Frequently Asked Questions

FAQs

On this page you will find answers to the most common questions we get asked about our work. Do you have a question that isn’t answered here? If so, please get in touch at info@theprsb.org.

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Who decides the content of the standards?

The standards are developed through a review of existing standards and research, followed by wide consultation with health and care professionals, clinical systems and tech suppliers, and people across the four nations.

Suppliers or developers in care provider organisations use them to design and incorporate in their systems, so that health and care professionals and people themselves can then record, access and share the information with everyone using the same specification, and have the same understanding of what it means. Care provider organisations should ensure that clinical systems conform to the information standards when they are purchased.

Using standards in practice means that health and care professionals, and people and their carers, can record or access the information needed for the best care and, where appropriate, it can be shared seamlessly and safely with other staff, other care settings and with people themselves, or their carers.

The standards are designed by health and care professionals, as well as people who use services. They are endorsed by professional and public bodies as good practice.

Health and care professionals already complete care records so this is not additional workload. The information standards are about ensuring that the information is recorded in a consistent, comprehensive way so it can be shared appropriately across the system. This will also mean that the same information will not need to be recorded multiple times.

The standard represents best practice and is the goal we should all be aiming for over time. However, we recognise that that there is a level of compliance that is still safe and effective without being 100% conformant with the standard. This minimum level is defined as the ‘must haves’ and applies to both data items and business rules. The PRSB conformance Quality Mark can only be awarded to organisations that meeting this minimum level. We hope that both system suppliers and organisations providing care will continue to progress their journey towards best practice.

When using the standard in a provider organisation, professionals who are recording or sharing the information must ensure they do so in accordance with the information model and the implementation guidance which sets out the data items that are mandatory (MUST be recorded or shared), required (SHOULD be recorded or shared, if available) and optional (MAY be recorded or shared).

No. The presentation of the data to the users of the system can be determined locally, based on local requirements. However, the conformance requirements of the standard and implementation guidance should be followed. 

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The information record standard sets out what information is needed in a particular situation. The FHIR profiles or APIs set out how to send that information – we need the ‘what’ and the ‘how’ to be right for interoperability to be successfully achieved.

Using FHIR or an API as a proxy for the information content definition is problem

It will take time for all systems to become conformant with standards. However, appropriate levers and incentives will be put in place to help drive implementation and adoption of standards, such as making conformance a requirement of relevant procurement frameworks. PRSB is working with suppliers and local systems to facilitate the transition.

Shared care records consolidate digital patient information from across health and care services to provide a single, holistic view of a person’s health history, facilitating integrated care across healthcare providers. The CIS defines a consistent set of structured information that should be available in all shared care records, enabling seamless communication across primary, secondary and community health and care settings.

The CIS underpins shared care records by ensuring the right data is available across different settings and between shared record services, improving the integration and quality of patient care.

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The International Patient Summary (IPS) is a globally recognised specification designed to share essential patient information across borders, enabling safe care during both planned and emergency situations.

The Core Information Standard (CIS) supports shared care records across health and social care in the UK to capture consistent, comprehensive, person-centred information across local care settings. Though designed for different contexts, IPS and CIS complement each other. IPS offers a minimal dataset for cross-border care, while CIS provides a broader record for UK-wide care services. The CIS can be used to generate an IPS, enhancing global and local care coordination.

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Shared care records consolidate digital patient information from across health and care services to provide a single, holistic view of a person’s health history, facilitating integrated care across healthcare providers. The CIS defines a consistent set of structured information that should be available in all shared care records, enabling seamless communication across primary, secondary and community health and care settings.

The CIS underpins shared care records by ensuring the right data is available across different settings and between shared record services, improving the integration and quality of patient care.

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Position Statement on shared care records and PRSB’s Core Information Standard

Overview

Shared care records

A shared care record brings together separate records from different health and care organisations together digitally in one place. It joins up information based on the person rather than one organisation.

Shared care records are a local solution based on geography for sharing important and up-to-date information about patients’ health and care.  This includes current health issues, medications, recent test results, care plan or treatment plan details, and information on social care or support needs.  The information can be from primary care, community services, mental health services, social care, secondary care, and specialist services such as ambulance services, cancer services, etc. and can also contain documents such as care plans, outpatient letters and discharge summaries.

Shared Care Records are made available predominantly to support professionals (including pharmacists, optometrists, dentists, podiatrists and social care services) in the provision of direct care by providing access to information that they are reasonably and foreseeably likely to need to access in the course of their professional duties.

Core Information Standard

The Core Information Standard was developed to support NHS England’s Local Health and Care Records Exemplars programme (now the Connecting Care Records (ConCR) programme) which supported, initially, five local areas to develop local shared care records in 2018 and now is a UK-wide standard that currently supports all ICBs in England.

It defines a set of information which should be common to most systems and would be an amalgamation of records drawn from different settings. It was expected that the information would be read only, at least initially.

It sets out what information should be shared between organisations and geographies and could be used to populate shared care records. It was expected that local implementations would define different ‘views’ in their shared care record of the information for different professionals (and other users, including people who use services) and local use cases. For example, a social worker may need access to different information than a consultant in A&E.


Alignment

The Core Information Standard has become accepted as the standard for Shared Care Records and is a requirement of the Minimum Viable Standard for Shared Care Records within the Levelling Up guidance and resources published by NHSE’s Connecting Care Records (ConCR) Team, which states that PRSB’s Core information Standard should be adopted by all ICBs. As the Core Information Standard is synonymous with a shared care record standard, PRSB will rename the CIS to the Core Information Standard for Shared Care Records.

