Health Information Exchange design and development

As a specialist provider of information systems architecture and design services, we work with clients at all stages of the development lifecycle, from problem definition and solution option appraisal through design and procurement to supplier implementation support and assurance.

Our aim is to provide the right mix of specialist technical expertise to meet our clients' needs.  We follow an approach that balances continuous delivery of business value with robust architecture design.

Central to this is the practical application of open standards, patterns and frameworks to help accelerate delivery.  This was demonstrated in full during our work with NHS England London Digital Programme wherein we provided expertise across four Enterprise Architecture domains and used TOGAF® [1] to help design and support development of a standards-based Health Information Exchange (HIE).

ldp_case_study

The challenge

The benefits of joined-up, person centred healthcare [2] are widely recognised and include improved quality of care and patient satisfaction through better planning, coordination, decision making and communication.  With this in mind, the vision of London Digital Programme (LDP) was to promote joined-up patient care between different care providers, settings (e.g. primary and acute care) and localities across London by establishing a London-wide Health Information Exchange (HIE) for securely locating and sharing electronic health record information.

What we did

Working in close partnership with LDP and with healthcare providers and sponsoring bodies across London, we led on the design of the HIE and provided the key architectural resources required to oversee development.  This included provision of:

  • Business Analysis expertise to engage sponsors/stakeholders and understand vision/requirements/desired outcomes
  • Information Architecture expertise to develop common data exchange model for implementing in HL7 FHIR XML and JSON
  • Solution Architecture expertise to design exchange solution for multi-vendor procurement and implementation, including specifying external SOAP and RESTful web-services interfaces
  • Security Architecture expertise to implement ISO:27001 ISMS and design SAML-based authentication service and XACML policy-based access controls
  • Implementation Governance and solution assurance across each architecture domain.

Our impact

Key outcomes of our engagement with London Digital Programme included:

  • Defining initial datasets commissioned as national standards for electronic documents used in crisis care information sharing and EoL care coordination. [3]
  • London NHS 111 urgent care service proof-of-concept demonstration to retrieve electronic palliative care summaries for triaging patients; and
  • GP practices, acute hospitals and hospices proof-of-concept demonstration to coordinate end-of-life patient care through creation and update of a single shared care plan.
  • Implementing set of HIE interfaces to enable healthcare providers to locate and share clinical documents securely using IHE, HL7 FHIR and SNOMED CT standards.
 
 

Sources

  1. The Open Group Architecture Framework (TOGAF®)
  2. National Voices - A Narrative for Person-Centred Coordinated Care
  3. Professional Records Standards Body (PRSB) - Crisis Care Standard

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