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When it comes to integrating systems and software used by NHS organisations, there is still much to do. Many systems used by the NHS do not exchange data, with one particular result being that NHS organisations are not able to fulfil the potential benefits of using the patient data that they hold.
The barriers to systems integration include perceived information governance risks across different NHS organisations, use of non-standard identifiers for patients which do not match the patients' NHS numbers (although as of 2015 the requirement to use such an identifier is enshrined in legislation pursuant to the Health and Social Care Act 2012 (Consistent Identifier) Regulations 2015), inadequate application programming interfaces (or APIs) and a general failure to sufficiently integrate existing systems with new systems, although they may be capable of being integrated.
A good starting position is for NHS organisations to buy sufficiently up to date systems that can interface with existing systems, insist that those systems conform with HL7 standards (essentially an international standard for transfer of clinical and administrative data between software applications) use patients' NHS number and adopt more sophisticated APIs. The input of users should also be sufficiently taken into account from an early stage in a project to ensure integration is reflected in a way that users will recognise and value.
As far as contract management is concerned, once the specification for each interface has been agreed, it should be explicitly clear which party has responsibility for identifying, managing, building and supporting systems interfaces, particularly in the design, build and test phases of a systems or software project.
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