Preparing for Integration
The following information is aimed at customers undertaking a UK Trust integration but has aspects relevant to any partner or customer looking to integrate with PKB.
It is important to start by identifying the stakeholders in your organisation required to support the integration. Whilst this can differ from customer to customer, the following should help with your planning and engaging the necessary people at an early stage of the process :
A clinical champion with a specific need to share data with patients. Most people agree that sharing with patients will be standard practice in the future but they need a concrete example of why they should do something today.
A pathology clinical lead needs to be engaged to support the sending of pathology data. Ultimately they will have to agree:
Which pathology test results are sent into PKB.
What (if any) delays to showing patients the results of specific tests are desired.
Which (if any) test results need to be sent with a specific privacy setting (e.g. Sexual Health).
That the pathology data being sent to be PKB is correct.
It is common for any pathology lead to have a number of questions about how PKB supports the display of pathology data. This pathology FAQ section will help with answering many of the more common queries that are raised.
The information governance / legal teams will have questions about data security and privacy, as well as formal documentation that needs to be completed. It is important that all IG related matters are resolved before formally starting the integration development. Information relating to IG can be found here.
The information technology department may have questions on data security and required integration team effort.
The integration team (potentially a 3rd party partner) will have questions about the scope and requirements of the integrations, as well as about how to functionally integrate with PKB.
The developer wiki will provide them with details of how to integrate with PKB at a technical level.
The Project Initiation Documentation (PID) completed in conjunction with the PKB Success team should clarify the scope and nature of the required integration. It is recommended that the customer integration team and the PKB integration team are engaged in this process. Once the PID has been "signed off" it will provide the context within which integration activity takes place, clearly setting out the required outcomes.
There should also be an internal clarification of understanding on what data can potentially be sent to PKB via the APIs we provide and how (usually it happens via an integration engine aka TIE), where any data gaps or challenges exist and what if any blockers exist (e.g. capacity, knowledge, local system integration issues).
The communications team will need to be aware of the project and related timescales to ensure messaging to patients, professionals and other stakeholders are managed effectively.
Guidance for integration planning
Planning an integration ordinarily starts with deciding on which patients to create records in PKB for and how they should then be supported to "register" and claim their PKB record. Some guidance:
We recommend creating a PKB record for all patients that have engaged with a customer "recently". Recently is interpreted by customers in different ways, for example they have been treated in the last 4 years.
To create a patient record an NHS number (Spine checked preferably) is required, along with a minimum of their name and date of birth.
Note that data sent to a record can only be seen once a patient has registered.
In order for a patient to receive a registration notification (email) then their email address must be provided.
Note that an email address can only ever be linked to a single PKB patient record.
An early activity for customers is often to engage in the collection and validation of patient email addresses.
Where an email address can't be provided via integration, alternatives for patient registration do exist.
The next stage is confirming what patient data to send. Typically one of the best clinical reasons and most impactful from a patient engagement perspective is to provide patients with their test results. By providing patients with their pathology data it has been shown to save clinical time and makes patients happy: appointments, phone calls and emails can be avoided when the patient can get their test results directly.
The next "quick win" is the sending of appointments to PKB because this can generate cash savings in avoiding sending appointment letters. Closely followed by the sending of documents such as discharge letters and letters summarising what happened in clinic, as this generates clinical improvements and increases safety because the patient and all their providers see the latest information about the patient.
We are often asked for guidance on how long an integration may take and what development capacity is needed. Whilst it is difficult to generalise as all customers have their own specific considerations, we hope the below provides some help:
The integration work is about 1 full-time equivalent (FTE) month of work for each integration stream. This includes aspects such as opening network firewalls to connect to PKB's servers; sending data in HL7 format; testing on the PKB test server and then the PKB production server; clinical sign-off on the appearance of the test messages.
Dedicating time to the integration is much more efficient than working part-time along with other tasks. In other words customers have found they can complete within one month if focusing full-time, but typically take much more than four months if they only dedicated 1/4 time. We were surprised to discover this but now know it is important to highlight to customers. There are several reasons for such delays, including integration specialists forgetting what they learned if there is too long a gap between calls, or staff moving jobs during a lengthy integration period requiring retraining.
Integrating is well worth the investment. Once an integration is completed it works for the whole organisation. In other words although your organisation may begin integration for the single department of the clinical champion, it can also be used by any and every other department that rolls out after that first department. No further integration work is necessary for new departments so the investment is highly scalable.