1. www.england.nhs.uk
Breaking down
barriers
Interoperability in primary
care
Mike Smith
Interoperability Lead for
Primary Care
NHS England
30th June 2016

2. www.england.nhs.uk
Interoperability
• Interoperability is the ability for one or more systems to communicate in
a manner that is seamless to users to achieve a task or goal
• Interoperability is an element of coalition willingness to work together
over the long term to achieve and maintain shared interests against
common threats
• Interoperability is the ability of different information technology systems
and software applications to communicate, exchange data, and use the
information that has been exchanged.

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A Historical perspective
NATO was established by the U.S. and Western Europe in 1949 after World War II
This new organisation was presented with the challenge to make different
participating nations’ forces, units and systems operate together as one military unit.
NATO identified three elements for successful interoperability:
• Unity of purpose
• Unity of effort
• Unity of command
In other words, it needs to be clear to everyone what they are there to do, how they
are going to do it, who is in charge

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Interoperability Barriers
Barriers Potential Solutions
Thinking and acting in Silos Patient storyboards to get everyone on
the same page/ LDRs
Costs of delivering interfaces Community shared effort
Lack of Standards C4H, PRSB
Governance and Trust Tools for data controllers & Patient
Supplier engagement Build Foundation APIs which can be
used for multiple uses
Inflexible Technology Reusable components, vendor neutral
Lack of Knowledge Demonstrators, Ecosystem

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Opportunities from being interoperable
• Products work across health economies
• Measurable efficiencies from providing interfaces
• Differentiate products by adhering to standards
• Putting patients in control builds trust in sharing and your product
• Strengthening supplier relationships
• Providing Technical solutions

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Interoperability Capabilities
Openinterfaces
Appointments
Manage appointments in order to co-
ordinate access to care
Tasks
Manage tasks in order to work effectively
across care settings
Access Record
Access a patient’s care record for the
purpose of direct care
TransfersofCare
eDischarge
Discharges from inpatient care back to
the general practitioner
A&E eDischarge
Information sent to the general
practitioner from an A&E attendance
Emerging needs

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An Example:
System One & Self-
referral integration

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Self referral to Physiotherapy: Now
Patient makes
web based self
referral
Self referral
electronically
triaged
Patient receives
email
advice/exercises
PDF created,
saved and
manually attached
to System one
Referral picked up
by admin team
Patient called by
admin team to
book System One
Appointment

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Self referral to Physiotherapy:
Proposal
Patient makes web
based self referral
Self referral
electronically triaged
Patient self referral
details imported to
System One
Patient receives email
advice/exercises &
link to System One to
book their
appointment

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Benefits of Self referral
• Patient in control of booking
• Allows patient to continue electronic journey
• Reduces administration time required significantly
• Reduces human error in IT booking / registering

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Fundamentally, technology integration with
S1 would deliver the required patient
journey benefits and in fact the scale
becomes unwieldy without an overall
Health Digital approach.
Dr Phillip Dale, Clinical Director Allied Health Professionals Surrey
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Neutral Platforms will drive success
• Interoperability relies on being:
• Open
• Collaborative
• Reusable
• Extensible
• Standards driven
• The interoperability platforms that will be successful will exhibit
these principles

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GP Connect - “A” Neutral Platform Example

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Code4Health Interoperability
Community
Creating a common and open set of APIs to support information sharing across
health and care

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Exploring new opportunities
An Ecosystem being developed by HSCIC will
help suppliers explore, develop and assure
interoperability opportunities more rapidly.
The first three APIs are:
Access Record Appointments Tasks
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Reasons to be cheerful
• We are listening
• Applying the TechUK Interoperability Charter
• Building Open APIs
• Developing an Ecosystem to accelerate progress
• Supports Interoperability Communities
• C4H, Aperta, Synapta, OpenHealthHub
• Building national supporting services
• Patient record locator
• Security proxy
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Any questions?

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Get in Touch
england.digitalprimarycare@nhs.net
#DigitalPrimaryCare
#FutureNHS
Digital Primary Care website