s) and stewardship for „First Of Type‟ projects

Provision of specialist skills where appropriate

DHID ITK Team



Develop applications to ITK standards

Ensure solutions are accredited

Deploy accredited systems

Provide input into the technical specification development process

Provide feedback regarding the usability of the specifications

Vendors



Ensure that front line problems are brought to the requirements forum (User forum)

Commit vendors to ITK standards when letting contracts

Enforce accreditation

Provide a market for vendor ITK based solutions

„First of Type‟ new standards and specifications

Call off ITK Interfaces from LSP contracts

NHS Trusts and

Consortia


ITK Community

DHID ITK

Team

NHS ITK User

Forum

ITK Technical

Forum

Vendors

NHS Trusts and

Consortia

Common NHS Business Requirements

Common Technical Specifications

Accredited Systems

ITK Forum Management GroupDHID

SMT

Modelled on „Continua‟ working groups © Crown Copyright 2011

ITK and the NHS

November 16/17th

ITK User Forum (Leeds and London)

97 English NHS organisations come together to discuss ways to solve common business interoperability problems through ITK

- More from Ben Dunlop shortly


Questions

Mark England

Head of Information Technology

Luton & Dunstable Hospitals NHS

Foundation TrustJanuary 2011

The NHS View of ITK


Some Context:


AgendaThe ITK (integration toolkit) is important to the wider NHS

and my Trust because:

1. Change is inevitable therefore agility is a pre-requisite

2. Money is too tight to mention

3. Monolithic has failed

4. Are we serious?


Who Says There Will Be More

Change?


Immense Architectural Challenges

within NHS!


Our HealthBus: An Enterprise

(Service) Bus – The ITK

ITK


“......away from an approach where we expect every organisation to use

the same system, to one where we connect and join up systems.”

(Information Strategy Consultation – October 2010 – DoH)

Monolithic has failed...


Is it real?


How does the NHS move the

ITK forward?

• “The Supplier will comply with <latest version> of the ITK

specifications.” (v1.1)

• “The Supplier will comply with NICA

accreditation in this and future releases within X months

of release”

• “The Supplier will ensure that for each

interface they are satisfied the Trust Operating Model

checklist has been completed.”


[email protected]


ITK Management Group

Direction & Priorities

Ben Dunlop – Technical Project Manager

NHS Yorkshire and the Humber

ITK Management Group

NHS Representatives from:

‣ ITK User Forum

‣ ITK Technical Forum (this session)

‣DHID Project and Technical Support

Chair – John Thornbury, Director of ICT,

Worcestershire Health ICT Services

Initial Meetings

First Meeting – 7th December 2010

‣Draft Terms of Reference and Governance Structure

‣ Initial Requirements Prioritisation

Second Meeting – 11th January 2011

‣Election of Chair

‣ ITK Technical Forum engagement

Group Terms of Reference

Core Responsibilities:

‣Setting Strategic Direction and Priorities for the ITK

‣Oversight of ITK User Group and Technical Forum

‣Engagement with Vendors and Trusts

‣Promotion of ITK Standards for take-up

ITK Management Group Priorities

‣Establish ITK Groups and Governance Structure

‣Ensure appropriate NHS representation

‣Engage with Vendors and Standards Bodies

‣Formalise Process for ITK Standards being established

‣Manage Expectations around Time-Frames and

Deliverables from the ITK

ITK User Forum Feedback

‣Survey of NHS organisations to identify existing

challenges and suggestions for direction for the ITK

‣40+ responses received

‣80+ current challenges reported

ITK Initial Priorities

‣Correspondence identified as “quick-win”

‣Establish ITK User Forum sub-groups to identify and

develop ITK requirements for:

‣General Correspondence

‣Patient Correspondence

‣Referrals

ITK Technical Forum

‣Sub-groups will be established to support the User Forum

requirements developed for correspondence

‣Opportunity for Vendors or NHS technical reps to input

around existing projects and potential standards

ITK Implications for VendorsWhy should we want to do it?

