HL7 UK NHS Implementers Group Integration 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

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