NHS Startup Part IV – Building Software/Apps

Building an app/software that can interface with existing software seems damn near impossible in the NHS.  Here is a summary of what I have learnt so far for those who are interested.

PART I – Basic Definitions

GPSoC = GP Systems of Choice.

GPSoC are an organisation that help GP surgeries have he best technology to support them. It is hoped that this can be accomplished by a “Common Interface Mechanism” for GP IT systems integration.

Common Interface Mechanisms = is a mechanism that would allow separate systems to integrate and share information. This would allow integration between Principle Clinical Systems (such as Emis Web, TPP SystmOne etc) with Subsidiary modules such as specialist apps and third party products.

GPSoC is also meant to hold principle software suppliers to account.

PART II – Different IT Products

There are three different categories of IT that GPSoC recognise.

1. Lot 1 – Core functionality products for a modern paper light GP practice. E.g appointment booking tools
2. Lot 2 – Products which support the GP practice hardware and medical devices
3. Lot 3 – Help GP practices to share information with other health care providers

PART III – Pairing Integration

Suppliers of clinical systems to General Practice are required to provide integration capability via an interface mechanism/mechanisms. The interface mechanism enables separate third party systems to access demographic and clinical data held within the system.

There are two scenarios for the use of this capability:

1. To support products, chosen by the practice and used within the practice, that need to integrate with principal clinical systems
2. To support the use of internet facing tools for patients (including record access and transactional services)

This is meant to look like this:

PART IV – The Process

So, the process seems rather long and convoluted. If you want to get any kind of “mechanism” to allow interoperability between your app and the GP IT providers software and then want to roll anything out which can be procured by the CCG then you have to go through a five step process:

1. Fill out PIQ (Pairing Integration Qualification) Entry Form. This involves the following:
   1. Clearly describing the service and functional capabilities
   2. Clearly describing the technical architecture
   3. Show that the technical architecture is up the best practice and technological standards
   4. Show that the technology has a considered approach to data storage
   5. Clearly describing the deployment method
   6. Clearly describing the service management and support arrangements
   7. Clearly describing the method of delivery and associated training
   8. Provide suitable information to support alignment to the NHS information strategy
   9. Provide suitable evidence to support provisional viability
   10. Provide suitable evidence regarding the ease of achieving a Pairing Integration
   11. Clearly describes the expected impact of the offered service on an interface mechanis
   12. Clearly describes identified risks and issues and the proposed mitigation actions
2. PIQ Initiation
3. PIQ Design Build and Test
4. PIA (Pairing integration assurance) – Development and test
5. PIA – Development First of Type

After the above five steps you get the full roll out approval.

Part V – Discussion

The above information is a rough overview of how to get APIs and get your idea on a roll. After having discussions with people who work at both TPP and Emis, it seems that this really is the only way to get anything going.

I am booked to have a phone call with someone from TPP on Monday to see if I can get some more information and how to make sure my application doesn’t fail. I have also contacted HSCIC/NHS digital and am booked to speak with someone from there as well.

It seems frustratingly hard to get anywhere. I do not know how small start-ups/bootstrapped companies can even get started! It seems like the only companies that are getting anywhere with all of this are large established corporations. There are only 25 or so companies that have managed to get anywhere with all of this in the last two years!

25 Companies that have gotten anywhere in the last two years

Also, as if the above process wasn’t convoluted enough, in reality the process is even more difficult. A CEO of one tech company mentioned how hard it has been and how the API process has delayed them immensely: http://www.digitalhealth.net/digital_patient/47749/iplato-launches-mygp-appointments-app-as-api-talks-continue

This is another interesting read: http://www.digitalhealth.net/news/47510//patient-facing-integrations-with-gp-systems-run-late

It talks about how all the deadlines are being missed and how only two companies have managed to get Full Roll out Approval since GPSoC started!

It seems like the environment is exactly the opposite of what was being aimed for with GPSoC.