HL7 UK response to How Standards Will Support Interoperability

In May this year the Faculty of Clinical Informatics (FCI) was commissioned by the NHS England Transformation Directorate to help them with consultation on their draft Standards and Interoperability Strategy.

https://facultyofclinicalinformatics.org.uk/blog/faculty-of-clinical-informatics-news-1/post/how-standards-will-support-interoperability-90

Hl7 UK welcomed the draft strategy as an important step forward in improving interoperability between systems used in health and social care and submitted a substantial amount of feedback to FCI.

We understand that the draft strategy has been revised and is ready for publication. In anticipation of that, we are making our full comments document available here.

In summary we made a number of high-level comments about the strategy and focussed on FHIR issues. Our main recommendations were:

Prioritize FHIR

The draft strategy placed considerable emphasis on defining a model care record and an overall architectural approach. Even if these initiatives should be pursued as advocated, we argued they will take a considerable amount of time and resource.

However, significant levels of interoperability can be achieved using FHIR or other HL7 standards, and that is without the proposed initiatives. We therefore strongly recommended that greater, overriding, priority be given to implementing interoperability solutions that are proven and can be deployed in the short term.

We also said the long-standing issue of information not flowing as required between the NHS and social care should also be a priority.

Exploit international initiatives and best practice in the UK

Our key message here was that technical solutions already exist and “we need to be looking at how the rest of world actually achieves interoperability”. We also highlighted the shining examples of the the YHCR (Yorkshire & Humber Care Record) and the SIDeR programme in Somerset.

We suggested that while local FHIR Profiles and IGs (Implementation Guides) are helpful, much progress can be made without them. In addition we pointed out that different versions or releases of FHIR should not be a blocker – these issues are relatively minor in comparison to all the other aspects of major interoperability projects.

Address funding

We were concerned that the strategy did address funding and said “Even if the many other actions that the Centre proposes to take are all achieved, that will be of limited use if there is insufficient funding either for deployments at local level or for central development. If the revised version of the document does not address funding in greater detail, there is a significant risk that the strategy will not have the support or engagement that it would otherwise deserve”.