Services Description
GPSoC Service Name
Healthcare Gateway Ltd – MIG – Electronic Clinical Correspondence
GPSoC Service ID
Service Overview
HGL-ECC
The Healthcare Gateway (HGL) MIG Electronic Clinical Correspondence (EEC)
service allows for the secure exchange of electronic discharge summaries and
clinical documents between service providers and GP practices. Documents can
be sent to both INPS and EMIS GP practices to be viewed with the GP practice
systems.
Practices can either accept the document to be stored in the patient’s record or
reject the document.
The service can provide the sending provider with an immediate response
confirming delivery followed by a further acknowledgment when the document is
filed or rejected. This is dependent on the functionality to receive
acknowledgements being activated in the providers system.
Discharges can be sent using HGL’s proprietary message type, or ITK discharge
message type.
The following document formats are supported:
Case Studies
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PDF
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Word 97/2003
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RTF
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HTML
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Kettering
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CDA (HL7 V3)
North Mersey Commissioners MIG benefits review
Background
Integrated Care and interoperability feature strongly on both the Health and
Social Care Act 2010-12 and the NHS Information Strategy - The power of
information local IM&T strategies. To support system integration the NHS
developed the NHS Interoperability Toolkit (ITK), which is a collection of
specifications, implementation guides to bring consistency to system integration
within the NHS.
Trusts are now expected to facilitate the development of local integration
solutions between disparate systems across the local health economy.
Informatics Merseyside on behalf of North Mersey Commissioners and Provider
Trusts have chosen to implement Healthcare Gateway’s ITK accredited Medical
Interoperability Gateway (MIG) as a North Mersey Message Hub for electronic
correspondence and to share detailed care records. By adopting an ITK
accredited system, it will make more attractive solution for system integration
with other providers system suppliers.
The Commissioning for Quality and Innovation (CQUIN) contracts are the main
driver for implementing the MIG clinical correspondence service trusts. The
Communication CQUIN indicator requires the providers to electronically
transmit certain types of clinical correspondence to the patient registered GP’s
clinical system.
The MIG clinical correspondence service is compatible with the EMIS GP clinical
systems which are used by 134 of 149 GP practices in Liverpool and Sefton.
Projects within the North Mersey Messaging Hub MIG
There are a number of projects implemented in Primary, Community and
Secondary settings.
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Aintree University Hospital Trust – Electronic Clinical Correspondence
Southport and Ormskirk Hospital Trust – Electronic Clinical
Correspondence
Alder Hey Children’s Hospital Trust – Electronic Clinical
Correspondence
Liverpool Women’s Hospital – Electronic Clinical Correspondence
The Walton Centre – Electronic Clinical Correspondence
Liverpool Heart and Chest Hospital – Electronic Clinical
Correspondence
Inclusion Matters – Electronic Clinical Correspondence
Royal Liverpool and Broadgreen Hospital – Electronic Clinical
Correspondence
Mersey Care – Electronic Clinical Correspondence
Cheshire and North Mersey Hub to Hub – Electronic Clinical
Correspondence.
Goal
The goal is to use the MIG Clinical Correspondence Service as a centralised
solution to enable the transmission of patient’s clinical correspondence between
the provider systems and the GP systems.
Objectives
 Enable clinicians to have access to the information they need to treat
patients safely and effectively in Primary, Community or Secondary
setting.
 Improve the sharing of patient information across Primary, Community or
Secondary setting.
 Enable electronic exchange of information between service providers and
the patients registered GP.
 Support paperless processes for both GP’s and Providers.
 Reduce consumables and stationary costs for GP’s and Providers
 Provide a more secure, reliable and efficient way of sending and receiving
clinical correspondence than faxing and posting.
 Provide a link to other messaging hubs nationally to improve
communications across geographical borders.
Outcomes
 ITK compliant messaging between systems
 Full audit trail for clinical correspondence at the sending organisation.
 Transmission of electronic clinical correspondence between systems.
 Time spent processing paper correspondence reduced.
Benefits
IM&T Benefits
 Shared information across Primary, Community and Secondary settings
providing integrated and joined up care for patients.
