1. Interoperability Capability Roadmaps
Proposal and Straw-Man
Adam Hatherly – 6th November 2015

2. Background
An interoperability strategy document was drafted in Nov/Dec 2013 with input from HSCIC and NHS England.
NHS England and the NIB subsequently established and chair an Interoperability Steering Group, with participation from a number of organisations including HSCIC.
This group (as part of the NIB) has identified some additional priority areas to be addressed as part of an interoperability strategy:
Ensuring adoption of the NHS Number as the primary identifier when sharing information
Establishing regional interoperability communities
Enabling open interfaces within and between integrated digital care records (IDCRs)
Prioritising the uptake of fundamental digital standards as ratified by the NHS England Board
For key transfers of care, specifying, introducing and adopting tight and consistent digital standards
Creating a national patient record locator service
Extending the use of the summary care record
Draft agenda:
Review the content of the previous strategy
Present/Discuss:
Interoperability aspects of the NIB
The three proposed HSCIC “Platforms” (Data Services, Digital Services, Direct Care)
Outputs from the “Interoperability Board” (NHS England strategy, handbook, etc.)
HSCIC plans (Spine roadmap, GPSoC IM2, eRS, etc.)
Wider initiatives (Middleware, TechUK Interop Charter, etc.)
Scope and terms of reference for uplifting the strategy.
Questions to discuss:
Is the TOGAF model used previously the right one?
Should we focus around a defined set of capabilities required to interoperate?
Can we create a roadmap to deliver the vision (and capabilities required to realise that vision)?
Actions/Next steps

3. Vision from 2013 interoperability strategy
Consistent: National logical information architecture
Locate: A central index or registry
Retrieve: Extensible national messaging/API specifications for “core” information
Update: Identification of “authoritative” sources of information – driven through the registry
Notify: A nationally defined publish / subscribe model

4. Supporting Technical Capabilities
In order to deliver on these strategic aims, a number of supporting capabilities need to be in place.
These may be delivered directly in local systems / organisations, regionally, or nationally.
Patient Index
Authentication
Authorisation
Lookup
Citizen Identity
Organisation Directory
Lookup
Endpoint Directory
System A
Lookup
TLS MA
Lookup
User Directory
Query N3
Internet
Messaging
Record Locator
Publish
Broker / Middleware
Subscription Service
Query
Relationship Service
Query
Subscribe
Preferences Service
Questions?
Query
Messaging Standards
DSA Repository
Reference Data
PKI
System B

5. Supporting Technical Capabilities
Patient Index
NHS Number
Authentication
Authorisation
Patient Record Locator
Lookup
Citizen Identity
Organisation Directory
Open Interfaces
Lookup
Endpoint Directory
System A
Lookup
TLS MA
Digital Standards
Lookup
User Directory
Query N3
Internet
Messaging
Record Locator
Regional interoperability communities
Publish
Broker / Middleware
Subscription Service
Query
Summary Care Record
Relationship Service
Query
Subscribe
Publish / Subscribe
Preferences Service
Query
Questions?
Messaging/API Specifications
Messaging Standards
DSA Repository
Registry
Reference Data
PKI
Information Architecture
System B
Several additional capabilities are required to support a full interoperability ecosystem

