Delivering interoperability can be a hard task so Liam King, managing director at Healthcare Gateway explores what the options are.
If you’re lucky enough to be asked to implement patient record sharing and interoperability for your NHS organisation, what should your priorities be? For me, making patient data available as quickly and reliably as possible would be at the top of the list, with the lowest risk of project failure running a close second. Best practice surveys, software functionality, researching software vendors – many other tasks will be on that list, but don’t neglect one vital question: how will the technology that supports day-to-day interoperability be delivered?
These days, the choice is usually between conventional installed software (either on an in-house server or hosted at a data centre), SaaS (Software as a Service, residing in the Cloud) and a managed service.
The last two might seem almost identical – you access them online, you pay a monthly fee – but beyond that superficial similarity, they are very different animals. Which model you choose affects how much effort is needed from your internal team, the overall chances of project success and, once up and running, how easy it is to manage interoperability from day to day.
Project success is hard work with software
Most software today may well reside in the Cloud and be called a “service”, but it is still a standard application that must be set up to fit your specific needs. For example, linking diverse systems often involves customising standard software – bespoke coding – which is notoriously time-consuming, expensive and fraught with problems like bugs or functionality at odds with what users need.
Buying, adapting and implementing software in this way increases project risk. Delays, cost overruns and even outright failure are all too common. It’s worth remembering that only a minority of IT projects are a complete success.
The responsibility for avoiding failure falls squarely on the internal NHS project team. They must define the scope and schedule, and make sure everyone sticks to it so that project objectives come in on time and on budget.
Once it’s running, they must check that the new software is being correctly updated and maintained so that it keeps working properly. Cybersecurity has to be rock-solid and personal data must comply 100% with data protection guidelines. If there are problems that leave clinicians without vital patient information, it’s the internal team’s phones that will start ringing.
And when issues arise beyond the software itself – data protection compliance, liaising and connecting to new sources or users of patient data – NHS IT and NHS project managers will usually find that, once again, it’s all down to them to sort out.
A helping hand for your project
All of this means that successfully delivering a conventional interoperability project demands serious in-house technical knowledge, experience and resources. There is a huge amount of IT talent in the NHS, but where specialist skills are lacking, CCGs (and now ICSs) will have to find outside consultants or train and recruit in a hurry to fill the gaps.
Contrast that with a managed service. It doesn’t just deliver software, it gives you interoperability as a service – it’s a one-stop shop. So, although there’s software under the bonnet, you don’t have to worry about installing it or keeping it running.
Instead, the service includes a host of experts that come in and make those vital connections between siloed systems quickly and smoothly, and help you take care of all the other details too. Supporting the scoping, delivery and – critically – the ongoing management of your interoperability programme is what they do.
Viewed from the outside, this kind of solution just works, simple as that. If you select a proven interoperability service that shares tens of millions of records every day with a host of experienced people in charge, there’s less project risk and significantly less work required to get a new project off the ground.
A one-stop shop for interoperability
A managed service is often seen a tactical fix, something that can quickly and reliably “glue” local data sources together but is somehow not as effective as a conventional “big bang” project with a big software brand. That is simply not true.
A managed solution can certainly deliver projects quickly but it can also scale easily to support regional exchange-to-exchange interoperability.
It also avoids the risk of being landed with software that isn’t able to develop in step with shifting NHS standards, reaches the “end of the line” and must be replaced at great expense. Instead, a managed service grows and evolves to fit your specific needs as they change over time.
The beauty of this sort of solution is that it’s a complete package, so there’s little need to worry about networking, security or upgrades for the interoperability software beyond the mandatory NHS audits. There’s advice and support on everything from information governance to ISO standard compliance: good providers will help write data protection statements or advise on running the baseline research for possible new data sources.
One example is obtaining consent for data sharing, something that can – and has – seriously delayed some programmes. Rather than just dumping that responsibility in the lap of the client, a managed service provider should do as much of that work for you as humanly possible, managing the third-party relationships with all the other contractors involved and acting as a single point of contact for all issues. Advice and resolution are a phone call or an email away.
The net result of choosing this method? Less risk and much less internal time and effort needed to deliver and maintain interoperability. A managed service is quicker, well proven and, with end-to-end help to tie up all the loose ends, can significantly reduce the stress and hassle for busy NHS teams.