NHS England/Improvement Transformation Directorate has released a new draft Standards and Interoperability Strategy, and has commissioned The Faculty of Clinical Informatics to support a consultation process seeking feedback and views to help shape the strategy further.
The new draft strategy, entitled ‘How Standards Will Support Interoperability,’ aims to ‘improve levels of interoperability’ across the NHS, as well as providing an overview of the challenges and opportunities, clarifies definitions of key terms, and outlines the main ‘foundations for success’.
Included within the 23-page document are sections on the vision of the strategy: forming a defined care model; the strategy’s architectural approach; the desired look of an interoperable health system; using open protocols and tools; enabling increased use of event-based architectures; enabling information discovery; making it easier to implement standards; and making it commercially attractive to develop standards-compliant software.
Included in the ‘foundations for success’, the document states: having consistent content models, providing clarity on ‘what already exists and what is required’, and providing guidance ‘early enough’ in the development cycle; publishing expectations of what standards ‘should be implemented’, and ensuring requirements are ‘consistent’ across procurement frameworks, assurance processes and spend controls.
The document also notes the need to introduce a mechanism to identify which vendors’ systems are ‘conformant’ to help providers choose ‘the right’ technology, and ‘understanding and overcoming’ current barriers to implementation.
On identifying the challenges, the document asserts that it is hard to measure progress; it is difficult to prioritise different care pathways against one another; there are gaps between health and social care, as well as a legacy issue as systems were designed with ‘health in mind,’ rather than social care; health and care providers are attempting to solve interoperability challenges alone, which leads to inconsistencies, duplications and wasted resources.
It then outlines the core components of a defined care model ‘fit to share’ with other practitioners, carers and the people receiving care. On the architectural approach of the strategy, the document provides insight into the criterion for a desired interoperable health system.
The document also focuses on ‘shared reusable record structures’, to build an ‘ecosystem’ of information standards, in which SNOMED CT, ICD-11, a procedure based classification (PBC), Unified Test List (UTL), Dm+d and HL7 FHIR are highlighted, with an aim to ‘drive uptake’ of these to strive for consistency.
On ‘building the missing blocks’, the strategy highlights: “having content specifications such as FHIR profiles and clinical terminologies is not enough to enable interoperability. We need to have the necessary guidance and components to enable suppliers to build APIs and interfaces in a consistent way.”
It then proposes that clear guidance is to be created so that system APIs can be delivered in a uniform, interoperable way and a national authorisation service should be created. It goes on to highlight: “we will create a technical ecosystem which allows systems to discover each other and connect securely, even where they have never encountered one another before. Essentially learning from Open Banking’s dynamic client registration approach.”