6. Proposed Work Package
As part of the proposed “Underpinning Architecture Group”, we want to begin looking at these technical capabilities in more detail.
Taking the interoperability “strategy” inputs into account, this work package will detail the technical capabilities and roadmaps for each capability.
The work package will need the support and sponsorship of the interoperability programme board.
Input will be needed from other organisations including trusts, suppliers and other national bodies to ensure the capabilities outlined align with their requirements – we would look to use the new Code4Health communities to support this.
Resource will need to be identified by the board, and time dedicated to supporting this work in order to gather requirements (ideally fed from the “Requirements Action Group”, and review outputs - this resource will largely be outside HSCIC.
Draft agenda:
Review the content of the previous strategy
Present/Discuss:
Interoperability aspects of the NIB
The three proposed HSCIC “Platforms” (Data Services, Digital Services, Direct Care)
Outputs from the “Interoperability Board” (NHS England strategy, handbook, etc.)
HSCIC plans (Spine roadmap, GPSoC IM2, eRS, etc.)
Wider initiatives (Middleware, TechUK Interop Charter, etc.)
Scope and terms of reference for uplifting the strategy.
Questions to discuss:
Is the TOGAF model used previously the right one?
Should we focus around a defined set of capabilities required to interoperate?
Can we create a roadmap to deliver the vision (and capabilities required to realise that vision)?
Actions/Next steps

7. Wider Alignment and Governance
From a HSCIC perspective, any capabilities that are required nationally would form part of a wider set of capabilities to deliver the strategic HSCIC platforms as set out in the NIB strategy - these include:
Digital Services – Services for citizens
Direct Care Services – Services for health and care professionals
Data Services – Services for indirect care or secondary uses
Co-ordination of the strategy for capabilities across these platforms is therefore essential, so part of the work for this work package will be input from the TAID Central Architecture Team to co-ordinate how the capabilities for interoperability fit into the wider set of capabilities across the Enterprise Architecture (tracked using the EA tool).
Capability assessments will be signed off by both the TRG and the Interoperability Programme Board.
Draft agenda:
Review the content of the previous strategy
Present/Discuss:
Interoperability aspects of the NIB
The three proposed HSCIC “Platforms” (Data Services, Digital Services, Direct Care)
Outputs from the “Interoperability Board” (NHS England strategy, handbook, etc.)
HSCIC plans (Spine roadmap, GPSoC IM2, eRS, etc.)
Wider initiatives (Middleware, TechUK Interop Charter, etc.)
Scope and terms of reference for uplifting the strategy.
Questions to discuss:
Is the TOGAF model used previously the right one?
Should we focus around a defined set of capabilities required to interoperate?
Can we create a roadmap to deliver the vision (and capabilities required to realise that vision)?
Actions/Next steps

8. Deliverables
A set of "Capability Assessments" detailing individual technical capabilities required to support interoperability across the health and social care system.
A roadmap document which summarises:
The set of capabilities identified
How, when combined into a coherent service offering, they support the specific use-cases identified by the Requirements Action Group.
The roadmap for delivering the capabilities identified
High level cost/time estimates (where possible)
Timescales: Q to draft and agree capability assessments.
Any subsequent work to deliver the new capabilities identified in this work package would need to be commissioned as separate work packages, with associated business case, etc.
Draft agenda:
Review the content of the previous strategy
Present/Discuss:
Interoperability aspects of the NIB
The three proposed HSCIC “Platforms” (Data Services, Digital Services, Direct Care)
Outputs from the “Interoperability Board” (NHS England strategy, handbook, etc.)
HSCIC plans (Spine roadmap, GPSoC IM2, eRS, etc.)
Wider initiatives (Middleware, TechUK Interop Charter, etc.)
Scope and terms of reference for uplifting the strategy.
Questions to discuss:
Is the TOGAF model used previously the right one?
Should we focus around a defined set of capabilities required to interoperate?
Can we create a roadmap to deliver the vision (and capabilities required to realise that vision)?
Actions/Next steps

9. EXAMPLE: Capability Assessment
The following slides are an example of how we might describe each capability in more detail, including:
The reason why it is required, and the benefits it brings
A model for assessing the maturity of implementations of the capability
An assessment of the current state of implementation of the capability, and it’s current maturity
A proposal for the target state for delivery of the capability, including whether it should be delivered locally, regionally, nationally, or some combination of these.
Draft agenda:
Review the content of the previous strategy
Present/Discuss:
Interoperability aspects of the NIB
The three proposed HSCIC “Platforms” (Data Services, Digital Services, Direct Care)
Outputs from the “Interoperability Board” (NHS England strategy, handbook, etc.)
HSCIC plans (Spine roadmap, GPSoC IM2, eRS, etc.)
Wider initiatives (Middleware, TechUK Interop Charter, etc.)
Scope and terms of reference for uplifting the strategy.
Questions to discuss:
Is the TOGAF model used previously the right one?
Should we focus around a defined set of capabilities required to interoperate?
Can we create a roadmap to deliver the vision (and capabilities required to realise that vision)?
Actions/Next steps

