The action or process used to ensure that a system provider meets necessary criteria to use the Open API services.
Access Control Framework. Access to NHS Care Records Service data (on Spine) is controlled by the ACF which registers and authenticates all users. It provides a single log-in and a record of each healthcare professional accessing a patient’s NHS care record. All information is provided on a need-to-know basis and based on a user’s role and legitimate relationship; with the patient. It stores the details of those relationships between healthcare professionals and patients, as well as patient preferences on information sharing (e.g. whether certain sensitive information is restricted from routine sharing).
A class in HL7 that describes if something happened or may happen.
A relationship between two HL7 act classes.
Access Control Service. The Access Control Service used on Spine
An Active patient as defined by GP Connect is any patient on a providers system that has Not Left and is Not Deceased. The concept of “Active” is related to the patient’s registration status rather than to the patients registration type. A providers system may have a number of different statuses which should be considered “Active”, many of those statuses may apply to a number of different registration type. Below is a basic example of a possible GP Practice representation of patient registration type and registration status, to help explain the concept of “Active” patient within GP Connect.
Advance Decision to Refuse Treatment. An advance decision (sometimes known as an advance decision to refuse treatment, an ADRT, or a living will) is a decision you can make now to refuse a specific type of treatment at some time in the future.
HL7 Admit/Discharge & Transfer messages carry patient demographic information for HL7 communications but also provide important information about trigger events (such as patient admit, discharge, transfer, registration, etc.). Some of the most important segments in the ADT message are the PID segment, the PV1 (Patient Visit). ADT messages are extremely common in HL7 processing and are among the most widely used of all message types.
An initiative launched by HL7 to accelerate the development and adoption of FHIR. Supported by 11 organizations, including EHR vendors Epic and Cerner and health systems Mayo Clinic and Intermountain Healthcare.
Academy of Medical Royal Colleges. The Academy of Medical Royal Colleges represents standards of care and medical education across the UK. By bringing together the expertise of the medical Royal Colleges and Faculties it drives improvement in health and patient care through education, training and quality standards.
The term Application Programming Interface is quite a confused term in the context of FHIR. Strictly speaking, an API is a set or services offered by a programming library that can be made use of by another application. Historically these would have been made available from a single machine although now they are available across networks. In the service/message/document categorisation, an API is a service interface although many don’t consider it so. As technology became increasingly capable of supporting distributed operations, the differences between SOA (Service Oriented Architecture) and API became blurred. In the context of FHIR we define APIs as REST based interfaces.
A response from one application to another indicating that a message has been received and is valid.
The role played by the application in a particular interaction.
SDS Accredited System Identifier
A set of activities intended to provide confidence that a system works as described and in a safe and secure way.
Attributes are abstractions of the data captured about classes. Attributes capture separate aspects of the class and take their values independent of one another.
Authenticated User Session. An Authenticated User Session is defined as when a real person is physically logged in to a system after being authenticated via their smart card or by another authentication method.
Choose and Book
Common Assessment Framework. The Common Assessment Framework (CAF) for Adults is a Department of Health funded project that aims to improve information sharing across organisations for multi-disciplinary assessment and care and support planning.
The Common Assurance Process is an NHS process that needs to be followed to gain accreditation allowing for connection directly to the Spine and PDS.
Care Record Element (CRE)
Are used by the Spine to identify Medication and Allergies and Adverse Reactions.
Consolidated CDA is an XML based implementation guide that specifies encoding, structure and semantics for a document that summarises a single patient’s clinical information.
The Clinical Commissioning Group is an NHS organisation made up of GP practices looking to understand the health needs of local people and use funds given by NHS England to buy services which meet those needs. Key challenges for our organisation are: tackling health inequalities and unwanted variations in quality of care, a growing elderly population with more long term conditions and a health and social care system in which any funding growth will be limited.
The Clinical Document Architecture provides an exchange model for clinical documents (such as discharge summaries and progress notes). By leveraging the use of XML, the HL7 V3 Reference Information Model (RIM) and coded vocabularies, CDA makes documents both machine-readable and human-readable. It guarantees preservation of the content by using the extensible Mark-up Language (XML) standard.