‣Opportunity to increase the value of your solution by

enabling it to connect to more systems

‣Supplier preference in NHS procurement decisions

‣Standardised requirements for NHS Trusts

‣Reduce support overheads with consistent approach

towards integration between systems

ITK Implications for NHS TrustsWhat do we get out of it?

‣Better integration off-the-shelf between core systems and

simplified Departmental systems integration

‣Easier transition when migrating systems

‣Criteria to assess capabilities when purchasing new

systems (ITK compliance)

‣Vendor influence with NHS-wide requirements

What next?

‣Manage development of correspondence ITK standards

‣Determine next areas for prioritisation

‣Promote use of the existing ITK standards bundles

‣Build materials to assist with ITK adoption across NHS

‣Case studies on implementations

‣ Identifying future potential projects/sites

Questions ?

Coffee & Networking

[email protected]


Interoperability Toolkit (ITK)

Accreditation Process

Richard DobsonSenior Assurance Analyst

National Integration Centre

Technology Office

Department of Health Informatics Directorate

[email protected]


Background• National Integration Centre and Assurance (NICA) have been operating NASP, LSP and

ESP assurance and compliance processes since the inception of the NPfIT; these are primarily aimed at systems wishing to connect to the National Spine and its directly connected infrastructure.

But with local interoperability in mind…

• ITK pilots concluded successfully providing useful data for taking this initiative forward to wider rollout

• One of the learnings from the pilots is vendors of ITK conformant products want to be part of an Accreditation program

• NHS CFH is working in partnership with vendors, providing guidance, support and ultimately Accreditation.


Interoperability Toolkit

Accreditation Scope• Accredited System Scope

• Provider system (e.g. PAS, GP Systems etc) upgrades to support ITK services

• ITK Middleware

• ITK Consuming Applications and Devices

• Accreditation Testing Scope

• Positive functional interface testing• Negative functional interface testing• Key expected behaviours e.g. error handling• Key Aim: evidence the adherence to ITK requirements

• Accreditation Testing Out of Scope• SPINE connectivity (currently, use CAP)• General Application functionality• Non-functional testing• End to end business testing e.g. UAT• Information Governance e.g. Authentication, Audit checks etc. • Clinical Safety

Key Point; this is about demonstrating that the ITK accredited products have interfaces that interoperate – it’s the interface that is accredited.


The Catalogue and

Other Services

http://www.connectingforhealth.nhs.uk/systemsandservices/interop/accred/catalogue

Accreditation Advantages

Accreditation brings a number of potential advantages for vendors and purchasers

• Purchase decision makers can be sure that product interfaces are interoperable with other suppliers products that have ITK Accreditation for the same message bundles

• This needs to be a key factor in the purchasers decision making

• Going through the Accreditation process will also entitle vendors to access other services and support from NICA, designed to help them get products accredited and ready for market as quickly as possible.

• Accreditation entitles vendor systems to be listed in the ITK

Accreditation catalogue that purchase decision makers

can access to help select appropriate interoperability

products.


So what are we doing

right now?

• The accreditation process has been established. The accreditation catalogue is up and running, and we have ~25 vendors expressing interest is attaining accreditation with the list growing

• A number of vendors you will probably be familiar have already been accredited including Intersystems with Ensemble, INPS/EMIS with their Medical Interoperability Gateway (MIG), and PCTI with EDT Server

• Orion are currently being accredited for their Rhapsody product

• Other vendors indicating January 2011 timescales include; Street Heavers, Fiorano, and iPlusIT.