 Improved information available for clinicians to support clinical decision
making.
 Faster communications between Primary, Community, Acute and Out of
Hours settings which will reduce the time spent by clinicians requesting
clinical information to support clinical decision making.
 Modernisation of information systems and processes
 Improved information for management and governance.
 Provide a consistent mechanism for the sharing of information and
interoperability with clinical systems
 Improved quality of information shared between Primary, Community,
Acute and Out of Hours
 A fully electronic solution will contribute to a cost reduction within North
Mersey trusts and GP practices with regards to printing, paper and postal
costs
 Improve NHS resource utilisation and cost savings.
Support
Overall North Mersey Programme
 Improved patient care and experience
 Reduction in requests for diagnostic tests
 Reduction in the number of tests carried out on patients
 Cost savings due to the reduction in admissions to acute services
 Reduction in the number of presentations to emergency departments
 Enable North Mersey trusts to achieve their local and national
contractual obligations for clinical correspondence. i.e. discharge
summary CQUIN indicator.
The Healthcare Gateway Limited (HGL) support team provides first point of
contact and own all issues with client support underpinned by robust service level
agreements ensuring service incidents are fully managed and handled swiftly.
Calls are logged through the HGL Service Desk who liaise with all customer and
suppliers until resolution. Clients have a Customer Operational Service
Agreement which outlines contact details, service levels, availability, priority
guidelines and escalation paths for contacting support. Regular service review
meetings are held at project board level between the HGL relationship manager
and clients to ensure effective service delivery is being achieved.
HGL also hold Operational Service Agreements between HGL and its data
providers which details the contact points, issue handling and responses, service
levels, availability, downtime procedures and escalation points. Evidence of the
overall service regime can also be demonstrated by the fact that the service is
certified to ISO 20000.
Service Availability
HGL provide a minimum 99% uptime service availability level during Standard
Support Hours.
Change Management
HGL have permitted downtime periods for the purpose of system administration
and maintenance. Permitted downtime is granted and controlled within our
change management process. We reserve the right to use this at our discretion,
provided that appropriate change controls are utilised and changes are subject to
approval by our change advisory board (CAB). Changes are implemented
utilising pre-determined change windows, these are available to review on
request. HGL will inform clients of any changes via the nominated contacts
within each client organisation.
Annual Permitted downtime allowance
An annual allowance of 12 hours of downtime is available for use in the provision
of major upgrades and service continuity testing and is subject to five working
days’ notice to clients when utilised. This allowance is only available for use
within the calendar year and cannot be rolled over to subsequent years, if unused.
Helpdesk Arrangements
The HGL Healthcare Gateway helpline has standard support hours of:
Monday to Friday
Saturday
Sunday/Bank Holidays
08:00 to 18:00
09:00 to 13:00
Closed
Priority 1 Incidents are classed as a MIG service major incident which causes
significant business impact and prevents the user from providing a normal
service. These would typically be incidents which:
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Cause unavailability of the entire service, a key module or major function
Or cause incorrect processing of data or errors in a major system
function
And affect all users at multiple organisations
Priority 2 Incidents are classed as MIG service incidents which cause localised
business impact and limit the ability of the user to provide a normal service.
These would typically be incidents which:
 Cause unavailability of individual organisations, a key module or major
function
 Or cause incorrect processing of data or errors in a major system
function
 And affect some users at multiple sites or all users at a single site.
[Note that the response times for Major incidents can be the same as for critical
incidents, and can be dealt with in the same way]
Priority 3 Incidents are classed as MIG service incidents which cause minor
business impact and affect non-critical functions. These would typically be
incidents which:
 cause minor disruption of services
 And leave most functions available but restrict performance, causing
inconvenience
Priority 4/5 Incidents are classed as MIG Service incidents which cause
negligible business impact, and do not prevent the use of system functions.
Incident Procedure
In the event of a failure with the service, the source organisation should contact
their normal 3rd party system supplier as per existing processes and agreements
to enable 3rd Party Supplier to perform their preliminary investigations and
resolves any issues within their control.