10. Endpoint Directory: Purpose and Benefits
The purpose of an endpoint directory is to hold details of systems that expose electronic messaging/APIs.
It would typically include details such as:
The organisation hosting the system
The types of interactions supported by the system
The address to send messages/API calls to
Links to details required to establish a secure connection to the API (e.g. API key, link to PKI, etc.)
The directory is typically used to look-up the details based on either a logical address (e.g. obtained from a Registry), or from other search criteria (e.g. the Organisation and Interaction type).
One benefit of a directory is to allow for discovery of endpoints that can be used, without having to have prior knowledge of all endpoints (e.g. to be able to find an endpoint in a specific organisation which provides the type of information needed)
Note: This would not fully describe the APIs / messages – it is purely the endpoint and high-level type of interactions supported. More detailed information about APIs and messages supported could ideally then be queried directly from the endpoint (e.g. by retrieving a FHIR conformance profile)
Draft agenda:
Review the content of the previous strategy
Present/Discuss:
Interoperability aspects of the NIB
The three proposed HSCIC “Platforms” (Data Services, Digital Services, Direct Care)
Outputs from the “Interoperability Board” (NHS England strategy, handbook, etc.)
HSCIC plans (Spine roadmap, GPSoC IM2, eRS, etc.)
Wider initiatives (Middleware, TechUK Interop Charter, etc.)
Scope and terms of reference for uplifting the strategy.
Questions to discuss:
Is the TOGAF model used previously the right one?
Should we focus around a defined set of capabilities required to interoperate?
Can we create a roadmap to deliver the vision (and capabilities required to realise that vision)?
Actions/Next steps

11. Endpoint Directory: Maturity
Dimension: Scale
Dimension: Scope
Level
Description
No directory – all messaging has to be pre-agreed between two systems and coded / configured into each system 1
Local directory – each system maintains a list of other endpoints it can send messages / API calls to, or the directory is shared but it is tied into a specific system or service and can’t be re-used outside that context. 2
Local directory within an organisation – a directory is maintained for an organisation, and used by all systems within that organisation 3
Regional directory – a directory is held and used by all systems within a region 4
National directory of all system endpoints. This could be a single national directory, or federated (akin to DNS)
Level
Description
The directory is specific to a certain type of interaction (e.g. it is purely for SOAP messaging) 1
The directory contains details of a constrained set of interaction and endpoint types. 2
The directory is extensible to support both current and future interaction and endpoint types
Draft agenda:
Review the content of the previous strategy
Present/Discuss:
Interoperability aspects of the NIB
The three proposed HSCIC “Platforms” (Data Services, Digital Services, Direct Care)
Outputs from the “Interoperability Board” (NHS England strategy, handbook, etc.)
HSCIC plans (Spine roadmap, GPSoC IM2, eRS, etc.)
Wider initiatives (Middleware, TechUK Interop Charter, etc.)
Scope and terms of reference for uplifting the strategy.
Questions to discuss:
Is the TOGAF model used previously the right one?
Should we focus around a defined set of capabilities required to interoperate?
Can we create a roadmap to deliver the vision (and capabilities required to realise that vision)?
Actions/Next steps
NOTE: Maturity levels can be aligned with the existing NIMM models used by NHS trusts to assess infrastructure maturity.

