We’re delighted to announce that following a rigorous assurance process with NHS Digital, we are now fully integrated with IM1, an NHS interface mechanism which means that we can now directly connect to GP clinical systems to read patient information, extract information in bulk and enter data into clinical systems. 

This is a highly anticipated achievement for Substrakt Health, and it’s been a lengthy process to get fully approved.

Here our Head of Product Misty Michael, talks about the integration journey, and what it means for us, our customers and NHS patients.

What’s the process for integrating with IM1?

The process for integrating with IM1 is pretty well documented. It starts with mapping out what you’re trying to achieve, which is then transposed over to a SCAL (Supplier Conformance Assessment List). 

The SCAL is used as the basis to communicate with NHS Digital, and outlines your product, with details of clinical and information governance (IG) use cases. NHS Digital then assesses whether your product is compatible with the IM1 API, and if so you are given access to an unsupported test environment to begin development. 

After development has completed in the unsupported test environment, you are given access to the supported environment, where you are able to agree the assurance approach with the clinical system providers before proceeding to the assurance stage.

We assured with both EMIS and TPP clinical systems. Each clinical system provider has their own requirements for assurance, with differing levels of test cases and auditing requirements. Upon agreeing a date with each provider, we booked in for witness testing and presented the required test cases and information to each separately. 

From that point, the provider signs off assurance from their perspective, then NHS Digital does assurance on their end which involves differing levels of sign off in relation to information governance and clinical safety.

Once NHS Digital has signed off the assurance, a recommendation to connect notice is sent across to the clinical system provider and arrangements are made to move across to the live environment.

How did you find the process?

The process is very robust, and for that reason can be incredibly frustrating. Adding in the complexity of different requirements from the separate clinical systems providers, it can be a very demanding process. 

I think the most difficult part for us was that some of our key APIs couldn’t sit on the same environment as the test environment that IM1 sat on, so a lot of creative thinking and planning was needed to ultimately overcome that issue.

Especially during the early parts of COVID, it was really difficult to get support from the providers, being overwhelmed with supporting practices and their own development, which slowed the process down substantially.

The highs were definitely the individual milestones. Successful development, witness testing, and assurance were all really exciting moments for everyone involved. Every milestone meant we were one step closer.

What impact will achieving this integration have?

The impact for our own team is a lot less manual work. The relief was palpable once medications successfully went live, as previously there was some manual intervention required from us to keep patient requests for repeat medications via our app, moving forward. There is still a good amount of manual configuration for patient appointments required from our team, but even without the configuration, patients will be able to see available appointments. Additionally, patients will now be able to see appointment availability extending beyond seven days, which was not supported by the use of our previous API connection.

For the patients, this will be the first IM1 API service that is able to show tailored descriptions alongside the appointments, aiding patients in selecting the right appointment for whatever issue they need addressed.

For practices, this is also a benefit as it means patients will be signposted to the correct appointment type. It also means the practice isn’t required to do anything beyond making appointments available online for patients to book those through the app, so there are many efficiencies generated from the integration.

How long has the process taken?

Longer than I’ve been at Substrakt Health, which has been two years, but it has been amazing to see the amount of collaboration between all of our team members whilst integrating with IM1. Everyone played an important role in determining how we could build the most effective integration possible and I couldn’t be prouder to work with our team on this.

Well done to everyone involved:

Martin Meredith, James Nutt, Tom Large – the main developers who made this happen
Our QA team, Andrew Archer and Sonya Parmar – who did the most in depth testing possible
Natalie Rawson who updated so many SCALs that I’ve lost count
Maria Walschikow for all her help with the clinical safety and IG side
Vickie Shellam for all her help with scoping out the tailoring and knowledge on the clinical system

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