Services Description

GPSoC Service Name / HealthShare Patient Index
GPSoC Service ID / ISC-HS-PI
Service Overview / HealthShare Patient Index provides the tools necessary for a local Health economy to manage its patients across all organisations. Wherever possible the NHS Number will be used as the common identifier, however this is not always possible and records relating to a single patient may often be separated.
Patient Index solves this problem by using a probabilistic linking algorithm to statistically determine whether two given records represent the same patient, different patients, or require human intervention to decide. Specifically the Index allows interoperating parties to define rules that allow potential matches to be highlighted for review, identifying the linkage for review in a human process. HealthShare only combines two patient records together when the aggregated record is requested in the clinician viewer or from another system. This avoids creating unnecessary linkages that might need to be reversed. The solution also identifies records that are probably not a match, but where there is sufficient uncertainty to warranty human review to improve overall data quality.

Figure 1 - HealthShare Patient Index
HealthShare supports all applicable IHE profiles for a patient index including PIX (Patient Identify Cross Reference Manager) and PDQ (Patient Demographic Query). This allows other PIX and PDQ compatible systems and solutions to immediately make use of the HealthShare Patient Index very quickly and easily, providing further benefit to the local health economy.
InterSystems see HealthShare Patient Index as an optional component that may not be needed in all deployments. When it is used there is a dependency on the procuring or represented organisation(s) to provide the sensitivity rules and to provide a suitable team to manage the probable links, probable non-links and review the matches that have been made.
Case Studies / For appropriate case studies please contact InterSystems, or alternatively, please see InterSystems Website for details of case studies in this service area.
Support / Support Arrangements
Support for the HealthShare packaged services is provided directly by InterSystems. InterSystems approach to support is based on delivery of processes and procedures in accordance with Information Technology Infrastructure Library (ITIL) best practices, a philosophy of “Continuous Improvement”, and root-cause analysis aimed the aim of reducing the level of calls to the Service Desk whilst improving customer satisfaction.
Services are provisioned by combining a proactive and reactive approach. Events are continuously monitored and alerts are automatically generated in order to avoid potential future problems.
Helpdesk Arrangements
InterSystems Help Desk is staffed by UK based personnel and forms part of the InterSystems Worldwide Response Centre (WRC),a global network of regional centres with extensive expertise across the product portfolio. The organisation is comprised of teams of individuals working together to provide support services that InterSystems customers require. The Help Desk is located in Eton at the InterSystems UK headquarters and will serve as the main point of communication for NHS organisations.
The Service Centre maintains a structured approach to application support services based upon an ITIL V3 compliant methodology and provides a single point of contact for the control and management of all issues relating to the collaborative working applications being supported. The Service Centre is managed and supported by the appropriate mix of specialists required to support a managed service operation for customers.
The Worldwide Response Centre (WRC) is available by phone, e-mail, and online 24x365 to provide product support to HealthShare clients who subscribe to support services. Guaranteed response is 30 minutes and at least 75% of all contacts are immediate. Clients determine the priority (Crisis, High or Medium) and requests are not closed without client permission. Clients rate the WRC staff 9.8 out of 10 for courtesy and professionalism.
The WRC meets ITIL best practices and provides Incident Management, Problem Management, Change and Release Management. Specific Service Level Agreements are determined for clients based on their requirements contracts.
All incidents, service requests, problems, and change requests, regardless of which component they affect, are managed using the Service desk application. When an incident (an event that negatively impacts the service to the user) is reported to the Service Desk, a new incident ticket is opened and an investigation triggered. The initial focus of the investigation is always to resolve the incident and return the portion of the affected system to normal operation.
In the event an incident requires a deeper level of investigation, a problem incident may be triggered and a Root Cause Analysis performed. In cases where a Problem investigation is warranted, the Service Desk application will again be used to record investigation activity. This allows the customer visibility into every step of the resolution process. Only when the customer has confirmed that the problem has been resolved to their satisfaction, will the Service Desk ticket will be closed. Once closed, the problem record forms part of a searchable database, to aide in future problem investigations/resolution.
Help Desk Response Time / Incident Fix Times Standard:
Incident Category / Response Time / Resolution or Provision of a workaround
1 / 15 mins / 2 hours
2 / 30 mins / 4 hours
3 / 2 hours / 2 days
4 / 1 day / Next New Version
Table 1 - Help Desk Response Time / Incident Fix Times Standard
Service Availability