The Code 4 Health, Community Interoperability Board was established early in 2016. This network of networks has taken on a leadership role across the service to coordinate and deliver working interoperability standards.
Clinical Information Modelling Initiative An international collaboration dedicated to providing a common format for detailed specifications for the representation of health information content. In this way semantically, interoperable information may be created and shared in health records, messages, and documents.
A class that is a clone of another class, derived from another class.
Common Message Element Type (CMET)
This is a reusable model which can be used in multiple messages. CMETs can speed up the process of developing messages and increase consistency between different specifications.
A system which consumes data using existing Open APIs
The FGM RIS central core component
Cardiopulmonary Resuscitation. Emergency treatment that supports the circulation of blood and/or air in the event of a respiratory and/or cardiac arrest.
Child Protection Information Sharing service. An on-line service that allows NHS unscheduled care services to access basic child protection information that has been provided by the Local Authority Children’s Services departments. The NHS is only able to see that a child or foetus has a Child Protection Plan or is in the Looked After system. The information provided is start, end and delete dates; plus a Children’s Services contact telephone number where the NHS can get further information. Basic information about NHS accesses is also passed back to Children’s Services.
Clinical Referral Information
Coded With Extensions (CWE)
Codes from other code systems which have the same sort of context (meaning) can be used.
Coded with No Extensions (CNE)
Only codes from the specified code system can be used.
The structural format of the data carried in an attribute. Every data element has a data type. Data types define the meaning (semantics) of data values that can be assigned to a data element. Meaningful exchange of data requires that we know the definition of values so exchanged. This is true for complex values such as business messages as well as for simpler values such as character strings or integer numbers.
Data Type Flavour
A subdivision of a particular data type, that will constrain that particular data type. Data type flavour titles are suffixed with (f).
Distributed Computing Environment Universally Unique Identifier A type of universally unique identifier (UUID).
Diagnostic Data Services
Direct Patient Care
The Caldicott Review defined it as a clinical, social or public health activity concerned with the prevention, investigation and treatment of illness and the alleviation of suffering of individuals. It includes supporting individuals’ ability to function and improve their participation in life and society. It includes the assurance of safe and high quality care and treatment through local audit, the management of untoward or adverse incidents, person satisfaction including measurement of outcomes undertaken by one or more registered and regulated health or social care professionals and their team with whom the individual has a legitimate relationship for their care.
The NHS Dictionary of Medicines and Devices is a dictionary of descriptions and codes which represent medicines and devices in use across the NHS. It is delivered through a partnership between NHS Digital and the NHS Business Services Authority and provides the recognised NHS Standard for uniquely identifying medicines and medical devices used in patient care.
Domain Message Specification Description of messages definitions and interactions relating to a specific business area (such as Ambulance, Child Health or Discharge etc.) This provides information to implementers regarding the use of HL7 messages restricted to a particular domain or related group of domains, for use within the English NHS. The main difference between this and a Message Implementation Manual (MIM), is that the MIM will contain a variety of domains with their business analysis artefacts included.
Do Not Attempt Cardiopulmonary Resuscitation. This only covers opinions (in the case of a clinician) or decisions (in the case of an ADRT) about withholding cardiopulmonary resuscitation (CPR) in the event of a future arrest.
Department of Health
The Directory of Services searches for available service to match patient needs. It can also be manually searched via a desktop of mobile device. The content services profiled on the DoS is owned and managed locally.
Demographic Spine Application
Draft Standard for Trial Use
European Economic Area
Electronic Health Insurance Card
Electronic Healthcare Record. This is the concept of electronic longitudinal collection of patient’s health and health care from cradle to grave. It combines information from different care settings held in different systems and in some instances, aggregates the data and shows them as a single record. It is a record in digital format that is capable of being shared across different health care settings, by being embedded in network-connected enterprise-wide information systems.
A class in HL7 that describes a person, animal, organisation or thing.
Electronic Patient Record. An electronic record of periodic health care of a single individual, provided mainly by one institution.
