Standards and interoperability (IT)
Standards and interoperability (IT)
The use of ‘standards’ within the health sector enables people, devices and systems to communicate in a more efficient and electronic manner. The growing use of standards should improve patient care and should also help to improve centralised records as well as enable improved analysis.
Standards can also reduce the need for health and care workers to ‘re-key’ information and for patients to need to repeat themselves about their experiences.
Interoperability refers to systems that interoperate with each other using shared technical standards.
The technical standards used within pharmacies and by pharmacy systems are sometimes developed and defined by a variety of stakeholders. NHS Digital and Professional Record Standards Body (PRSB) have had a large role with setting standards using feedback from stakeholders including patients, pharmacy teams and others.
Overview and examples
When standards are implemented most effectively by system suppliers and wider stakeholders then these should not need to be noticed by pharmacy teams using systems. GP practice systems also align with many global clinical codes such as SNOMED CT codes. Pharmacy systems also align with some SNOMED codes and partially because of the use of EPS with aligns with the Dictionary of medicines and devices (dm+d).
Examples of standards:
- Train tracks: From 1845 the Royal Commission on Railway Gauges supported a standardised train track size so that trains and train tracks could be more frequently built to a shared specified size enabling trains to operate across different areas of the country.
- EPS: NHS Digital EPS standards enable a GP practice to use their clinical system to send an electronic prescription to the central NHS Spine where it can be downloaded by pharmacies using their patient medication record (PMR) system.
- Flu notification: Electronic flu vaccination notifications are being sent from pharmacies to GP practices. The notifications are securely transferred from certain systems used within pharmacies to certain GP practice systems automatically.
List of health standards and related organisations
These include the below listed alphabetically.
|Organisation(s) / standards||Type||Area||Further information|
|Data Coordination Board (DCB), previously SCCI||Organisation||England||Oversees the development, and approval of information standards, data collections and data extractions.|
|dm+d NHS medicines database||Standard/database||England||The NHS standard dictionary for medicines licensed in the UK. Electronic systems that exchange or share information about medicines relating directly to a patient’s care must adhere to this standard by using dm+d identifiers and descriptions when transferring information.|
|Endeavour Health (charity)||Organisation||England||Aims to improve healthcare by enabling the design of, and researching the effectiveness of, new forms of healthcare information technology and healthcare provision with particular emphasis on patients as users of IT.|
|Everyday Interactions||Standard/Report||England||Outlines public health impact ‘pathways’ to support pharmacy teams and others to record what they ‘do’ in their interactions with patients, what data can be collated and also the possible impacts from these interactions. These pathways could be of interest to pharmacy contractors and their system suppliers. The pathway templates include: Obesity, alcohol, dementia, and smoking.|
|FHIR Foundation||Organisation||England||Promotes global adoption and implementation of the FHIR® platform standard.|
|FHIR standard||Standard||England||A platform specification that defines a set of capabilities used across the healthcare process, in all jurisdictions, and in lots of different contexts.|
|GP Connect||Standard||England||Enabling access for Direct Care purposes to Patient data in GP Provider Systems via new APIs based on open healthcare data exchange standard.|
|GP2GP service||Standard||England||Allows patients’ electronic health records to be transferred directly, securely, and quickly between their old and new practices, when they change GP practices.|
|HL7 UK||Organisation||England/UK/Global||Dedicated to providing a framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information.|
|Informatics Design Authority (IDA) and Informatics Portfolio Management Board (IPMB)||Organisation||England||To provide technical review and support on proposals for data standards.|
|Information Sharing Gateway (commercial)||Info sharing /consent model system||England||Organisations can sign-up to co-sharing agreements. Aims to ease the administration and risk assessment of information sharing agreements in the public sector. It has been designed to support Information Governance (IG) reporting / flows.|
|Interoperability Handbook (NHS England and NHS Digital)||Standard||England||Explains the interoperability options you can take and how to procure using interoperability tools and standards. Provides a framework for: (1) Business Justification for investment in contributing towards integrated EHRs; (2) IG templates and guidance; (3) cliniciand and patient engagement; and (4) Open interface.|
|Interoperability toolkit (NHS Digital toolkit)||Standard||England||A set of common specifications, frameworks and implementation guides that support interoperability.|
|INTEROPen||Group||England||An action group to accelerate the development of open standards for interoperability in the health and social care sector. Leading organisations and individuals are encouraged to join INTEROPen. Members include NHS Digital, GP system suppliers, and many of the organisations included within this list.|
|medConfidential||Organisation||England||Campaigns for confidentiality and consent in health and social care – seeking to ensure that every flow of data into, across and out of the NHS and care system is consensual, safe and transparent.|
|NHS Digital||Organisation||England||Supports the NHS and social care services.|
|NHSX||Organisation||England||Supports use of digital across the NHS.|
|NHS number||Standard||England||The NHS Number is the unique patient identifier in operation in the NHS. It is used to efficiently share patient information across and within organisations. It is composed of ten digits: e.g. 123 456 7890|
|Notifications from pharmacy systems to GP practice systems||Local piloting to occur prior to confirmation of national roll-out||Leeds pilot||
Interoperable structured notifications which can be communicated across clinical IT systems (e.g. from pharmacy system to GP practice system) can improve patients’ care outcomes, and bring other health-related benefits.
PRSB sets out standards for notifications which could be sent from pharmacy systems to GP practice systems.
|ODS (F) code||Standard||England||The contractor code is a pharmacy’s unique identifying code which appears at the top of the schedule of payments document that is received from the Pricing Authority each month. The code is officially known as the ODS code, and was previously called the OCS code, NACS code or F code.|
|Open Source Programme (NHS England)||Programme||England||NHS England and NHS Improvement supports the Open Source Programme because it is intended to be about making best practice IT solutions in health and care accessible to all. The programme suggests making the software, or the source code freely available and downloadable from platforms such as GitHub,|
|openEHR||Organisation||England||This not-for-profit company has a vision of life-long interoperable electronic health records (EHRs); and computing on EHRs to improve the quality of health care and research. Its mission is to promote and support implementation.|
|Professional Record Standards Body (PRSB)||Organisation||England||Works with the public and healthcare professionals to define the standards needed for good care records.|
|Standard dosage syntax||Standard||~||A standard to encourage a more standardardised structure to represent dosage instructions, for example, “Take two tablets three times a day.”|
- E-learning Health Informatics (NHS Digital)
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