1. Systems Integration - How do you connect a region
Eileen Jessop – Deputy Director Informatics
The Leeds Teaching Hospitals

2. A Fraction of Our Programme for 2012
Patient Care and Dash Board
Merged Switchboard - AVA
Order Communications
E-DAN/EDID
Maternity
Dental Institute
Infrastructure
Wireless
Digital Dictation
Genetics
Clinical Portal
Collaboration
The Leeds Care Record

3. But at the heart of our programme
Integration

4. But what we have got is complex Infrastructures - A Need To Change
Problems
Too many servers
Too many different protocols
Too many data “standards”
Too many points of failure
No more PAS Connections
Limited Development and Support Staff
Duplication of tasks every time an interface is created.
WASTE OF RESOURCE!!!

5. Questioned What Can we do regionally
Centre for a number of Regional Hubs
We don’t make it easy to connect to us
Regional problems - Renal
Our solution

6. Could we be innovative about our approach to our clinical networks
Experiment
Recycle ideas
Be Patient
Big picture
Recycle ideas – was it the right idea at the wrong time
Its about ‘Nowism’ and results
We work in success cultures, its what we know, if it was the right idea someone would have done it already so we make enemies mostly internal
We want to cling to the familiar
Be patient – persistance is everything
Magnus Lindkvist

7. Lots of coffee and whiteboards
Current Architecture and the need for change.
Grown organically over a number of years
New integration platforms put in with no migration done from existing platforms.
The server in purple are physical boxes currently in use that deliver interfaces. There are way to many, they all need supporting, maintaining, rack space space in the server room, air-conditioning, access to an interruptible power.
A multitude of different message formats and standards and protocols for the collection and delivery of messages.
Limited resource available to specify, develop, implement and support the existing infrastructure
We have reached the limit of connections that PAS will support which means we had to consolidate if we where to meet the future integration requirements of the Trust.

8. Future Architecture
It’s a picture so much work behind this so much more still to be done.

9. Could we leverage our development of PPM and Portal with our investment with Ensemble and Health Share Foundation?
IHE Profiles, such as XDSb, XCA, XCPD, PIX, and PDQ
CDA and CCD Documents, NwHIN Direct
HL7v2, HL7v3
DICOM
X12
and more
Composite Health Record
Clinician Viewer
Patient Index
Provider Directory
Terminology Engine
Consent Management
Clinical Message Delivery
Active Analytics
Rolls Royce Visit – Look at the Trent Engine through Lego and you understand the complexity of what RR have built. Building models and experimenting looking at things differently through other’s eyes.

10. Thank you for listening Questions
Tertiary Care: Oncology, Cardiology