Practice EDI Administrator

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Practice EDI Administrators Workshop
Pathology Messaging Implementation
Programme(PMIP)
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Objectives of the Day

• Introduce the HA/local team
• Overview of the project nationally
• Overview of the project locally
• The practice EDI administrator
• Roles and responsibilities
• Cryptography requirements in the practice
• Practice installation testing using NMAS
• Testing with local labs
• The practice implementation pack

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The ltltinsert namegtgt Team

• Introduce the Presenter(s)
• Introduce the Project Manager
• Who is involved at the HA/PCGs/PCTs
• Who is involved from the Trusts/labs

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PMIP National Overview

• Clinically safe and robust without information
  loss, substitution or addition
• Builds upon NHS and supplier experience of
  Pathology links
• All practices enabled to electronically receive
  pathology results for
• Haematology, Biochemistry and Microbiology
• All NHS pathology laboratories in Trusts to be
  sending messages for the above disciplines to the
  new standard within the time-scale
• PHLS are also planning implementation

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PMIP Implementation Road Map

• 60 of practices enabled by Mar 02
• Need to tackle the huge job of 8,800 practices
  upgrades independent of labs
• Work with suppliers to upgrade and test
• 100 of practices enabled by Dec 02
• Labs must undergo through testing
• Concerned with proven ability to receive messages
  from local labs
• Local Benefits Realisation
• Introducing procedural changes for the practice
  team
• Starting daily use of pathology messages by the
  practice
• Maximising use and value of pathology messaging

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PMIP The Benefits

• Improved privacy and confidentiality
• Improved data quality
• Improved tracking and auditing of results
• Improved legibility of results
• Improved local clinical analysis
• Capability to set alert facilities
• Enhanced efficiency at practices
• Time reduction spent locally searching for
  records and results

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PMIP The New Bits

• Developed by users, suppliers and centre
• Acknowledgements and audit trails
• Cryptography (scrambling of data)
• RFA 99 v1.1 for GP systems
• NMAS central testing system
• Clinical good practice guidance

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PMIP GPSS Implementation

• RFA 99 v1.1 upgrade and configuration
• Load of national dummy patient database
• Enables local end to end testing
• Pre-configuration of NMAS as a Trading Partner
  (a local lab)
• EDI S/R ID
• X.400 address
• Systems training as required for the practice

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PMIP Local Overview

• Context (within the LIS)
• Scope (what is in/out)
• Plan (how is this going to be delivered)
• Who is responsible for what
• Timetable for roll out and implementation

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The Practice EDI Administrator Role
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Practice EDI Administrator - Primary Role

• Generates and administers the practices security
  keys
• Undertakes the formal practice installation test
• Administers and sets up the new/upgraded, GP
  clinical systems functionality for messaging

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Practice EDI Administrator - Secondary Role

• Acts as first point of contact for supplier
  installation and training
• Liases with the HA on Tracking Database
  information updates
• Liases with the HA and NHS trust for maintenance
  of the pathology messaging link
• Contributes to the ongoing work process changes
  within the practice for benefits realisation

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Cryptography
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Cryptography

• Also referred to as encryption or PKI encryption
• Why are we using it?
• Guarantees the accuracy of the record
• Satisfies the Data Protection Act and the General
  Medical Council about confidentiality
• Enables GPs common law duty of care towards their
  patients

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Crypto Demystified
Public Keys Anybody can use
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So Many Padlocks

• Problems
• Lots of public keys to give out
• Lots of people giving out lots of public keys
• What happens if I lose my private key?
• How do we manage all these damn public keys?
• Solution
• Public Key distribution via a Key Server
• A means of verifying the public keys before they
  are made available (this IS Dr Bloggs Partners
  Key)
• Ease of management of public key when cancelled
  or no longer trusted

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Overview of the Service
Public Key Server
Labs Private Keys
Practices Private Keys
Tracking Database maintained by HA/PCT staff and
used to register for keys
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Practice Role Key Generation

• Pre Registration
• Coordinating with RFA 99 v1.1 upgrade
• Requesting registration for cryptography
• Receiving the authentication code (direct)
• Receiving the reference code (from the HA)
• Generating the keys
• Re-inputting the Password
• Who does it, when and in case of absence

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Example Authentication Code

• Subject "Electronic Pathology Messaging Security
  Authorisation Code".
• As you know, electronic pathology messaging is
  currently being implemented in your health
  community. This e-mail contains your
  authorisation code which you will need in order
  to set your computer system up to receive
  encrypted pathology messages.
• Please ensure that you keep the contents of this
  e-mail safely so as to avoid losing the
  information it contains.
• Your authorisation code is XXX XXX XXXX
• To complete the set up of your system for secure
  pathology messaging you will also require a
  reference code. Please see below for details of
  how you will be provided with your reference
  code.
• Please note that both of these codes have a
  limited lifespan of 30 days. The authorisation
  code provided in this e-mail, and its associated
  reference code, will expire on ltDATEgt.

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Practice Role Key Revocation

• Planned Revocation
• Surgery closure/merger
• GP system change (new EDI S/R ID)
• Emergency Revocation
• Disaster or security breach
• Practice Policy
• Who in the practice can request revocation
• Who to contact when requesting revocation
• How are results handled in the interim

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HA Role GP Key Revocation

• Planned Revocation
• Via Tracking Database
• Emergency Revocation
• Via Escalation Contacts
• Escalation Contacts for GPs
• Who from the practice can request revocation
• What procedures for authentication will be used
• Will it be HA or PCT level

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National Message Assurance Service(NMAS)
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What is NMAS

• National Message Assurance Service
• A centrally provided tool for
• Systems suppliers
• Local implementations
• Provides 5 services
• Message checking
• Message testing
• Clinical governance message checking
• GP practice installation testing
• RFA testing

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Why is NMAS Required?

• Clinical safety robustness
• Enable appropriate responsibility
• VFM improved efficiency of testing and
  development
• Strategic EHR and the need for standardised
  information

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NMAS Overview
Practice
Lab
Path reports
E-mail and acks
Testing reports example acks
Path reports and e-mail testing reports
Org details updates
TDbase
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NMAS Practice Installation Test

• Conducted by Practice EDI Administrator
• E-mail request to NMAS
• Report returned to Practice EDI Administrator and
  GP system supplier
• Tracking Database automatically updated on pass
• Tests practice
• Communication links
• Acknowledgement generation
• Cryptography
• Tracking Database details

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End to End Testing - Overview

• Tests
• Communication links
• Acknowledgement generation
• Cryptography
• Range of report types
• Procedures
• Occurs after
• Lab message testing
• Practice installation test
• Uses
• National dummy patients (test messages)
• End to end testing does not test systems

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Implementing End to End Testing

• This will vary from HA to HA
• Complete this slide to reflect your own plans

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Information available from the HA

• Leaflets
• Implementation of National Standard Pathology
  Report Messaging in General Practice
• Encryption of Pathology Result Messages in
  General Practice
• Implementation Pack for General Practices
• Local Escalation Contact Information
• Project Plan
• By contacting ______ ltltinsert HA leadgtgt

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Additional Sources of Information

• Local trading partner agreements
• From your HA or Lab (clarifies responsibilities)
• GP system supplier handouts
• Shows how to generate keys and complete NMAS
  installation testing
• The national pathology website
• http//nww.nhsia.nhs.uk/pathology