I’m working on changing over our DTS clients to MESH at the moment but wondered what we can do to be Transfer Of Care future proof.
As I understand it, we can do the following to send letters to GP’s
EMIS - Kettering XML format via DTS (?html)
INPS - Kettering XML format via DTS (?html)
TPP - Kettering XML format via DTS (we use this but only for community referrals - document format HTML)
EMIS - ITK XML with ITK SOAP - payload CDA including PDF document (or html?)
DOCMAN (so both EMIS and TPP) - Kettering XML format via DTS (?html)
Is this correct?
The documents we get in tend to be either from file drops or HL7v2 with the document formats pdf, html or rtf.
Metadata is equally a mixed bag but I use FHIR DocumentReference as it can be easily converted to ITK XML/CDA, IHE XDS, Kettering, DTS etc (if you manage your metadata). As we use HL7 FHIR internally, I prefer HL7v2 feeds as it’s a simple mapping exercise and it also works very well with the mixed bag of file feeds/formats.
IN - File or HL7v2
TIE/Middleware - HL7 FHIR
OUT - Kettering XML+DTS or ITK/CDA (IHE XDS is also possible)
Format - Answer seems to be documents should be html format? and use FHIR to decouple middleware/business logic from the OUT formats (i.e. don’t design middleware around the endpoint or source formats). It also allows move from Kettering+DTS to ITK+CDA
Reason for html: easier to convert to PDF and transform to basic CDA.
p.s. Another reason for using a different middleware format. We send these documents to an Document Management system. So by converting our IN documents to FHIR we quickly support multiple output systems - rather than build a point to point system for each interface.