NHS ENGLAND HAS been talking about the latest strand of its move toward open digital solutions to provide interoperability between the myriad departmental systems that are proprietary, incompatible or just plain disparate.
The organisation is to adopt Vendor Neutral Archive (VNA) as a standard format to store everything from X-rays to scanned letters and patient notes, in order to avoid lock-in with proprietary systems and allow easy sharing of data across the NHS.
VNA is not a format in its own right, but rather a standard of the Picture Archiving and Communication System. This is tailored to meet the needs of the medical community and based on common standards which are yet to be defined but revolve around incompatibility.
Rachel Dunscombe, chief information officer at Bolton NHS Foundation, has been leading the charge for VNA adoption.
She told The INQUIRER: "We've got 300 different IT systems in place and we're just one of around 100 hospital trusts, and then you've got GPs, mental health, clinics and so on, so we're just a fraction of it as a starting baseline."
Peter Coates, NHS England open-source programme head, added: "There's an enormous baseline to work with here and those systems range from large US-based megasuites which cost tens if not hundreds of millions of dollars, way down to departmental systems, and down to Excel spreadsheets."
The possibilities generated by using open source or at least open standards are huge.
"It's fair to use the terms interchangeably here because there are some systems where an open source solution isn't appropriate, but we would still want that information to be compatible and accessible in a common output," said Coates.
Dunscombe added: "Traditionally, those systems have not spoken to one another. What we see in Europe is that this open approach is already in place, with checks to ensure that systems can talk to one another, so there is some kudos there.
"Up to now we've had to build point-to-point links, or bespoke links, or sometimes they simply won't link at all. What we need to get to is the right number of systems, but that we're not held over a barrel by any one supplier."
Once the information is in this common pool NHS workers will be able to cross reference information between doctors, with potential cost savings from avoiding repeated analysis such as X-rays or MRI results.
There is also the possibility of using big data analysis tools to find patterns in the data that can be used in diagnoses.
"This isn't sci-fi. Some of this stuff is happening now. IBM's Watson has been used for some of these things, and it's not unaffordable," said Dunscombe.
"The supercomputer crunching the numbers is not an issue. The issue is getting large enough high-quality data sets in large enough amounts in a format that everything can work with, and that is what this project is about."
The single NHS database was scrapped in 2011, but that project was on a tiny scale compared with this one, which can bring together not just rigid fields but the whole remit of patient data to bring a holistic picture of the nation's health in a much more cost-effective way. µ
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