What is the relationship between the International Patient Summary (IPS) and the Core Information Standard (CIS) for shared care records?

Overview 

These 2 standards exist for different purposes, but nevertheless there is strong alignment between them.   

The CIS is the information standard to support shared care records for use across health and social care in the UK.  It is a specification for a comprehensive but constrained set of information for sharing a person’s details, health and care conditions, treatments and care services between those caring for the person. Systems conforming to the CIS enable all those caring for the person to have a more complete picture of the person to support more holistic and person-centred care, with different views of the information for different uses.   

The IPS is a high-level international specification for a set of patient information that can be used when caring for a patient across organisational boundaries, including country boundaries, for both planned and unplanned care.  The IPS specifies a minimal, structured yet non-exhaustive set of information to support safe clinical care.   

Alignment 

At a high-level there is very good alignment between the IPS and CIS.  The CIS is a wider dataset with 38 sections (V2) as opposed to the 20 blocks of IPS (edition 2).  The 20 blocks of IPS map well to the CIS sections, with only 1 not mapping, that is ‘cross organisation’, which has the details of the originating organisation and date of the IPS.  There are 15 sections of CIS with no direct mapping to the IPS.     

IPS is high level specification with a description, data type and conformance for each element (data item). The CIS uses a slightly different approach to conformance and data types but also includes cardinality and value sets with defined terminology constraints.  The value sets are based on primarily SNOMED CT with NHS Data Dictionary for administrative type elements (data items).   

PRSB supports the IPS, and it is expected that CIS would support the generation of an IPS from a shared care record.   

What is the relationship between OpenEHR, HL7 FHIR and PRSB information standards?

Overview

PRSB, openEHR, and HL7 FHIR share a goal of enabling integrated care and interoperability. PRSB standards bridge the gap between different platforms, ensuring that the professional and person information needs are defined for different use cases which can then be implemented in openEHR or FHIR. openEHR is an open, vendor neutral platform for electronic health records and computable clinical and research data. It focuses on storage and structure of clinical information, while FHIR is a messaging standard for exchanging health information.

PRSB’s platform-agnostic standards can be implemented using both openEHR and FHIR (and other interoperability standards), allowing flexible and interoperable data exchange. PRSB is working on aligning its standards with openEHR and FHIR through collaboration and proof-of-concept projects.

PRSB, openEHR and HL7 FHIR have a similar vision and principles:

  • Enabling integrated care and interoperability
  • Enabling patient centric information and care records where data can be easily shared and updated
  • Semantic definition of information must be meaningful to those who use it and defined by them
  • Principle of separation of data from systems
  • Information standards should be equally relevant to secondary uses as direct care
  • Data locked in hundreds of legacy systems is a huge barrier


The PRSB defines the information that users need to see or collect. Our information models, value sets and templates are platform agnostic by design – i.e. they can be picked up and used by providers or system suppliers to understand the information needs and design these into systems. The information models draw on a library of re-useable building blocks, set out in a logical model, ensuring that the same information is recorded in the same way and can be shared and understood inter-changeably. PRSB maintain an extensive membership network and governance infrastructure that ensures wide consultation and support for information models and ongoing maintenance and development of them.

openEHR is a publicly available specification for an EHR application and includes a data architecture comprising archetypes, termsets and templates. openEHR specifications run on an openEHR data platform enabling data from different sources to be collected and presented from one place. openEHR archetypes are similar to PRSB components but include the technical specifications to enable them to run on the openEHR platform.

Alignment

PRSB information models can work effectively with openEHR and directly with FHIR technical messaging standards or with other platforms or proprietary supplier systems. Information Standards as maintained by the PRSB provide a bridge between different interoperability standards (FHIR, CDA, HL7v3 etc) and the various EHR architectures, both proprietary and as standardised by openEHR.

PRSB have a well-established relationship with HL7 FHIR and an aligned approach to standards development. PRSB intend to work with openEHR to further develop the detail of how our products can work together and provide benefit from doing so.

The relationship between OpenEHR, HL7 FHIR and PRSB information standards

Logical model layer
PRSB logical/information models define the clinical content for a defined use case or domain of care. They include common components (building blocks) which sit within an under-pinning logical model (defining the relationships between them) and include value sets and implementation templates.

Messaging layer
HL7 FHIR is the interoperability standard used for carrying structured messages between systems.

Data/storage layer
openEHR Clinical Data Manager (CDM) provides a data repository enabling collecting and presenting data in one place. openEHR archetypes define common components and templates are used to pull them together along with termsets to deliver functionality to deliver use cases. Supplier systems have their own data layer serviced by supplier specific API’s.

Notes

Archetypes are broadly equivalent to PRSB common components (building blocks) and termsets are equivalent to PRSB-defined value sets). PRSB components and openEHR archetypes are broadly equivalent.


Further work

We plan to do further work to explore how PRSB standards and openEHR archetypes and models can work together optimally and prove the concept with a worked example.

  • Explore how openEHR can benefit from established PRSB community for mutual benefit – in discussion with openEHR.
  • Adapt our development processes to map more closely to existing FHIR profiles and openEHR archetypes and templates at inception so that alignment is baked into the models from the start rather than requiring a subsequent step.
  • Encourage alignment of the NHS England canonical data model and the PRSB logical model and mapping to openEHR.