Comprehensive Clinical Assessment (interRAI)
Interoperability - high level workflow and overview of schedule for development
October 2015
Prepared by: Andrew Downes National interRAI Software Service Manager. Email [email protected]
Background and Context
The readership of this brief paper is assumed to be non technical.
The purpose of this paper is to present at a high level the scope and approach to provide a menu of services that will be developed and offered by the National interRAI software service to support interoperability with external software systems used by (amongst others) residential care providers.
The services will be able to be consumed by software systems external to the national interRAI software service that support care in various sectors across the continuum, eg Residential, primary, community and secondary.
This menu provides a framework for service providers and their associated software platforms to work within and provide an appropriate level of access relative to the needs of the
organisation
Principles and givens
There are a set of key principles that help determine the approach being taken. They are: 1. The interRAI methodology must be upheld in distributed systems
2. Need to work with and within the boundaries set by interRAI
3. The national interRAI platform is the single source of truth for interRAI data
4. A single menu of services should exist that supports different levels of interoperability to allow facilities choices
5. interoperability mechanisms will be developed once for use across many systems
High level Workflow
The following picture demonstrates at a high the workflow (or use case). The workflow assumes that the resident has been admitted from a community setting and will already have had an interRAI assessment and therefore be registered on the national interRAI system. This will be the more typical situation as the roll out of interRAI increases to residential care.
Facility nurse National interRAI platform Facility nurse “Mrs J” “Mrs J” Community or Facility nurse
Home care/community interRAI Information already available as
Mrs Jones is transferred To a facility On an NHI search, facility nurse can
Pull down previous home care interRAI Assessments and care plans.
interRAI data will be PDF or Structured
Via single sign on and NHI The national platform can be launched
From within the local system
The resident can be administered and then Assessments completed
Facility
‘Resident is admitted to Facility or facility is requested to
review prior to admit
On an NHI search and likely other trigger, facility nurse can Pull down long term care interRAI
Assessments
interRAI data will be PDF or Structured
Other clinical staff Eg DHB, community NGO,
Primary care
Ability to look up assessments Complete new assessments etc
Start
Note that all functions on The left hand side of this diagram are equally available
for non facility based service providers/systems
Scope of Services
The scope of services that will be offered by the national service are outlined in the table below. These are detailed slightly more in appendix 1.
Brief description What this means in practice for a nurse
Basic login access to national platform A nurse browses to the interRAI site and logs in. This is how the system is accessed today.
Single sign on to national platform. A nurse can log into her/his own facility system and by selecting a resident locally, then be logged into the national interRAI system ‘in context’ such that the resident information within the national platform is presented.
Update 17/02/2013:
The single sign on function is currently being reviewed with a view to aligning with national initiatives and infrastructure.
Access to Summary Reports as a PDF only on NHI number look up from external system
After completing assessments in the national system, the nurse will select a resident in the local system, calls are made to the national system by NHI (and likely some other trigger to assist
workflow) for various reports. These can be viewed in the local system and if need be stored locally. The reports are only PDF in this case.
Access to reports with increasingly structured data
After completing assessments in the national system, the nurse will select a resident in the local system, calls are made to the national system by NHI (and likely some other trigger to assist workflow), for assessment reports.
The data will be fully structured demographic and assessment data in a format that can be manipulated by the local system (XML).
Planned Schedule
The table below briefly describes the planned schedule and current progress.
Item Deliverable Description Planned
delivery
Current progress Items to be developed
in parallel 1. Test system for single sign on and basic pdf reports
Ability to test SSO and pulling back basic pdf assessment reports with no structured data End of Sept beginning Oct 2012 Completed
The HISO CDA standard has completed public comment and has been reviewed for final publication. 2. Use cases and initial specifications for simple PDF <> structured data reports Documents that describe the workflows that the technical specifications will be developed from 28th September 2012 Completed 3. interRAI rules
Rules for handling structured interRAI data as agreed with interRAI collaborative
interRAI have been asked to register the assessment form names with LOINC to be able to assign LOINC codes
4. Circulation for comment Circulation of uses cases and specifications for comment/clarification 1st October 12th October 5. Development and further detailing for technical specifications Design and
development for the CDA services and publication of final specifications for use by software vendors
Mid October onwards
This has essentially been completed and final documentation is being prepared 6. Test system for CDA Ability to test differing levels of complexity for reports from simplest pdf through to fully structured
March 2013
Subject to final general release testing, testing environments will be made available to interested services/vendors
Key
In progress no concerns Completed Problem area needing active management/intervention
Status Table for interoperability ‘readiness’
The following table describes the readiness status of inter-operability with the national
interRAI platform for various software vendors for interested parties. As other vendors express an interest in this work they will be added to this listing.
Vendor/Supplier Interoperability method Autumn care Procura Ion Thought ware Info-geni LeeCare Momentum Healthware Netsoft Hutt Valley DHB (Orion) VCare CDA level 3 reports pdf reports n/a Key
Development in progress Testing validated Scheduled for production or in production
