Nottingham University Hospital Trust Middleware Case Study
13th September 2010
At the heart of any NHS Trust is the powerful IT integration engine that ensures the large number of clinical and administrative systems can communicate with each other and channel data between the various systems.
In the case of Nottingham University Hospitals NHS Trust (NUH), the business-critical SeeBeyond integration that had been in place for five years was near the end of its life an in need of an upgrade. The complexity of integration required was increasing all the time as new systems were incorporated and the ‘one to many’ requirement of a single set of diagnostic results from one patient being required by multiple departments meant a constant flow of new departmental interfaces was being developed.
The sheer scale of clinical activity was generating around half a million messages a day. For example the pathology system alone could create 30,000 unique results messages each day which are subsequently sent on to eight different systems.
For the interfaces team at Nottingham it meant a significant amount of time was being spent maintaining the system versus investing that time in new systems and technologies to benefit the wider hospital.
The system was clearly in need of an upgrade but what we wanted to take the opportunity to really future proof our system. The amount of change management and testing required in a hospital setting meant it was critical for us look at fixing once and fixing properly so that we weren’t faced with similar issues in a few years time.
Integrella undertook a system ‘health check’ to understand the integration environment, the issues the Trust was facing day-to-day and assess what treatment was required to ensure the Trust could have a stable integration environment but without necessarily a huge investment or a need to change the skill set required for the team.
It was obvious from the health check we undertook that there were some significant improvements that could be made to the integration engine. We were conscious that the solution needed to be agile enough to meet the Trust’s strategic objectives while making the most of its existing investment. The latest technology on the market is rarely the most stable so we needed to balance innovation with common sense.
The recommendations made as a result of the health check focused on creating stability and management reporting; efficiency improvements, and setting organisational standards. At the centre of the health check was the plan to upgrade from the Trust’s existing SeeBeyond ICAN 5.0.5 integration engine to Sun’s composite application platform suite Java CAPS 5.1.3. Java CAPS was chosen in order to:
- Leverage the Trusts investment in its existing integration solution
- Take advantage of existing skill sets within the team
- Enable the Trust to move towards a service-orientated architecture (SOA) environment
This meant a re-architecting of the integration solution rather than a fundamental rip and replace or re-writing of functionality. From the Trust’s perspective the integrated development environment (IDE) for Java CAPS was similar to what the team were used to with SeeBeyond, meaning all the benefits of a new stable integration environment but a comfortable transition for the team to something they were broadly familiar with.
The move to JCAPS also resulted in the interfaces team being able to support the Trust’s wider IT strategy of virtualisation. The new approach has meant fewer physical servers are required and the virtual servers can be used more productively with different roles. This is has led to a significant saving in physical space, which is at a huge premium in the hospital, in addition to further cost savings and reduced energy consumption.
Coupled with the technology upgrade was a new dashboard to provide a high-level view of how the integration solution is performing. The Trust already had an in-house developed system in place but the new web-based dashboard created by Integrella moves away from the traditional ‘point in time’ dashboard approach to something that provides clear charts that highlight any key issues. Equally important for out of hours monitoring was the need for any dashboard information to be easily accessible and readable on mobile devices as well as easily configurable to ensure the optimum amount of information was available.
A key requirement from the Trust in its brief was to help the team internally transition to the new system and develop their skill set. This included new team members with little or no experience of JCAPS, a refresh for more experienced team members, as well as the opportunity for the whole team to pick up new techniques they could apply in their day to day role. As a result Integrella developed a bespoke training programme for the whole team at NUH which one team member praised as ‘intangible but invaluable’.
The new integration engine and activity undertaken by Integrella has created a stable and reliable integration environment. At a day to day level for the interfaces team this has meant:
- A stable technology environment for frontline clinicians responsible for patient care
- Significant saving of the team’s time and energy resolving issues
- Improved stability with less maintenance time required from the team
- Savings in space, money and energy consumption through virtualization
- Fewer out of hours calls
- Very rare rebooting of the system required, so no impact on services available to clinicians and administrative staff
- A more motivated team as more innovative IT projects can be focused on, rather than frustrating day-to-day maintenance issues
For the Trust, it can be assured in the knowledge that the integration environment at the heart of its hospital is the best and most stable that it can be.
Integrella was chosen for the project with NUH in a competitive tender. As the client puts it:
It was clear form the start that Integrella knew and understood our requirements. We were hugely impressed with the work their team put into the original proposal. The comprehensive nature of what they were recommending gave us every confidence in their ability to deliver.
We’ve not been disappointed