Once satisfied that the 3rd Party Supplier application have been eliminated as
possible cause of the service failure, the source organisation will be responsible
for reporting the incident to HGL support in order raise a new incident with them.
The HGL support team will record the incident, assigning it an appropriate
priority level based upon the impact and urgency of the incident. Once the
incident record has been created and all necessary details provided, HGL support
will assume incident ownership and responsibility for resolution within the target
time determined by the chosen priority level. HGL will keep track of incident
progress with all resolving parties (e.g. GP system suppliers) and provide updates
to the Source Organisation.
Major Incidents
Priority 1 incidents will be treated as Major Incidents. These follow the standard
process in terms of recording and resolution, but with the addition of an
escalation/communication process to involve all relevant resolving parties at the
earliest opportunity after opening the incident. In the first instance, invocation of
a major incident will be notified to all contacts supplied by the customer and
relevant GP supplier stakeholders. Subsequent updates provided every 2 hours or
as advised. Where co-ordination of investigation activities is required across
different stakeholders, HGL will chair a meeting with the major incident group via
a teleconference to agree next steps in investigation to ensure all relevant actions
are covered.
Service Levels
An incident log created by Healthcare Gateway support will be given a priority
which will dictate the target resolution time. The priority is derived from the
assessment of the impact and urgency of the reported issue (see above). The
priority levels and target times are as follows:
Service Level Priority & Resolution targets
Priority Level
Target Resolution Hours
1
4
2
8
3
16
4
48
5
144
Resolution times operate within support hours only and apply to MIG errors only.
Where incidents are referred to another party Healthcare Gateway support is not
responsible for the resolution time and the Service Level Agreement (SLA) will be
placed on hold at the point of handover to the supplier.
Escalation
An incident can be escalated in the following scenarios:
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An incident is nearing, or has breached its target resolution time or is at
risk of breaching
The circumstances, impact or urgency of the incident has changed
suddenly
A progress update has not been received or contains insufficient
information
The resolution provided was not sufficient
In all cases an escalation can only apply to an existing incident record.
Healthcare Gateway Limited publishes a list of escalation contacts available to all
customers with names, telephone numbers and email addresses.
Dependencies
Service Dependencies
The HGL ECC service is designed to connect existing and trusted systems
together within a locality; therefore there is no additional requirement for
hardware or software license. Third party suppliers consuming or providing data
through the MIG will be required to be MIG compliant. There are already many
MIG enabled system suppliers, however for those not compliant; these systems
will be required to progress through the MIG supplier accreditation process. HGL
provide a MIG software development kit, technical specifications, test harnesses
and sample messages to support this process, including access to the MIG
technical integration team. This complete service is free of charge.
Third Party Dependencies
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GP Systems consuming data must currently be EMIS or INPS
Third Party Supplier Engagement
Before the actual ECC service goes live, HGL will check that it has gone through
full user acceptance testing ensuring it meets the customer needs. HGL have
developed test plans to be used for acceptance testing of all MIG services, these
test plans can be adapted or incorporated into the customers’ acceptance criteria,
if the MIG service forms part of a wider project scope or the customer wishes to
expand on the acceptance criteria.
The Testing Phase will include a pipe cleaning exercise to ensure all security
certificates have been successfully installed and all firewalls have been opened.
Following a successful pipe-cleaning exercise a date will be agreed with all
stakeholders to go through full end to end testing as per the agreed test plans and
criteria.
Infrastructure Dependencies
ECC is supplied as a service and requires no specific hardware or software to be
used. The only infrastructure dependency is that the customer must use N3 to
access the ECC Service.
Local Personnel Dependencies
To ensure a smooth implementation of the ECC, service, there is a requirement for
dedicated project management resource from the customer side. This is typically
required to support stakeholder engagement, information governance and data
sharing agreement sign off and supplier integration.
