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ITK FAQs


What is ITK?

How does the Trust Operating Model help with implementing an ITK solution?

How do I get involved?

What standards does ITK utilise?

Are existing standards (e.g. HL7) sufficient by themselves?

How strict are ITK specifications?

Is Information Governance covered by Accreditation?

How do I encourage vendors to be ITK compliant?

How do I register a requirement?

Which vendors are accredited?

How is ITK Accreditation enforced?

How do I obtain the ITK specifications, Trust Operating Model or accreditation details?

How does my organisation accredit our solution?

Who else is implementing ITK?

Can I use my current output (for example, 'Kettering' discharge summary)?

Why should I use Clinical Document Architecture (CDA)?

What correspondence can I send?

What are ADTs?

What are Spine Mini Services?


What is ITK?

ITK is not a software solution in itself, but is a collection of specifications and standards that will allow interoperability.

ITK is structured in terms of:

  • Admission, Discharge and Transfer Interactions
  • Correspondence Specifications
  • Interaction with NHS National Services (Spine Mini Services)
  • Clinical Dashboards (commissioning/performance data)

Underpinning all these ITK standards is the ITK 'Core'. The Core provides common standard artefacts that are used by all the packs that go into making up the ITK specification.

Core common artefacts include:

  • Core service definitions - definitions of services which are applicable across the ITK
  • Transport Specifications – messages and contents have been designed to be independent of transport. Web services are the default transport, but others such as Data Transfer Services (DTS) are also supported.
  • Architecture Specifications – specifications describing the expected technical behaviours of ITK applications and middleware
  • Distribution Envelope - ITK payloads are wrapped in a 'thin' wrapper called the Distribution Envelope. The Envelope contains information for routing the transmission and some details about its payloads.
  • Acknowledgement framework - an overview of the acknowledgements appropriate for ITK implementations
  • A Trust Operating Model describing the responsibilities of an organisation deploying an ITK solution (for example, Information Governance, Clinical Safety, Governance)

The ITK also includes an accreditation process and a list of vendors, system name and version is recorded on the Accreditation catalogue.

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How does the Trust Operating Model help with implementing an ITK solution?

Connection may be implemented locally within Trust boundaries, to non-NHS organisations, to other NHS Trusts, or to Spine-Compliant applications (provided by Local Service Providers or Existing Systems Providers).

The Trust Operating Model assists with the implementation of integrated systems by helping define architecture, information governance and clinical safety components.

In particular it provides guidance on Trust responsibilities in terms of ensuring that local systems do not compromise any Spine Compliant systems to which they connect.

This does not cover Spine Compliance as this is dealt with by NHS CFH separately. The Trust Operating Model is available to download from TRUD in the NHS ITK Core pack.

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How do I get involved?

Interoperability with ITK will only happen if NHS Trusts specify use of ITK-compliant systems and vendors build to that specification. Prioritisation is driven by the NHS through the ITK Management Group. The developed candidate release specifications will then only become formal releases following successful deployment.

To notify us of a project, join a forum, or log a development request please complete the online Enquiry Form.

To join the online discussions you will need to register with the NHS Networks and join the relevant ITK Networks.

There is also an ITK focussed group on LinkedIn that provides an additional opportunity to get involved.

The inclusion of these links should not be understood as an endorsement of those websites, the site's owners or sponsors. The views expressed within the ITK Network are those of the individual community members and, unless specifically stated, not those of NHS CFH or DHID.

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What standards does ITK utilise?

The Web Services transport uses SOAP and widely adopted WS-* standards.

The content carried in ITK messages is flexible, and the most appropriate standards for each usage will be selected. So far this has consisted of web services, HL7 v2.4 A3 (HL7 UK) and HL7 v3 including Clinical Document Architecture (CDA). ITK also supports the transmission of other files (for example, PDF, Word) for systems that are not yet able to produce CDA.

HL7 Intellectual Property is used in the following places:

Pack HL7 content
Core

Business Ack uses HL7V3

Correspondence

CDAR2 from HL7V3 - for CDA profiles

Dashboards

HL7V3 used for dashboard feeds

HL7V2

HL7V2 used for ADT Messages

Spine Mini Services

HL7V3 used for PDS Mini Services 

Contact HL7 UK for advice on licensing and membership.

The DH ID ITK Team has representation on HL7 and IHE bodies and is also working with the Clinical Division and the Royal Colleges who will help define the structured clinical content. Other standards may be considered in line with business need.

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Are existing standards (e.g. HL7) sufficient by themselves?

No. The existing message standards such as HL7v2.4 are frameworks which then require local profiling or tightening on deployment. Traditionally each deployment has profiled these standards individually, thus losing interoperability.

ITK includes a profile where many of the common elements have been tightened, removing much of the need for local interpretation.

By keeping the ITK specifications consistent within the NHS, it is possible to encourage wider interoperability with overall reduced cost, yet offering wider opportunities for vendors.