Clients that manage their own systems can achieve at least 99% uptime, excluding planned outages, if they implement our recommended configurations and follow systems management best practices.
Where selected, InterSystems’ hosted service offering provides a minimum of 99% uptime excluding planned outages that are agreed with the client 30 days in advance.
Contractual Remedies
Specific Service Level Agreements and related remedies, such as credits for service failures and termination options, will be included in Call Off contracts with each client.
Customer Satisfaction
The InterSystems Worldwide Response centre boasts an unrivalled track record of customer satisfaction, having achieved an average of 98% overall satisfaction rating since 2001. This has been derived from customer satisfaction feedback, provided by thousands of InterSystems customers and responded to by tens of thousands of end users.
A formal governance mechanism for escalation of satisfaction issues will be agreed and regular management reviews may take place, over and above the monthly service review meetings.
CLIENT PRIORITY / CRISIS / HIGH / MEDIUM
Escalation / Immediate verbal notification to all appropriate senior managers by the director of client support. / Immediate automated notification to senior management. / Immediate automated notification to WRC management.
Table 2 - Escalation Governance
Simple satisfaction surveys are automatically generated for the designated customer contact upon closure of every incident within the Service Desk application. The “simple” survey inquires as to whether or not the incident was resolved to the customer’s satisfaction (Yes/No) and whether or not they have any additional feedback to share. Comprehensive satisfaction surveys are also automatically generated on a random selection of incidents. The InterSystems executive team meets formally on a weekly basis to review customer satisfaction and address issues of service delivery and/or service support. Low or “unsatisfied” results automatically trigger instant management alerts that will result in a detailed internal review and subsequently; a follow up process with the customer is initiated. More comprehensive satisfaction surveys will be conducted throughout the service management lifecycle, for the duration of the contract, as agreed with the customer.
Dependencies / Service Dependencies
  • Implementation and use is dependent on integration to relevant data source systems to input data into the Index.
  • To ensure successful delivery to a schedule to be agreed with InterSystems, the customer must ensure that all source system providers to connect to the HealthShare Patient Index have empowered and knowledgeable staff, complete end-point interface documentation and technical staff able to verify message delivery available as agreed.
  • The customer must make sure that they are staffed fully in accordance with levels defined by InterSystems and agreed prior to commencement of the project in order to fulfil the agreed project plan.
  • The customer must ensure that all end-point production and test systems are actively available at all times as required by the service.
Third Party Dependencies
  • The customer manages the relationship with their third party solution or data source providers to ensure necessary work is undertaken to complete end-to-end integration to allow data feeds to the Index
  • End users may independently contract with HealthShare Implementation Partners to provide additional services in relation to HealthShare.
Infrastructure Dependencies
  • The InterSystems HealthShare Patient Index solution will require the defined system-software, servers, and storage requirements to be provided for each individual contract. Two options are available for deployment :-either a client self-hosted solution or an InterSystems hosted solution within appropriate secure data-centre capacity within the UK.
Client Self-Hosted Option
  • In a client self-hosted environment a detailed document will be provided detailing all of the server, storage, and system-software such but not limited to virtualisation, operating systems, and backup management. The hardware resource requirements will be determined based on the expected workload in terms of both processing and storage requirements.
  • The HealthShare solution is supported on a wide variety of platforms and operating systems. These operating systems include Microsoft Windows Server, Linux (Red Hat and SUSE), and IBM AIX UNIX.
  • Network topology is to be provided by the client to convey network connectivity options (copper, SFP, SFP+ etc.), network (VLAN) assignments, DMZ and firewall requirements, and any other established pertinent network security practices. This information is necessary to understand the deployment model and determine if there are any security risks or vulnerabilities.
InterSystems Hosted Option
  • In an InterSystems hosted environment, HealthShare will be deployed onto InterSystems owned and operated equipment as a fully managed service and will be provisioned to support the contract terms. InterSystems leverages a completely virtualised architecture providing elastic resources to be agile and rapidly respond to changing requirements.
  • Network connectivity methods (N3, MPLS, IPSEC VPN, etc…) and bandwidth requirements will need to be determined along with the respective demarcation points/addresses to establish WAN connectivity between the client and InterSystems data centres.
Local Personnel Dependencies
  • This will be discussed as part of the call off. For customer-led initiatives the local resource requirements will vary according to the scope of use of the solution.
  • The customer will provide project sponsorship, project management, as well as functional and technical resources required by the project.