Questions

Technical Design Strawman

Correspondence & Spine Mini

Services

Tim DaveyTechnical Architect

Technology Office

Department of Health Informatics Directorate

[email protected]


Overview

In order to keep up the momentum generated by the pilots, work is already in progress on two key areas identified as priorities:

The intention is to transition this technical design work over to the Technical Forum as soon as it comes online

Spine Mini Services

• Providing a simplified, lightweight mechanism for accessing key Spine functionality

• Initial focus on read-only access to PDS to assist with patient tracing

• Design is well underway, and initial pilots in progress

Clinical Correspondence

• Building on the Discharge Summary demonstrated by the pilots

• Strawman design work aimed at increasing flexibility and allowing anytype of clinical content to be carried


Clinical Correspondence

- GoalsGoals

• Ability to carry any kind of CDA document

• Ability to include attachments with a document

• Ability to carry non-CDA content (eg PDF, TIFF)

• Ability to transmit metadata describing key aspects of the document (sender, recipient, patient, time etc)

• And also… other enhancements to support end-to-end addressing, audit, tracking etc


HTTP Header

SOAP Header

Payload

HTTP Header

SOAP Header

Distribution Envelope

Payloads

Header

Payload

Payload

“Send Discharge Summary”

“Send CDA Document”

Pilot

Latest1. Service name made more generic – ready to send any type of content

2. Distribution Envelope added – to store additional “end-to-end” details

3. Multiple Payloads possible – enabling attachments / metadata to be added

The next few slides explain further…

Clinical Correspondence - Enhancements


The Distribution Envelope provides technical support for more complex end-to-end usage scenarios


Header

Payloads

Payload

Payload

Payload

Original Service Requested

Address List

Manifest

Tracking Id

Audit Identity

An end-to-end “business” address

Allows the type and content of potentially multiple payloads to

be described

Allows a user identity to be passed end-to-end for audit

purposes

Facilitates end-to-end message tracking

Clinical Correspondence –Distribution Envelope


Attachments and Metadata open the way to rapidly automating a wide range of existing scenarios


Header

Payloads

Payload

Attachment

Attachment


Header

Payloads

Content Metadata Payload

Opaque Payload

•Attachments (eg image) can be embedded within a CDA document

Attachments

Non-XML content, and Metadata

• Payload need not be CDA, nor even XML. “Opaque” payloads may be sent (eg PDF, TIFF)

• A metadata structure and taxonomy and structure has been drafted

• This allows key facts about the payload to be provided (eg from, to, patient etc)

Clinical Correspondence –Attachments and Metadata


Spine Mini Services -

GoalsGoals

• Make it easier to connect to key Spine services

• Easier technical interface

• Easier accreditation

• Identify high-value Spine services to open-up

• Provide ease of use - and limit risks - by constraining the available functionality (80/20)

• Start with read-only access to PDS


Spine Mini Services -Concept

PDS

App

PDS

App

ITK MiddlewareE2E CAP

Assurance

Modified CAP Assurance

ITK Interface Accreditation

Middleware must ensure Spine is protected regardless of app behaviour

A restricted set of functionality, appropriate to this lighter assurance approach (e.g. read only)

Only appropriate for apps that would not otherwise be PDS connected at all


Spine Mini-Services -Status

The plan is to continue the successful ITK approach of working closely with real NHS projects to finalise the mini-services specifications

Draft Service Definitions

• Verify NHS Number

• Get NHS Number

• Get Patient Demographics

• Get Patient GP Practice Details

• Get Patient Demographics and GP Practice Details


Spine Mini-Services -Status

The plan is to continue the successful ITK approach of working closely with real NHS projects to finalise the mini-services specifications

Progress

Concept agreed

Interface defined

Supporting behavioural specifications defined

Operating Model implications defined

Assurance and Accreditation approach drafted

Real-world pilot projects initiated


Questions

Open Invitation for

Involvement

Paul SandersonNHS Engagement Lead

Technology Office

Department of Health Informatics Directorate [email protected]


• Provides the NHS ITK User Community with a web presence

– Encourages everyone to get involved

• both open and closed networks and forums

• WebEx and other collaboration tools available

• Provides an opportunity for the NHS, DHID, vendors and other

stakeholders to share information, latest news and project

intelligence

• Supports the work of the ITK NHS and Technical Forums and sub

groups

• Open invite for all to get involved and contribute

– Go to http://www.healthictportal.com and register


Questions

Questions & Feedback

[email protected]



Questions

Any Other Business

[email protected]



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