The SystmOne GP solution from TPP and CSE Healthcare System’s RiO solution have traditionally shared patient information through paper-based referrals and discharge letters where information has been manually keyed into both systems. GPs have historically created a patient referral which is entered into SystmOne, sent via fax or post to BDCT, and then manually typed into the RiO system. Discharge Letters were then similarly sent back to GPs to be scanned into SystmOne.
The RiO system has been in place at BDCT since 2009. It serves approximately 1,900 users and over 10,000 patients, providing services for Adult Mental Health, Older People's Services, Forensics, Child and Adolescent Mental Health Service, Drug & Alcohol and Learning Disabilities. Likewise, SystmOne has been in place with the BDCT Community Services for many years and serves over 1,500 community staff members and over 11,000 patients. BDCT Community Services include Adult Community Nursing, Allied Health Professionals, Children's Services, Substance Misuse and Primary Care Mental Health.
Tony Middleton, Head of Informatics at BDCT, commented on the project: "The integration between these two systems is part of a wider Healthy Ambitions initiative in Bradford to join up health and social care. Both the SystmOne and RiO systems are critical to the Trusts they serve, and it was vital that the Trust, both System providers, and our Integration Service partner, ReStart, worked together as closely as possible to enable the success of this project."
The Trust, working in partnership with its key stakeholders, Clinical Services and Clinical System providers, established a Project Board to set the objectives and oversee the progress and overall effectiveness of the project.
When asked about the key objectives of the initiative, Tony responded: "BDCT is pursuing an integration and interoperability strategy. Our main targets for this project are to reduce the risk associated with manual input of patient data from one system to another and avoid duplication of effort in the process. It is our intention to provide GPs and Clinicians with a Single Point of Access to patient records and ultimately improve the patient experience at the same time."
The Trust completed a thorough Risk Assessment prior to the project commencing. The team at BDCT identified a number of potential risks to the Trust, the PCT and its patients if the project did not go ahead. These included: inability to deliver effective care to service users, inability to support the Organisational Transformational Programme, increased clinical risks, inconsistent data quality and loss of data in transit.
Like many other Trusts in the Yorkshire & Humber Strategic Health Authority (SHA) region, BDCT had already purchased InterSystems Ensemble® rapid integration and development platform as a Trust Integration Engine (TIE). Integration Services Provider, ReStart Consulting, who already had a longstanding relationship with other Trusts within Yorkshire & The Humber were recommended to the Trust to manage the deployment of Ensemble, providing consultancy and services around the solution to enable the smooth integration.
The Trust had its own set of quality assurance objectives. It firstly had to ensure that interface messages between the systems would be transactional-based with messages pushed from the source system. In addition, the receiving system had to provide acknowledgement messages to be returned to the source system for all interface messages received. All message content had to be encoded and formatted to agreed industry standards and transfer of these messages had be over a secure N3 network. Finally, messages had to be sent in a synchronous method to ensure they could be processed in the correct sequence.
Mike Symers, Managing Director at ReStart Consulting said: "This is another success story for ReStart and InterSystems in the Yorks & Humber region. It is teamwork that has brought this project to fruition in such short timescales. The Project Board which consisted of BDCT, the Clinical System providers and ReStart worked closely together to effectively map out the project in incremental stages, and we owe the rapid success to this model of working."
Phase 1, which has been completed and tested, is set to go live in September 2012. The objectives of Phase 1 were to enable basic transactional integration for the Healthy Ambitions SPoA. Phase 2 is set to roll out next and provide read-only access to Primary Care Records for RiO Users at the Care Trust. Phase 3, which has yet to be initiated, will aim to deliver integration for all SPoA Services for Registrations, Referrals, Admissions, Discharges and Transfers. The final Phase will aim to deliver full integration between BDCT's two major Clinical Systems to deliver the objectives of the Trust Transformational Programme.
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About ReStart Consulting Ltd
Restart is a niche supplier of data integration and data management solutions in the Healthcare market, operating within NHS Trusts to provide integration solutions around the applications deployed within the Trusts. ReStart’s consultants come from a variety of integration backgrounds ranging from the largest Healthcare integration projects in the NHS, such as the spine and the integration at Imperial College, to major European commercial projects. This mixture provides an outstanding technical level of competency when working across the integration requirements of the NHS.
ReStart has worked in nearly 50 Trusts and with the background of its consultants has built over 1000 interfaces through the years. Restart supports the Interoperability Tool Kit (ITK) approach being created by Connecting for Health (CfH) and provides a coherent Service Orientated Architecture (SOA) approach to the Trusts where it has deployed integration engine solutions.
ReStart Consulting covers the full range of deliverables including Architecture consultancy, deployment, training, mentoring, and on-going support of complete integration environments. In particular, part of the company’s added value is in the Java CAPS and Ensemble training courses where it provides tutoring that builds on the knowledge and practice gained from the basic courses these companies provide.
InterSystems Corporation is a global leader in software for connected care, with headquarters in Cambridge, Massachusetts and offices in 25 countries. InterSystems Ensemble® is a platform for rapid integration and the development of connectable applications. InterSystems Caché® is the world's most widely used database system in clinical applications. InterSystems HealthShare™ is a strategic healthcare informatics platform for information exchange and analytics within a hospital network, and across a community, region or nation. HealthShare leverages InterSystems iKnow and DeepSee technologies to unlock all patient information, including unstructured data, and to enable real-time analysis. InterSystems TrakCare™ is an Internet -based unified healthcare information system that rapidly delivers the benefits of an Electronic Patient Record.