Electronic Prescription Service enables prescriber’s – such as GPs and practice nurses – to send prescriptions electronically to a dispenser (such as a pharmacy) of the patient’s choice. This makes the prescribing and dispensing process more efficient and convenient for patients and staff.
The NHS e-Referral Service combines electronic booking with a choice of place, date and time for first hospital or clinic appointments. Patients can choose their initial hospital or clinic appointment, book it in the GP surgery at the point of referral, or later at home on the phone or online
For the purposes of federation of appointment bookings through the Appointments API, the “federation” is simply considered to the list of the organisations which are members of the federation, for example as a list of ODS codes
Female Genital Mutilation
Female Genital Mutilation Risk Indication System
Fast Healthcare Interoperability Resources. A standard for exchanging healthcare information electronically. (FHIR, pronounced “Fire”) defines a set of “Resources” that represent granular clinical concepts. The resources can be managed in isolation, or aggregated into complex documents. Technically, FHIR is designed for the web; the resources are based on simple XML or JSON structures, with an http-based RESTful protocol where each resource has predictable URL. Where possible, open internet standards are used for data representation.
First of Type
The chosen recipient(s) to test the first deployment of the new capabilities.
The FHIR Management Group provides day-to-day oversight of FHIR-related work group activities including performing quality analysis, monitoring scope and consistency with FHIR principles and aiding in the resolution of FHIR-related intra and inter-work group issues.
The FHIR Maturity Model provides a sense of how mature a resource is based on the level and types of review it has been subject to.
Fully Specified Name. Each concept has one Fully Specified Name (FSN) intended to provide an unambiguous way to name a concept. The purpose of the FSN is to uniquely describe a concept and clarify its meaning. The FSN is not a commonly used term or natural phrase and would not be expected to appear in the human-readable representation of a clinical record.
Government Digital Service
GP Connect Licence
The terms and conditions for usage of the GP Connect service.
System transferring full GP records between GP systems when patients register with a new GP. (Implemented using HL7 v3)
General Practice Extraction Service is a centrally managed primary care data extraction service.
General Practice Extraction Tool provides facilities to define, build and execute approved Query Specifications in order to provide data from GP Systems.
The functions delivered by GP System Suppliers to extract data described in Extraction Requirements from Data Provider Systems and send Data Provider Output to GPET-Q in accordance with the GPES-I Interoperability Standard.
The central system developed by the GPET-Q Contractor to enable the management and scheduling of data extractions by GPET-E systems.
GP System of Choice contract whereby a number of suppliers have gained approval to offer services via a centrally controlled contract.
Health Care Provider. Refers to a person licensed, certified or otherwise authorized or permitted by law to administer health care in the ordinary course of business or practice of a profession, including a health care facility.
Health Level Seven HL7, is an all-volunteer, non-profit organization involved in development of international healthcare standards. HL7 is also used to refer to some of the specific standards created by the organization e.g., HL7 version 2.x, version 3.0, HL7 Reference Information Model (RIM).
Health and Social Care Integration. This integrates local health and social care services, to improve coordination between local health and social care agencies leading to improved experiences for those people using these services.
Health and Social Care Information Centre. The Health and Social Care Information Centre is a data, information and technology resource for the health and care system and plays a fundamental role in driving better care, better services and better outcomes for patients in England.
Hyper Text Mark-up Language. HTML is not a programming language, it is a markup language. A mark-up language is a set of mark-up tags. HTML uses mark-up tags to describe web pages.
Although initially used as an adjunct to support effective training, the Intelligent Data Toolkit has been enhanced to support content changes in the clinical system and to enable cost effective commissioning in localities.
Immigration Health Surcharge
The Interoperability Toolkit, in the context of the NHS this is a set of common specifications, frameworks and implementation guides to support interoperability within local organisations and across local health and social care communities. The ITK is not a piece of software; it is not a product which is downloadable from this website.
Implementation Technology Specification. The ITS defines how to represent an HL7 message in a serial form that can be transmitted from a sender to a receiver.
