1. Yorkshire Centre for Health Informatics Case Study: X-Lab: Using the NHS MIM Yorkshire Centre for Health Informatics

2. Acknowledgements This presentation was created by the Yorkshire Centre for Health Informatics (YCHI) with supporting materials from NHS Connecting for Health and HL7 UK.

3. Learning Objectives To appreciate how the MIM has been used by eHealth software developers To learn more about the benefits and challenges of implementing the MIM

4. Presentation Outline Who is X-Lab, and what do they do? What is the business process being supported? Why does X-Lab use the MIM? How does X-Lab use the MIM to determine its messages for its service? How does X-Lab exchange messages using the MIM? What lessons were learned during implementation? How has X-Lab used the MIM to fit to legacy? What did you learn about the MIM that you wish you had known beforehand? What advice would you give to anyone wishing to use the MIM?

5. Who is X-Lab, and what do they do? Simon Davy, Software Architect

6. What is the business process being supported? Wilfred Smith, a 62 year old hypertensive who feels tired all the time, arrives at his local practice to see his GP. During the consultation Dr. Sugden, the GP, makes a preliminary diagnosis of moderate iron deficient anaemia arising from a possible duodenal ulcer and so decides to request a Full Blood Count (FBC) and Urea and Electrolytes (U&Es). He selects the items from the pathology catalogue and, as the practice has contractual arrangements with two laboratories which can carry out the investigations Dr. Sugden also indicates that he wants the request to go to Arrowe Park Hospital. The system automatically ascertains that there are two request messages required (one for FBC and one for U&Es) and assigns a local system request number for each request and Placer’s Request IDs (PRID) for the individual request items. He then accepts the complete communication data set and the requests are added to the Treatment room work list. Mr. Smith returns to the waiting room until called. Nurse Pat Screens calls him into the treatment room and reviews the pathology request. She collects the appropriate blood samples and confirms on her clinical system that all the samples have been taken, from which the system sets the actual date and time of collection. This triggers the Order Fulfilment Request interaction (POLB_IN020001UK01) and the sending of the electronic requests to the laboratory. The laboratory system receives the electronic requests and deems them to meet the requirements of the laboratory system for confirming the request. An application acknowledgement for each message is generated and sent to the placer system (POLB_IN020002UK01 or POLB_IN020003UK01 for a rejection).

7. Why does X-Lab use the MIM? Simon Davy

8. How does X-Lab use the MIM to determine its messages for its service?

9. How does X-Lab exchange messages using the MIM? A larger version can be found in the Resources for this RLO.

10. What lessons were learned during implementation? Simon Davy, Software Architect

11. How has X-Lab used the MIM to fit to legacy? Simon Davy, Software Architect

12. What did you learn about the MIM that you wish you had known beforehand? Simon Davy, Software Architect

13. What advice would you give to anyone wishing to use the MIM? Simon Davy, Software Architect

14. Conclusions The MIM is one of the most comprehensive messaging guides around, and is the approved messaging format for the Spine. Take time to review the MIM in its entirety for work that has already been carried out defining common data types such as names and times. It may be that they will reduce your workload in the future! Lots of advice and guidance is available via teams working on the MIM, and will help support you when creating your applications. They are also there to help you with any technical issues you may face during implementation.

15. Further Resources Web Sites X-Lab – http://www.x-labsystems.co.ukhttp://www.x-labsystems.co.uk HL7 UK – http://www.hl7.org.ukhttp://www.hl7.org.uk NHS Connecting for Health Data Services – http://www.connectingforhealth.nhs.uk/systemsandservices/data http://www.connectingforhealth.nhs.uk/systemsandservices/data Books Benson, T. (2009) Principles of Health Interoperability HL7 and SNOMED. Hinchley, A. (2007) Understanding HL7 - A Primer on the HL7 Version 3 Interoperability Standard.

16. Yorkshire Centre for Health Informatics Leeds Institute of Health Sciences Faculty of Medicine and Health Charles Thackrah Building 101 Clarendon Road Leeds, United Kingdom LS2 9LJ Tel. +44 (0) 113 343 4961 www.ychi.leeds.ac.uk