Sharing the best to last

The Information Sharing Challenge Fund may well be the most innovative information initiative to come out of the Department of Health, but it comes with eye-wateringly tight deadlines and has no clear future.

Friday, 5 October, is the deadline for submissions for an initiative that was announced on 31 August, and which is expected to award £2.2m of unspent funding from the National Programme for IT in the NHS to 40-50 projects.

All of these will have to support information sharing for defined business benefits, and be spread through the NHS interoperability toolkit to deliver benefits by the end of March 2013.

What happens after that date is unknown. As a result, something that has the potential to be a hugely important development in NHS IT interoperability may instead just prove a final postscript to NPfIT.

Main aim is to drive ITK use

According to the ISCF website: “The fund has been established to accelerate the exchange of digital information, address barriers to the development and early adoption of re-usable approaches sharing digital information and reduce the associated costs of integration across the NHS.”

It offers development challenges with small pots of seed-corn funding – typically between £25,000 and £75,000. The maximum award will be £99,000, the ceiling before European procurement regulations apply.

The money can be used for almost any aspect of a project to develop, deploy and promote ITK standards, and the main aim is to drive the so far limited use of ITK messaging templates within the NHS, and prove its value.

The technically rigorous ITK interoperability messaging templates are grounded in HL7 standards. With HL7 now committed to become an open standard, this means the Department of Health is backing open, re-usable standards-based interoperability that can deliver proven benefits in health and social care digital integration.

Three types of award available

Specifically, the programme board is looking for local organisations to commit to a “first of type implementation of a new digital information sharing specification.” Three types of award are available: for development, adoption and deployment; but not all are available for every ITK capability.

The main ITK capabilities awards will be made available for: clinical correspondence: maternity forms; digital device capture integration (a new ITK specification); telehealth personal health monitoring; clinical dashboards; admission discharge and transfer; and discharge summaries.

ITK Personal Demographic Services Spine mini-services are excluded from the funding as are ITK Release 1 capabilities.

In addition, the project is also inviting expressions of interest for additional capabilities. Possible future quick wins are identified as: order communications; document repositories; care planning and task assignment; and patient centric records

The prospectus says: “Priority will be given to projects that show real, significant innovation and the ability to realise benefits, as well as demonstrate commitment and deliverability.”

ISCF a shadow of original sharing plan

The idea of ISCF has been around for more than two years. One year ago, Keith Naylor from the Department of Health’s Informatics Directorate said an announcement was imminent.

Unfortunately, the extended purdah either side of the 2010 General Election, the extended passage of the Health and Social Care Bill through Parliament, and the generally parlous state of NHS Connecting for Health added up to a recipe for paralysis.

The delays mean the fund is almost out of time before it begins. Indeed, the tight timescales suggest a looming ‘use it or lose it’ Treasury deadline; something admitted by Naylor, who told an industry event last month that he didn’t want to have to hand money back to Treasury.

The ISCF was also conceived as a far more ambitious initiative. During its long gestation, it has been whittled down to little more than spare change left by CfH’s consultants down the back of sofas in Princes Exchange.

As one trust IT manager told EHI: “This could have transformed NHS IT and the interoperability landscape if it had been introduced a few years ago.”

However, it may still just provide a taste of what is to come, even if the official line is that this is a “one-off.” If it delivers the hoped for benefits, it would seem crazy to not take it as a template for future interoperability.

Winners of challenge fund to hear by end October

The fund seems to have generated an enthusiastic response. EHI reported recently that more than 150 bids have been submitted.

An independent panel will evaluate the bids during the course of October with announcements on successful projects expects by early November.

“We’ve made the evaluation as tight as possible as we want you to have as much time to use the money to use the money and deploy,” Naylor said. Applicants have to self-certify their ability to deliver within the schedule.

All projects “must lead to a successful deployment and demonstrate ‘meaningful use’ of digital information exchange, in a health and social care environment, by 31 March 2013.”

Yes, that’s all projects completed by 31 March. NPfIT may be officially over but the era of impossible deadlines is alive and well.

To get paid, the chief executive of the organisation concerned will have to write and say: “I have a system live and its delivering benefits and those benefits can be audited”, explained Naylor. “And we want a case study or other collateral to prove the benefits.”

Severe limitations

EHI readers broadly welcomed ISCF but said the deadline would severely limit the projects that can apply: “The 31 March deadline in effect counts out any larger project unless it’s an in-house development or involves multiple commercial partners,” one noted.

Instead, existing projects are likely to get rebadged. “What’s likely to come of this is existing projects being opportunistically punted in and a lot of piddly stuff of little consequence,” a commenter said. “There are likely to be a number of good ideas that get compromised during a mad dash to meet the March deadline.”

Another more sceptical take came from an EHI reader who argued that driving an update of ITK is not without issue, given its reliance on proprietary platforms whose funding is uncertain.

As with so many national IT initiatives, ISCF looks both ambitious and rushed, and its future is uncertain. It’s to be hoped that it won’t just be a footnote to NPfIT. It could be so much more.

Fortunately, inviting expressions of interest for additional ITK capabilities beyond existing messaging templates certainly points to an ambition (if not yet the money) for further development.