The Interoperability Toolkit

The Interoperability Toolkit (ITK) is one of the standards that are applicable to the NHS Interoperability Framework. Before discussing the ITK in more detail, I will provide a context.

Patient Records

Patient records are central to the delivery of healthcare and serve a number of functions including the recording of clinical assessments and interventions. Aggregated data is also utilised at a local and national level to inform commissioning.

Electronic Patient Records

The digitisation of patient records offers a number of advantages over paper based records. These advantages include automated backup of records, reduced use of physical storage space (since paper based notes are switched to servers), off-site access to records using mobile devices and the potential to develop analytical clinical support tools which use computers to process clinical data to help improve clinical decisions. Not all healthcare services have electronic patient records but most providers are moving in this direction.

Getting Electronic Patient Records to Talk to Each Other

When patients move between healthcare providers – for instance between primary care and the hospital – they may find that one provider does not have information that the other provider has. There are many providers and many electronic paper record systems. For two systems to talk to each other they have to solve a number of problems. When these problems are solved a patient can move between providers and healthcare information can be accessed by the different providers. A key solution to this problem of health information gaps is the Health Information Exchange (HIE).

The Health Information Exchange

There are many definitions of what a Health Information Exchange is. (Hersh et al, 2015) define a HIE as follows:

‘Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations’

Whilst this definition is simple, the process of sharing clinical information between healthcare organisations is technically complex and encompasses a range of software, hardware and governance issues. The process of helping systems to talk to each other is helped by the development of standards. A set of standards is outlined in the NHS interoperability framework.

The Interoperability Framework

A digital copy of the Interoperability Handbook can be found at the NHS England website (NHS England, 2017). The handbook explains how an interoperability framework can support an interoperability strategy. The Interoperability Framework has three layers – a governance layer, an exchange layer and an interpretation layer.

The Standards Applicable to the Interoperability Framework

Appendix A in the Interoperability Handbook shows how various standards map onto the Interoperability Framework (NHS England, 2017).

The Interoperability Toolkit

Amongst the standards that map onto the Interoperability Framework is the Interoperability Toolkit. Further information can be found at the NHS Digital website (NHS Digital, ITK, 2017). The ITK contains a mixture of specialised technical information as well as material that is relevant to governance. The ITK includes service details, technical details of how data is transferred, the behaviour of the systems, details of the Spine mini-service (which enables communication with the National Spine) and organisation level information.

Citations

https://digital.nhs.uk/article/1104/Read-Codes, accessed 8.4.17

https://digital.nhs.uk/interoperability-toolkit/releases, ITK, 8.4.17

https://www.england.nhs.uk/digitaltechnology/info-revolution/interoperability/, accessed 8.4.17

Hersh WR, Totten AM, Eden KB, et al. Outcomes From Health Information Exchange: Systematic Review and Future Research Needs. Eysenbach G, ed. JMIR Medical Informatics. 2015;3(4):e39. doi:10.2196/medinform.5215.

There is also an NHS Digital Twitter account here.

Links to Other Posts in the Health Information Exchange Series

General Posts to Date on Health Information Exchanges

Posts on Examples of Health Information Exchanges

SNOMED CT®/ICD Mapping and Harmonisation Posts

SNOMED CT® Posts

ICD 1-10 Posts

ICD-11 Posts

Index: There are indices for the TAWOP site here and here

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