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How strict are ITK specifications?

The general philosophy of ITK is to provide tightly constrained standards profiles that enable a very high degree of out-of-the-box interoperability. However we do understand that there is a trade-off between interoperability and the flexibility to adapt to meet individual customer requirements. This trade-off is managed by constraining only the fields where it is appropriate to do so at a national level.

If you feel that ITK specifications are incorrect or do not meet local need, then please contact us via the online Enquiry Form.

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Is Information Governance covered by Accreditation?

No. The accreditation process is intentionally lightweight and only covers the technical interface.

An important principle of the ITK is that it devolves responsibility for implementation to NHS organisations who should ensure that appropriate IG controls are applied to any systems they may implement locally.

Part of the ITK pack is the 'Trust Operating Model' which provides extensive further guidance on these aspects, including a Self Evaluation Checklist.

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How do I encourage vendors to be ITK compliant?

It is the responsibility of NHS trusts to request ITK compliant systems through the procurement process, enforcing it contractually. The ITK DHID Team has prepared some sample text for inclusion in an Output Based Specification. This is available to accompany the Trust Operating Model in the Core pack.

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How do I register a requirement?

The NHS ITK User Forum has been created for the NHS to discuss business requirements. The NHS ITK Management Group will then prioritise needs and direct sub-groups to complete a full NHS business requirement.

Requirements can be registered either through the NHS ITK User Forum or by completing the online Enquiry Form.

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Which vendors are accredited?

A list of vendors, system name and version is recorded on the Accreditation catalogue. This list also indicates the specification bundles and version against which it has been tested.

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How is ITK Accreditation enforced?

It is up to NHS Trusts to ensure this through procurement. Accreditation is awarded for a specific version of both the ITK specifications and the accredited software. Once accreditation is awarded it is permanent but only for that specific combination of IT specifications and software version.

On release of a new software version, re-accreditation will be required. This is a lightweight process that, for example, might be naturally incorporated into a vendor's regression testing.

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How do I obtain the ITK specifications, Trust Operating Model or accreditation details?

Information about ITK, including Specifications, Accreditation and the Trust Operating Model, is available from TRUD. Users will need to register on TRUD and sign up for the correct 'release sub-packs'.

These include:

  • NHS ITK CORE (Common requirements – includes Trust Operating Model)
  • NHS ITK CORRESPONDENCE (CDA document specifications)
  • NHS ITK DASHBOARDS
  • NHS ITK HL7V2 (initially ADT messages)
  • NHS ITK SPINE MINI SERVICES (initially PDS subset)
  • NHS ITK ACCREDITATION

Links to file transfer sites are available from the TRUD registration page.

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How does my organisation accredit our solution?

Accreditation is awarded to vendors based on a particular version of a product.

In order to achieve accreditation, a vendor must demonstrate the technical conformance with the ITK requirements. To discuss accreditation, or for further guidance, vendors should contact ITK Accreditation Mailbox.

The Accreditation pack, including the ITK Testbench is available to download from TRUD.

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Who else is implementing ITK?

Case studies for 'first of type' deployments will be published on the NHS CFH website. Let us know about your project and success stories using ITK.

Discuss your projects and share your lessons learned on NHS Networks.

The inclusion of this link should not be understood as an endorsement of that website, the site's owners or sponsors. The views expressed within the ITK Network are those of the individual community members and, unless specifically stated, not those of NHS CFH or DHID.

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Can I use my current output (for example, 'Kettering' discharge summary)?

ITK has a maturity model that supports legacy systems in moving existing output messages from point to point, as well as a development path towards a fully structured, fully coded document (CDA). For more information on the maturity model, please see ITK for NHS Organisations.

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Why should I use Clinical Document Architecture (CDA)?

The HL7v3 CDA standard for representation and machine processing of clinical documents aims to represent information in a way that makes the documents both human readable and machine processable.

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What correspondence can I send?

There are many document interoperability standards developed for correspondence such as Hospital Discharge and Ambulance Reporting.

These provide conformance specifications for the transmission of certain types of correspondence, using HL7's Clinical Data Architecture (CDA).

There also exists a general CDA conformance specification that allows other formatted documents (for example a portable document format (PDF) to be embedded within a CDA document.

Current developments include specifications for Discharge Summary, Outpatient Letter, A&E Attendance, Out of Hours Report, Ambulance Report.

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What are ADTs?

Admission, Discharge and Transfer Interactions (ADTs) are based on HL7's version 2 ADT message specifications. These message definitions interact with Patient Administration Systems (PAS) to provide standardised interoperability between PAS systems and offer other interfaces into PAS systems such as through admission booths.

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What are Spine Mini Services?

Spine Mini Services specifications define interaction with NHS National Services (Spine). This includes, for example, services that allow interaction with the Personal Demographic Services (PDS).

These Spine Mini Services are available via middleware suppliers and provide facilities to look up and verify NHS Numbers, as well as return patient demographic information.

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