Data Architecture update – November 2020

Posted on Posted in Health Data Architecture, Mauro Data Mapper, Terminology Server
Data Architecture update – November 2020
Sunrise over Timm Lane, Oakworth

I prepare a data architecture update for colleagues in NHS Digital and other interested organisations – I’m sharing it here for the first time. Let me know if it is useful.

Federation and subsidiarity – our contribution

Accountability for the health and care system in the UK is taken by many organisations. The four nations each have their own arrangements with just a few regulatory or international responsibilities falling to Westminster. Within England, social care lies with councils and the health system with the NHS. Providers are dominantly independent businesses competing in a structured, regulated market.

The inevitable (and desirable) consequence is diverse ways systems operate and are held to account. Local networks agree best approaches to clinical practice depending on the needs of their patients, their geography and priorities. Similarly, each trust has its own governance and assurance schemes, all requiring to be fed with data.

And yet the health and care systems seek to deliver seamless care, so every patient can be treated anywhere and our clinicians are aware of the care already being planned and delivered. It’s a tough challenge and one that depends on being able to share data safely and effectively. Our work to establish a UK wide framework for a Terminology Server and the prospect of a federation of metadata catalogues is designed to support that challenge. Adopting solutions for just NHS Digital would have been easier, but enabling the whole health and care system to share and understand coded data is much more valuable.

So where are we on these two projects?

Terminology server

The procurement framework has now been formally launched with a press release, accompanied by a new entry on NHS Digital’s Services website. The framework will enable organisations working in Health & Care across the British Isles to procure their own terminology server with a view to creating a virtual network of terminology servers that syndicate content from each other, enabling organisations to better leverage national and local terminologies.

The NHS Digital server build and work to convert code systems to FHIR resources continues to progress well although the build has an anticipated delay. The expectation is for live service to be in January 2021.

Our focus now is to:

  •  Conclude system build and pre-test content load, as well as commence system testing, in parallel with commencement of build work for the Terminology Cache.
  • Firm up UAT plans, including training arrangements for testers
  • Progress service acceptance with approval of the service support model, finalisation of allocation of responsibilities to support teams and agreement of the support processes.

Metadata catalogue

The second half is to be able to share metadata across the health and care systems. In a consultation last year the metadata vendors advised there is no common standard for sharing metadata. Each vendor needs to develop their own interfaces to integrate with their competitors. I am taking a couple of approaches to enable metadata to be shared.

  1. Contributing to the Mauro Data Mapper metadata catalogue open source ecosystem, along with Health Data Research UK, a significant number of research-focused NHS providers and SAIL Databank.
  2. Working with British Standards Institute to develop standards for sharing metadata. My expectation is that these will be sector agnostic, not healthcare specific. 

These two steps will enable metadata, models and rules to be shared across the health and care system while allowing organisations to retain control of their own metadata. It will be a contrast to a few years ago when I counted at least seven different DH funded metadata catalogues running as independent islands of (meta)data.

Migrating the Data Dictionary into Mauro has enabled us to improve the quality of the Data Dictionary product. We’re now refining the data migration and extending Mauro to handle data transformations and classification rules. Our Data Dictionary transformation is going well, but it will be into the next financial year before we fully complete it.

Congratulations

Casting a computer eye over a vocabulary can, depending on your point of view, either highlight any inconsistencies or enable systematic improvement. I’d like to highlight a quiet achievement within Information Representation Services. The latest edition of the UK SNOMED CT, released on November 11, was the first to be “fully classified”. Classification is a process that generates a set of logically consistent inferences by applying description logic rules to the stated view of concept definitions. The October release is a significant milestone in the refinement of the UK release of SNOMED CT. Well done Information Representation Services.

Iain Carpenter retires

I learned today that Iain Carpenter has now decided to fully retire. I want to recognise his work in health informatics. I first came across Iain when he was leading the Royal College of Physicians Heath Informatics Unit – we were discussing interRAI, an international collaborative to improve the quality of life of vulnerable persons through a seamless comprehensive assessment system. We also discussed the World Health Organisations International Classification of Function (the classification for “how are you?”, rather than “what’s wrong with you?”).

Iain then led the crusade to create a minimum set of clinical standards for record keeping, which eventually led to the establishment of the Professional Records Standards Body. Iain has also supported me in both the Data Design Authority and the BSI committee for Health Informatics. In his words, he is now thoroughly enjoying being completely unrestrained in pursuit of activities that he has yearned for and been unable to pursue freely through his career. He is totally indulging in music with my trumpet and jazz, in bands playing together live on line (synchronous with up to fifteen players at present!), doing a jazz course, gardening, walking the dogs and looking forward to what will hopefully be an unrestricted sailing season next year.

He adds “I am really pleased that the vision of standardised digital health and social care records and its potential is gradually coming to pass. It would be great to be in it as a young guy starting out, but that is not to mean that I am not utterly and completely happy and content where I am. The PRSB has really delivered with the skill and commitment that Lorraine [Foley] has brought to it. I feel that we are moving from development to implementation and I can totally let go and not feel guilty.”

Iain – I wish you a happy retirement. Enjoy!