Sub-Contractor(s)
N/A
Pricing Information
Implementation Charges
The HGL ECC service is charged on a managed service model which reflects the
discreet nature of the specific data sharing exchange. As a managed service,
Healthcare Gateway Limited (HGL) provides all the required technology to broker
and route data from end to end, including the necessary hosted infrastructure,
configuration, and system support. This is complimented by implementation
services to project manage the ECC deployment, during which we will work with
all stakeholders and suppliers. This approach provides customers with flexibility
and scalability to adapt to changing conditions and improves security, business
resilience and overhead and risk. New MIG services can be incrementally added
and can benefit from reduced charges based on volumes.
HGL separate the ECC service implementation charges into two components,
Project Initiation and Implementation.
Project Initiation
On contract signature, HGL will request that a Projection Initiation meeting takes
place (normally within 7 working days) with all stakeholders. This meeting will
initiate a phase of work to confirm and agree:
Project scope, commercials and deliverables for the project
Project dependencies such as supplier accreditation and information
governance/sharing agreements
Customer and HGL responsibilities
Support procedures and issue reporting handovers
Training requirements
Implementation process
Test Plans and acceptance criteria
Project plan
This project initiation phase is charged at £1,300
Implementation
Following the project initiation phase, HGL follow the agreed implementation
project plan, which will be updated by HGL as the project progresses. The
appointed HGL project lead will ensure regular check point calls are scheduled
with all stakeholders to discuss progress, raise risks and/or issues and review
progress in line with the implementation. HGL will also ensure that before any
MIG Service can go live, the customer is familiar with the HGL support process as
outlined the HGQM002 MIG Operational Service Agreement and that
communication plans are in place to support the HGL Major Incident Process or
Maintenance Events.
A standard implementation will cost £2600 per sending system (such as Acute
discharge system) that the customer wishes to connect and this charge covers all
work required by HGL to implement the MIG ECC service to the agreed project
plan.
Summary of Implementation Charges
Service Charges
Project Initiation - £1300
Implementation - £2600 (Per sending system)
Charge Description
Unit Price (exc VAT);
ECC Service for up to 50,000
Documents
Exit Charges
Invoicing Terms
13p per document per annum
See volume discounts section for pricing
larger volumes
HGL do not apply any exit charges to customers once a contract for ECC services
has ended. On contract expiry, HGL will ensure that all sharing agreements and
end point configurations are disabled for that service.
All HGL implementation and service charges will be invoiced in arrears.
Invoice frequency
Project Initiation will be invoiced on the production of the agreed project
implementation plan.
The Implementation charge will be invoiced once the “Commencement of Service”
Milestone has been reached. This is the point at which HGL has completed the
necessary configuration work to enable all end points and that the service is
available for use by the customer. For the avoidance of doubt this does not mean
that the customer needs to have actually commenced use of the service.
ECC Service Charges will be invoiced three months in arrears. The first invoice
will be produced 3 months following the date of the Service Commencement
Milestone.
Invoice delivery period
Invoices will be produced within 5 working days after the completion of the
Project initiation phase, Service Enablement or three monthly service charge
period.
Payment Terms
Due date for payment
30 days after receipt of a valid invoice
Details of any early payment discounts
Discounts
None
Volume Discounts
Number of Documents
First 50,000 documents
Next 50,00 documents
(up to 100,000 documents in total)
Next 150,000 documents
(up to 250,00 documents in total)
Next 250,000 documents
(up to 500,000 documents in total)
Next 500,000 patients
(up to 1 Million documents in total)
Above 1 Million documents
Discounted Prices
13p per document per annum
10p per document per annum
8p per document per annum
6p per document per annum
4p per document per annum
2p per document per annum
Worked Pricing Example
Connecting 1 x Sending system (e.g. Hospital Discharge) and providing them with
ECC Document Services for 180,000 documents:
50,000 documents * 0.13= £6,500
50,000 documents * 0.10= £5,000
80,000 documents * 0.08=£6,400
Total ECC charge ------------- £17,900
Resource Based Pricing
Other Pricing Information
Project Initiation charge ---------------------------- £1,300 (one off)
Implementation charge (1 Sending System) -- £2,600 (one off)
Additional HGL project or technical consultancy days can be purchased for
projects if required by clients. Please see the SFIA rate card for details.