JSON Web Token
Legitimate Relationship Service. A Legitimate Relationship is a relationship between a clinician (or NHS organisation work group) and a patient, that gives the clinician, or work group member, certain levels of entitlement to access that patient’s health record maintained on National Systems.
Messaging Exchange for Social Care is the main asynchronous messaging service used across health and social care. It works on the Spine infrastructure. It’s used to transfer electronic messages directly from one application to another, so different organisations can communicate securely. As an example, pathology labs use MESH to communicate test results to GP practices. MESH replaced the Data Transfer Service (DTS).
Model Interchange Format is a set of XML formats used to support the storage and exchange of HL7 version 3 artefacts. It is the pre-publication format of HL7 v3 artefacts used by tooling. It is also the formal definition of the HL7 metamodel. The MIF can be transformed into derived forms such as Unified Modelling Language (UML) /XML Metadata Interchange (XMI) or Web Ontology Language (OWL).
The Medical Interoperability Gateway is a supplier lead interoperability solution provided by EMIS + Vision which allows third parties access to GP data.
The Message Implementation Manual describes the HL7 messages used for communications across the NPfIT programme.
– Not all messages are HL7v3
– Not all messages are in the MIM
Multi-Payload Message format for carrying a combination of CDA and non CDA HL7 messages, linked by a common Control Act in the payload.
.NET is both a business strategy from Microsoft and its collection of programming support for Web services. Microsoft’s goal is to provide individual and business users with a seamlessly interoperable and Web-enabled interface for applications and computing devices and to make computing activities increasingly Web browser-oriented. The .NET platform includes servers; building-block services, such as Web-based data storage; and device software. It also includes Passport, Microsoft’s fill-in-the-form-only-once identity verification service.
N3 is a Wide Area IP Network (WAN), connecting many different sites across the NHS within England & Scotland. It also connects to other networks via Gateways, notably to the Internet via the Internet Gateway.
National Administrative Codes Service. The service previously known as the National Administrative Codes Service (NACS) is now known as the Organisation Data Service (ODS). It was responsible for the publication of organisation and practitioner codes, and for the national policy and standards with regard to the majority of organisation codes. These code standards form part of the NHS data standards.
NHS Connecting for Health. NHS Connecting for Health was an agency of the Department of Health. This organization was delivering the National Programme for Information Technology (NPfIT) in the NHS. Since 1st of April 2013 substantive functions of this organization are transferred to the Health and Social Care Information Centre.
NHS Care Record Service. The NHS Care Records Service (NHS CRS) is a secure service to improve the way health information is stored and shared in the NHS in England. It is linking health information from different parts of the NHS to support the NHS in delivering better, safer care.
National Programme for IT. A key aim of the National Programme is to give healthcare professionals access to patient information safely, securely and easily, whenever and wherever it is needed.
National Record Locator Service is a technical proof of concept acting as a national index to identify available records for patients and locate them across local and national care record solutions (such as SCR).
The Organisation Data Service is responsible for publishing organisation and practitioner codes, along with related national policies and standards. They’re also responsible for the ongoing maintenance of the organisation and person nodes of the Spine Directory Service, the central data repository used within various NHS systems and services. These code standards form part of the NHS data standards. This was previously known as National Administrative Codes Service (NACS).
Object Identifier. A unique identifier e.g. used to identify coding systems.
On the wire (instance format)
The format of the xml instance that actually flows over the network between systems.
Overseas Visitors Manager
The involvement of a HL7 role class in an HL7 act class.
The Patient Administration System is a core component of a hospital computer system which records the patient’s name, home address, date of birth and each contact with the outpatient department or admission and discharge. The NHS patient’s record and appointment tracking system is often called PAS, depending on the NHS Hospital Trust. This computerised administration solution that assists with planning, tracking and recording the patient’s contact with the outpatient department or admission and discharge.
Primary Care Trust. Responsible for primary and community health services within a geographical boundary.
The Personal Demographics Service (PDS) is the national electronic database of NHS patient details such as name, address, date of birth and NHS Number (known as demographic information) and medical information.
