Cegedim Healthcare Solutions powers millions of electronic prescriptions for the NHS with DataStax
Cegedim Healthcare Solutions is part of the Cegedim Group, a major supplier of healthcare technology and information services across Europe, and currently the only healthcare solution provider approved to provide NHS GP clinical systems and NHS pharmacy dispensing software across the whole of the UK. Cegedim Healthcare Solutions also offers intelligent healthcare solutions to support collaborative working across the healthcare landscape with solutions for community care and shared care, as well as an innovative solution for population health management.
The company supports GPs and pharmacies with IT solutions for the efficient delivery of patient care, including the dispensing of medicines via electronic prescriptions. This is based on a real-time integration with NHS applications and the NHS Spine, delivered securely over the private Health and Social Care Network HSCN. To interact with these NHS systems and support critical real-time prescription fulfilment, Cegedim turned to DataStax Enterprise for its critical messaging and data expertise.
Supported 10 to 15 million prescriptions per month
Processed more than 80 million messages per month securely
Managed increase in prescription fulfilments and message volumes during COVID-19 pandemic
Cegedim Healthcare supports over 5,000 GP’s and more than 4,000 pharmacies as well as a range of other healthcare professionals with applications and services. This includes managing electronic prescriptions, which are replacing paper-based services. With this level of care providers creating and using prescriptions, a central service was required to process and manage the volume of messages, routing them effectively and integrating with the central NHS prescription services.
Behind every prescription is a wealth of data. Every time a patient visits their doctor in the UK’s National Health Service and receives an electronic prescription, messages are sent from the GP to the NHS Electronic Prescription Service to create the electronic prescription and log the medicines prescribed. When patients pick up their prescriptions, the pharmacy systems create their own messages to log the activities. Messages are also sent on to other NHS and public sector bodies that are involved in supporting patient care, health operations, and relevant services. Each of these messages must be sent securely, and the service just be always available.
This centralised Message Handling System (MHS) is business critical as it feeds both the Prescribing and Dispensing services, any implementation would need to handle the significant volume of transactions these services generate. The MHS needs to be both highly reliable, resilient and able to scale up to satisfy high transaction volumes without any downtime or degradation of performance.
The MHS application uses the Apache Karaf modulith runtime and ActiveMQ to manage messages. Alongside these components, the team at Cegedim required a data store that could handle the volume of transactions and process them in real time.
In order to implement the right approach to data for this application, Cegedim turned to DataStax. DataStax provides a scale-out, cloud-native NoSQL database in DataStax Enterprise (DSE), which is built on Apache Cassandra. “With so many messages and so much data created every month, we knew we had to run our application on a database that was built for availability and performance. Apache Cassandra met our technical requirements, and DataStax’s enterprise-class version of Cassandra met our requirements around support too,” commented Barry Fitchett, Solution Architect at Cegedim. “The team at DataStax helped us understand how to make the most out of Cassandra as part of our wider application development approach.”
The UK’s Electronic Prescription service relies on real-time messages passed between GP systems, pharmacy management applications and the NHS. Our solutions are required to support a large volume of secure messages. We required a rock solid and continuously available platform to support this service. Our initial choice around DataStax Enterprise has proved to be the right one.
Solution Architect at Cegedim
DSE was implemented across two data centres, with 14 cluster nodes spread across both locations. This provides geographical redundancy assurring availability requirements to meet our stringent SLAs. Data is automatically distributed across clusters and nodes, so any incident will not affect availability for the messaging application. “We liked Cassandra for two reasons. One was how reliable it was and that any failure events, from individual nodes up to a whole data centre would not affect performance or availability. Secondly, Cassandra has the ability to scale by just adding nodes as we need them, which supported our long term approach to managing the application very well,” continued Barry Fitchett.
Services are split across different nodes, with some supporting messaging and others providing search functionality for support staff. This is achieved by a set of nodes managing the production messaging system, while a second cluster of nodes uses the Apache Solr support in DSE to provide search functionality. This provides support staff with the data they need on prescriptions and status without affecting overall performance of the messaging system. Alongside this, the team can use DSE’s support for Apache Spark for analytics at scale.
The Cegedim team worked with DataStax to implement DSE for their application, including implementing processes on how long to store data for. Prescription data and messages are retained for a contracted time frame for audit purposes with a total of nine terabytes of data in place. The messages are managed using DSE’s Time-To-Live (TTL) functionality, which automatically manages how long data is retained. “The DataStax team helped us understand how Cassandra works around data and how we could model that over time. We host each month’s messages as a table which automatically updates as prescriptions are created. This made it easier for us to expand the data model and add more fields as we needed them. Over time, TTL manages how much data we keep live in our production implementation,” said Steven Barnes, Solution Architect at Cegedim Rx.
Each month, the MHS application is responsible for processing between 10 million and 15 million prescriptions, totaling around 80 million messages. This has increased as Cegedim has expanded the number of pharmacies that use its services.
“Over the past twelve months, we have seen how critical it is for the healthcare ecosystem to manage the data around prescriptions and ensure that patients get a high quality experience. Our portal for managing messages around prescriptions helps our customers to maintain their efficiency. Our implementation of DataStax supports our successful work with GPs, Pharmacies and other care providers,” commented Damian George, Head of Enterprise Platforms at Cegedim Rx.
In the past year, as the COVID-19 pandemic took place, the company has seen growth in demand for electronic prescriptions services. “We have seen a marked increase in prescriptions during the pandemic. Our implementation had the capacity to cope with this increase in volume without any degradation of performance. The resiliency that we had designed into the system made it very easy for us to manage increases in demand” added Steven Barnes.