Sub-Contractor(s) / InterSystems do not expect to sub-contract the delivery of any Catalogue item or Service. Contract staff may be sourced and used to support and extend the InterSystems delivery capacity, however contractual responsibility for any delivery will remain entirely with InterSystems

Pricing Information

Implementation Charges / Below implementation sections are standard for setting up the HealthShare Patient Index. Depending on the specific customer requirements, the implementation steps can vary slightly in terms of man-days as well as in the number of steps. This is especially true if the Patient Index is being implemented independently of InterSystems Health Information Exchange. Therefore, the implementation man-days and number of steps presented below, is indicative.
Standard Setup of HealthShare Patient Index Infrastructure (17 man-days):
  • Install HealthShare Patient Index and its components with dummy interfaces to make sure the solution is properly installed, configured, tested and ready to be connected
Infrastructure (17 man-days):
  • Install HealthShare Patient Index and its components in accordance with the customer requirements at the disaster recovery centre (if applicable)
Documentation (17 man-days):
  • Provide documentation in accordance with the agreed project plan and deliverables
  • Participate to the creation of Interface Technical Design and Mapping documents. One document per interface is required
  • Update the Systems document to reflect components and processes used for interface(s)
Configuration (34 man-days):
  • Configure/tuning of Hardware, Infrastructure & Environments
  • Configure the HealthShare Patient Index platform according to customer requirements:
  • Development environment
  • Integration/Operability tools
  • dB Management system (Repositories/Registries)
  • IHE and HL7 Interfaces
  • Data Import Services
  • Data Stewardship Portal
  • Demographic Database
  • Probabilistic Matching Engine
  • Operational Reporting Services
  • Audit and Security Services
Testing (average 17 man-days per development area):
  • Testing in accordance with the agreed project plan
  • Address issues logged in InterSystems’ web-based Trak Resolution Centre (TRC)
  • Perform Unit Test
  • Unit Test Plan
  • Unit Test Execution
  • Support the Pre-Production Test with the customer end users – Using data supplied by the connecting source systems, the customer reviews the representation of the data
  • Pre-Production Test Plan
  • Pre-Production Test Execution – Performed by staff from customer end users
  • Documented Pre-Production Test Results – Created by the customer end users
Cutover to Production (17 man-days):
  • Create the technical cutover checklist
  • Enable data feed flow into the LIVE system
  • Assist the customer end users with validation in the LIVE system
  • Observe and communicate any issues related to data processing for two weeks following go live in the production environment
  • Transition to InterSystems Support (if applicable)
Training (17 man-days):
  • Train the various users in accordance with the agreed project plan
  • Train the customer super users on usage of the TRCresponsecentre application
Customisation/Development (average 17 man-days per development area):
  • Provide and participate with customisation as required and agreed in project plan before project commences.
Interface Development
The total average implementation of the HealthShare Patient Index is 102 man-days + 17 man-days per connecting interface + 17 man-days testing per connecting interface.
Service Charges / Charge Description / Unit Price (exc VAT);
Service Subscription Fees
The pricing for HealthShare Patient Index (PI) is based on two factors: a base subscription that provides the underlying software needed to operate the solution, and a service subscription proportional to the overall usage of the solution.
For the initial production instance that operates PI we charge a primary server subscription fee. For subsequent production instances and additional systems used for training, testing, development, or failover, we offer a secondary server subscription fee.
Subscriptions include Software License, Software Update and Technical Assistance services. A subscription can be upgraded to larger capacity at any time. Subscriptions are available on a month-to-month basis, with no fixed term, or on a fixed term basis for up to ten years.
Service subscription fees for HealthShare PI are based on the volume and scope of patient information handled by the exchange measured in Health Licensing Units (HLUs). HLUs can be defined at call-off to reflect the specific nature of the HealthShare project. Commonly used measures include organisational metrics (beds, patient encounters) and population-based metrics (patients, population).
For population-based service pricing one HLU is required for every 25,000 people in the defined population served by the Patient Index.
Illustrative Licensing Example:
A cross care setting health information exchange is deployed to serve a population of 250,000 citizens using InterSystems HealthShare PI.
The deployment architecture includes 1 primary production instance and 7 secondary instances of the PI software.
Monthly Subscription Pricing:
1 x Primary @ £2,587
7 x Secondary @ £647
10 x HLU license @ £243
Total Monthly Fee = £9,546
PI can be deployed at an end user location or remote hosting facility.
These prices do not include hosting or managed service these are available from InterSystems and will be negotiated at call off. / Primary Server Monthly Subscription = £2,587
Secondary Server Monthly Subscription = £647
Monthly Service Subscription = £243 per HLU
Software Update Programme
The Software Update programme provides free updates to new software versions. In addition, when switching computers, the Software Updates programme provides free transfers in some cases and trade-in credits in other cases. Annual Software Update fees are calculated as a percentage of the License Fees stated above.
Technical Assistance Programme
The Technical Assistance Programme provides assistance via telephone, fax, or email for problem resolution during normal business hours; emergency assistance 24 hours/day, 7 days/week; and problem updates via email.
Participation in the Software Update Programme is a prerequisite for Technical Assistance. On-site software installation is not included in Technical Assistance or License Fees. Annual Technical Assistance fees are calculated as a percentage of the License Fees stated above.
HIE can be deployed at an end user location or remote hosting facility.
These prices do not include hosting or managed service these are available from InterSystems and will be negotiated at call off. / Annual Software Update Fees = 15% license list price
Annual Technical Assistance Fees = 7% license list price
Software Licenses
As an alternative to using HealthShare on a subscription basis, HealthShare PI server capacity is available on a traditional one-time-charge license basis.
In this case, Software Update and Technical Assistance services must be purchased separately (see below)
Prices for up-front payment of monthly service subscriptions are available on request.
PI can be deployed at an end user location or remote hosting facility.
These prices do not include hosting or managed service these are available from InterSystems and will be negotiated at call off. / Primary Server License = £81,671