CSW Builds HRI Prototype

CSW Health  has announced that it has developed a Health Records Infrastructure (HRI) prototype for South Staffordshire Healthcare NHS Trust in support of the NHS Information Authority’s development of a national HRI infrastructure.

Currently undergoing final testing the new system, which provides an index of all records held on an individual patient in local clinical systems, is due to go live in January 2003 with over 700,000 patient records.

The concept of HRI, based on linking up existing computer systems containing patients’ health records, is being pushed by the NHSIA as central to the development of a national infrastructure to support integrated clinical records. The idea is to share patients’ health records nationally by hooking up different systems holding patient data to create a ‘virtual record’ rather than create a central national database.

CSW are also supporting the NHSIA with the design and implementation of the core Web Services required to support the HRI. The HRI developed for South Staffordshire uses XML, and is web-based.

The pan-community HRI demonstrator for South Staffordshire is based on CSW’s Case Notes product and designed to provide access to local person-based health information through a common interface. South Staffs was one of the leading sites of the NHSIA’s ERDIP programme over the past two years.

"CSW has been working with South Staffs on the project since the summer," explained Dave Nurse, technical director at CSW told E-Health Insider. "We had already built a community gateway as part of the South Staffs ERDIP using Web Services."

NHS users access the system by logging on to a central gateway application, and can then access clinical systems such as GP systems, acute electronic patient records and an electronic health record within two local primary care organisations.

Authorised users use the prototype HRI to search for a patient’s records using the National Strategic Tracing Service (NSTS), and the patient’s post code. Using the local Exeter Community Index the user is then directed to the local information systems that hold the patient’s data.

Making use of XML-based Web Services the HRI identifies matching patient records held in local clinical systems, creating a ‘virtual’ record of the NHS events for an individual patient created.

Searches can be made using the NHS number, first name, surname, date of birth, alias or gender. This provides a list of possible patients. Once the appropriate patient is selected the system creates a list of third party systems on which information about that patient is located, using the Exeter community index.

In practice the HRI provides a gateway to local third party applications that have been registered and which meet a set of common standards. These standards include various roles and relationships with the third party system and HRI, patient details, consent and confidentiality issues, auditing and the transfer format.

In this first phase of development the HRI provides an index of locally held records and then ‘drops’ users into local systems. Later phases of development will build a full virtual record extracting data from local systems.

"Phase one of the HRI is to identify which systems have information about a patient and to provide a secure interface into them," explained Mr Nurse.

Although the patient’s information continues to be stored on the separate local third party systems across South Staffs, the virtual record created will be made available to staff and patients when and where it is needed. The person viewing the record is only able to view the information they are authorised to see.

A variety of security mechanisms are used to protect confidential patient information, including: Hypertext Transfer Protocol Secure (HTTPS), firewalls and passwords. The project has also investigated patient consent issues, leading to the development of an access control framework and a simplified patient consent record.

Mr Nurse said that the new HRI system is designed to be extremely scalable. "Any system that can interface with HRI can be added."