12. Endpoint Directory: Current State
Application / Service
Maturity Level
Description
Spine CIS Directory
Scale:
Scope: 0 1 2
The Spine directory (aka SDS) is national, but it currently only holds TMS endpoint details.
DTS RATS
The directory for DTS is national, but it can’t be queried directly, and only holds DTS endpoint details. This is currently also the case for MESH.
Acute Trust Systems
Most Acutes trusts have some integration engines in place, which maintain details of endpoint systems within the trust. This is typically not exposed outside the integration engine though.
GP Systems
The four main GP systems will each have a local directory of systems they integrate with. This is not exposed externally.
Other trust systems
Many other trusts rely on specific pre-agreed point-to-point integrations between pairs of systems.
PCTi DocMan ?
MIG
The MIG will have some form of locally held directory, but this is not exposed externally, and only supports the proprietary MIG message interactions.
Draft agenda:
Review the content of the previous strategy
Present/Discuss:
Interoperability aspects of the NIB
The three proposed HSCIC “Platforms” (Data Services, Digital Services, Direct Care)
Outputs from the “Interoperability Board” (NHS England strategy, handbook, etc.)
HSCIC plans (Spine roadmap, GPSoC IM2, eRS, etc.)
Wider initiatives (Middleware, TechUK Interop Charter, etc.)
Scope and terms of reference for uplifting the strategy.
Questions to discuss:
Is the TOGAF model used previously the right one?
Should we focus around a defined set of capabilities required to interoperate?
Can we create a roadmap to deliver the vision (and capabilities required to realise that vision)?
Actions/Next steps

13. Endpoint Directory: Target State
Scale:
A national directory will support endpoint discovery for messaging/API calls within and between organisations.
Scope:
As well as supporting the main national messaging endpoints (i.e. TMS and DTS/MESH), the directory should allow locally defined endpoint information to be queried.
The exact mechanism for this would need to be agreed with trusts and suppliers, but could either be achieved by:
Allowing local trusts delegated authority to created and update entries in the directory themselves as they add/remove local endpoints.
Providing a mechanism for a query to be delegated to local directories where these exists (akin to DNS).
The interface used to query the directory should use an extensible format for the data returned, to allow for locally defined profiles for endpoint details.
Draft agenda:
Review the content of the previous strategy
Present/Discuss:
Interoperability aspects of the NIB
The three proposed HSCIC “Platforms” (Data Services, Digital Services, Direct Care)
Outputs from the “Interoperability Board” (NHS England strategy, handbook, etc.)
HSCIC plans (Spine roadmap, GPSoC IM2, eRS, etc.)
Wider initiatives (Middleware, TechUK Interop Charter, etc.)
Scope and terms of reference for uplifting the strategy.
Questions to discuss:
Is the TOGAF model used previously the right one?
Should we focus around a defined set of capabilities required to interoperate?
Can we create a roadmap to deliver the vision (and capabilities required to realise that vision)?
Actions/Next steps

14. Endpoint Directory: Roadmap
TIME
Spine Directory
Add DTS/MESH endpoints to the directory
Allow local trusts to add local endpoints (e.g. ITK-WS endpoints)
Define new simple, extensible API for querying the directory
Draft agenda:
Review the content of the previous strategy
Present/Discuss:
Interoperability aspects of the NIB
The three proposed HSCIC “Platforms” (Data Services, Digital Services, Direct Care)
Outputs from the “Interoperability Board” (NHS England strategy, handbook, etc.)
HSCIC plans (Spine roadmap, GPSoC IM2, eRS, etc.)
Wider initiatives (Middleware, TechUK Interop Charter, etc.)
Scope and terms of reference for uplifting the strategy.
Questions to discuss:
Is the TOGAF model used previously the right one?
Should we focus around a defined set of capabilities required to interoperate?
Can we create a roadmap to deliver the vision (and capabilities required to realise that vision)?
Actions/Next steps
…repeat for all other capabilities…
.. and incorporate into a combined roadmap…