The HL7 Patient Identification segment is found in every type of ADT message (i.e. ADT-A01, ADT-A08, etc.) and contains 30 different fields with values ranging from patient ID number, to patient sex, to address, to marital status, to citizenship. The PID segment provides important identification information about the patient and, in fact, is used as the primary means of communicating the identifying and demographic information about a patient between systems.
Portable Network Graphics. Is a bit-mapped image format and video codec that employs lossless data compression. PNG was created to improve upon and replace GIF (Graphics Interchange Format) as an image-file format not requiring a patent license.
The name given to a group of suppliers who provide the GP’s with the core system available under the GPSoC contract.’
An individual or an organisation that provides health care for a patient. Also a system which provides data by exposing Open APIs.
A server that acts as an intermediary for requests from clients seeking resources from other servers
Professional Record Standards Body The independent PRSB is the first point of call for care professionals, service providers, commissioners, policy makers, professional bodies and system suppliers for expertise and all matters relating to care records. The PRSB is a national body providing an independent patient and professional voice on health informatics issues, to ensure that professionally endorsed standards are adopted to enable safe and effective information sharing and exchange.
Personal Spine Information Service. The central database on the Spine containing clinical records for each NHS patient.
Path To Live
Permission to view. Permission to View (PTV) business service that records that a patient has given an explicit permission to view their SCR.
Preferred Term. Each concept has one Preferred Term in a given language dialect. The Preferred Term is a common word or phrase used by clinicians to name that concept.
RBAC is the process through which a national set of job roles, activities and work-groups can be applied to grant users access to functionality and indirectly to data within NHS national (Spine) services. Role Based Access Control defines roles and allowed business activities associated with a user (via their smartcard). (Implemented using SAML).
Individual or an organisation responsible for the requesting an action to be performed for the patient.
Representational State Transfer is a protocol based upon a network of Web resources (a virtual state-machine) where the user progresses through the application by selecting links, such as /user/tom, and operations such as GET or DELETE (state transitions), resulting in the next resource (representing the next state of the application) being transferred to the user for their use. Typically preferred due to it being “stateless” so no information about the client session needs to be maintained on the server.
Interfaces are often referred to as being “RESTful” when they follow principles of “REST” to avoid debate about whether they conform to “REST”.
The Reference Information Model is the cornerstone of the HL7 Version 3 development process. An object model created as part of the Version 3 methodology, the RIM is a large, pictorial representation of the HL7 clinical data (domains) and identifies the life cycle that a message or groups of related messages will carry. It is a shared model between all domains and, as such, is the model from which all domains create their messages.
Refined Message Information Model (RMIM) is a HL7 model derived from the HL7 Reference Information Model (RIM).
Resource-oriented architecture is a style of software architecture and programming paradigm for designing and developing software in the form of resources with “RESTful” interfaces.
A class in HL7 that describes A responsibility or part played by an entity.
The Schematron is an XML structure validation language for making assertions about the presence or absence of patterns in trees. It is a simple and powerful structural schema language.
Summary Care Record. The SCR is intended to support patient care in urgent and emergency care settings. The SCR will store a defined set of key patient data for every patient in England except those who elect not to have one. This data will make a summary record created from information held on GP clinical systems. This summary record will help in ensuring continuity of care across a variety of care settings.
The NHS Spine Directory Service is a component of the NHS Spine service comprising of the Spine User Directory and Spine Accredited Systems and Services. The SDS ensures that transactions/messages are only processed from authorised users and systems. (Implemented with LDAP). The Spine Directory Service also stores a record of each NHS organisation. It is a key component of the Spine.
A person who uses or is eligible to use a health care or Social Care service.
Spine Mini Service Provider. Middle ware that provides access to lightweight, filtered services on National Applications.
