Digital Health Ecosystem Wales (DHEW), a collaboration between NHS Wales Informatics Service (NWIS) and Life Sciences Hub Wales, has collaborated with Welsh health technology startup Concentric Health on a project to develop and understand the potential for APIs within the healthcare system in Wales.
As part of our commitment to opening up systems and data as part of the Digital Transformation Programme, we wanted to develop a mechanism for external, internet-hosted systems to communicate securely with internal NWIS systems through the use of application programming interfaces (API’s).
APIs offer the opportunity to avoid complex integration work, allowing proven and promising technology solutions to interact with data and systems to help develop new services and products.
The objective for the project was to co-design and develop APIs in an agile way, allowing DHEW to better understand the needs of industry and the NHS, and make progress towards the use of such API’s in the health service in Wales.
In order to address these objectives, DHEW partnered with Concentric Health, a health technology startup. With both teams based at Cardiff’s Tramshed Tech and Concentric already in the process of deploying software within Welsh Health Boards it was a natural collaboration.
The initial phase of the project developed an API to search for patient demographics, and an API to send a document back to NWIS’ document store – these are two functionalities used by Concentric Health’s digital consent platform. Over the course of a four week project the team worked together with the aim of demonstrating use of Concentric’s digital consent software alongside NWIS’ systems using interoperable (FHIR - Fast Healthcare Interoperability Resources), internet-facing API’s.
The project team included Mark Frayne and Huw Angle from DHEW, and Dr Dafydd Loughran, Jon Pearse, and Martyn Loughran of Concentric Health. Cloud-hosted development environments of NWIS architecture were used for the project, including the Welsh Demographics Service (WDS) and Wales Clinical Records Service (WCRS). Enhancements were made to the services to allow communication to and from authorised systems using FHIR API’s.
Throughout the project, both teams shared ideas and technical knowledge, learning from each other to rapidly iterate the functionality. By the end of the four weeks they had developed the APIs, demonstrating that agile co-design API projects can have an impact for health boards and the adoption of health technology across Wales.
DHEW and Concentric Health have developed a proof-of-concept integration between Concentric’s digital consent application and NWIS’ systems, using interoperable API’s for both patient demographics and storing of documents.
Patient details can be securely requested by a clinician using Concentric’s application from the development NWIS server. WCRS can automatically receive a consent PDF document, to be viewed in the Welsh Clinical Portal, when a consent document is generated in Concentric’s application.
Dr Dafydd Loughran, CEO of Concentric Health said:
“Getting interoperable, internet-facing API’s working alongside the national infrastructure in Wales could have significant impacts on the outcomes and experience of care for patients, as well as supporting our clinicians to provide a safe, efficient service. The API’s developed during this project are not bespoke for Concentric, they could be used by any health technology needing to perform similar functions.
Projects such as this one demonstrate the potential for Wales to be a leader in digital healthcare innovation. With core IT systems already shared across a population of three million people, making it easy and attractive to innovate alongside health boards could see Wales become a launchpad for health technology globally."
Alongside its evident advances for digital healthcare technology in Wales, the project also highlighted the benefits of collaboration between diverse organisations across Wales’s healthcare technology ecosystem.
It marked the first time DHEW has carried out research and development in collaboration with a third party, with both Concentric Health and DHEW sharing their respective industry expertise.
Huw Angle, Lead Software Developer at NWIS, said:
“This is the beginnings of a significant improvement in the service that NWIS offers to developers. It’s a demonstration of us working to engage and collaborate with the wider health tech sector to support the aims of the Digital Health Ecosystem project, whilst actively seeking feedback on how to improve these new APIs.”
Now in its second phase, the collaboration continues with the aim of getting the API’s used in live clinical practice at a Welsh Health Board.
“A challenge over the next few months is to traverse the hurdles, both technical and political, in order to get these internet-facing, interoperable API’s in use alongside NWIS systems."
Alongside the API’s described in this project, the next phase of DHEW’s work also includes the transfer of patient reported outcome data to a central NWIS database, a collaboration also involving DrDoctor and Patients Know Best.