Defining Standards in the NHS

but haven't we had too much of government standards and targets and all that?

To be honest I'm not entirely sure. But this post is not about that kind of standard. This post is about standards for 'interoperability'.

So, what do I mean any why is this important.

We use standards for interoperability all the time. If you buy a DVD it will play on a DVD player because someone, somewhere has defined a standard for how DVD players read DVD discs. Provided both the disc and the player meet the standard then the disc will play in the DVD player. Or consider the keyboard on which this is being typed. It's a standard qwerty keyboard on my laptop. All keyboards work pretty much the same way so I can pick up any computer and type into it with the same degree of accuracy (or, in my case error) without having to learn a new keyboard layout.

Ok, so this is all very interesting but what has it got to do with the NHS?

Well, the answer goes something like this.

Suppose, for a minute that the government defined a standard for the electronic recording of entries on a patient's medical records. The standard could be very simple. Let's say that every entry on a patient's records had to contain a date and time of entry. The NHS number of the patient. The name of the patient. A code identifying what was done or was test was carried out (e.g XRays would have a code, prescriptions would have a code) and then some kind of document or image or text that describes the entry in more detail. For example, for an X-Ray we might just have an image of the X-Ray picture.

Now suppose that the health minister decreed that, from a certain date, all equipment purchased by the NHS had to comply with the standard. So, for X-Ray machines that would mean that if you went to get an X-ray done the machine would have to send a message to the central hospital computer saying "hey, we did an X-ray for this patient, here's their NHS number and name and here's an image of the X-Ray". The hospital computer would then say "right thanks for that I'll update the patient's medical records OR maybe I'll pass this information on to the place that stores the patient's medical records".

Suddenly, lots of stuff starts to become possible that wasn't possible before. Let's say you need to go to the hospital to get an X-ray done. The hospital updates your records saying that an X-ray is needed and what sort of X-ray it is. They might offer you an appointment but you might want to get the X-ray done somewhere else that is more convenient, may be a private clinic. So, you go to the private clinic, you give the clinic access to your medical records. They can see what kind of X-ray you need. They do your X-ray and then they send the "hey we've done an X-ray" message. Your medical records are updated. The doctor who wants to see the X-ray can be told that the X-ray that was requested is now done and the doctor can see the image of the X-ray. The doctor can take appropriate action based on what they see.