The most comprehensive and precise clinical health terminology product in the world, owned and distributed by SNOMED International. Systematized Nomenclature of Medicine Clinical Terminology. This is a clinical terminology. It is a common computerised language to facilitate communications between healthcare professionals in clear and unambiguous terms. It has greater depth and coverage of healthcare than the versions of Clinical Terms (Read Codes) that it will replace and will enable clinicians, researchers and patients to share and exchange healthcare and clinical knowledge worldwide. SNOMED CT has been chosen to be the common language for gathering and sharing medical knowledge in the NHS Care Records Service. It will cut down the potential for differing interpretation of information and the possibility of errors resulting from traditional paper records.
Method for systems integration and development that allows different applications to exchange data in a loosely coupled way.
A protocol specification for exchanging structured information in the implementation of web services. SOAP allows processes running on disparate operating systems (such as Windows and Linux) to communicate using Extensible Markup Language (XML). Since Web protocols like HTTP are installed and running on all operating systems, SOAP allows clients to invoke web services and receive responses independent of language and platforms.
Is a collection of national applications, services and directories which support the health and social care sector in the exchange of information in national and local IT system’s. A national, central service that underpins the NHS Care Records Service. It manages the patient’s national Summary Care Records. Clinical information is held in the Personal Spine Information Service (PSIS) and demographic information is held in the Personal Demographics Service (PDS). The Spine also supports other systems and services such Choose and Book and the Electronic Prescription Service.
Spine Directory Service
Spine Directory Service (SDS) is the main information source about NHS registered users and accredited systems and services.
Standard for Trial Use The original DSTU2 FHIR standard has been superseded by the new standard STU3. To reflect that important parts of the spec are well past the draft stage
Synonym. A synonym represents a term, other than the FSN or Preferred Term, that can be used to represent a concept in a particular language or dialect.
A template is a HL7 Refined Message Information Model which is used to constrain another HL7 model.
Templated (instance format)
The format of the xml instance that has been transformed from “on the wire” format to a conformance format to enable more rigorous testing.
Transaction Messaging Service. This is a message transfer service that allows clinical messages from NHS Care Records Service (NHS CRS) users to be securely routed to the service they are requesting and to manage the response to that request. Depending on the type of message (e.g. relating to Choose and Book or the Personal Demographics Service), the Transaction Messaging Service identifies where the message needs to be sent.
Terminology Reference-Data Update Distribution Service. The Terminology Reference-data Update Distribution Service (TRUD) provides a mechanism for the UK Terminology Centre to license and distribute reference-data to interested parties.
The Unified Modelling Language is a family of graphical notations baked by a single meta-model, that help in designing and describing software systems. Especially useful when working with OOP paradigms.
Unattended Messaging Session. An Unattended Messaging Session is defined as when a system sends a message with no user intervention, and with no authenticated user session. Examples of this might be a Patient Administration System (PAS) requesting PDS retrievals as part of populating the day’s patient list.
Uniform Resource Locator. Is a reference (an address) to a resource on the Internet. For example a URL could be the name of a file on the World Wide Web because most URLs refer to a file on some machine on the network. However, URLs also can point to other resources on the network, such as database queries and command output.
A list of actions or event steps, typically defining the interactions between a role (known in the Unified Modelling Language as an actor) and a system, to achieve a goal. The actor can be a human or other external system.
Use Case Diagram
A visual presentation of a Use Case, standardised within UML.
Validated NHS number
A valid NHS Number is one that has the correct format and passes the Number check digit calculation.
Verified NHS number
A verified NHS Number is one where the patient’s identity has been cross-checked using demographic details on the Personal Demographics Service (PDS).
A Vendor Neutral Archive is medical imaging technology in which images and documents (and potentially any file of clinical relevance) are stored (archived) in a standard format with a standard interface, such that they can be accessed in a vendor-neutral manner by other systems.
A HL7 term for a subset of a HL7 vocabulary code list.
eXtensible Markup Language is a protocol designed to store and transport data. XML was designed to be both human and machine readable.
XPath is a major element in the XSLT standard. XPath can be used to navigate through elements and attributes in an XML document. XPath is a syntax for defining parts of an XML document. XPath uses path expressions to navigate in XML documents. XPath contains a library of standard functions.
Transform. A language for transforming extensible Mark-up Language.
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