The North East and North Cumbria Integrated Care System (NENC ICS) is leading a digital transformation effort to improve diagnostic capacity and efficiency across eight NHS Trusts. Central to this ambition is the implementation of a cutting-edge Referral and Booking Management (RBM) system. Designed and delivered by Answer Digital, and powered by InterSystems' Health Connect Cloud integration technology, the solution forms the backbone of a unified, region-wide data platform. Together, the partnership has laid the foundation for greater interoperability, improved service transparency, and an increase in diagnostic capacity.

The Challenge

With diagnostic services scattered across multiple systems and sites, NENC ICS lacked real-time visibility into regional referrals, appointments, and capacity. Manual processes and disparate integration engines at the trust level created inefficiencies and limited the ability to respond to demand. To streamline operations and make more informed decisions, the ICS needed a centralised data platform capable of aggregating diagnostic information from multiple trusts—without disrupting existing infrastructure.

The Solution

To realise this vision, Answer Digital implemented a centralised integration engine using InterSystems Health Connect Cloud, chosen for its proven scalability, healthcare-specific capabilities, and compatibility with HL7 v2 messaging.

Working alongside the ICS and trust-based integration teams, Answer Digital:

• Deployed and configured a regional integration engine hosted on InterSystems Cloud.
• Integrated eight local Trust Integration Engines (TIEs) using HL7 v2 interfaces to extract digital imaging requests, reports, and status updates.
• Developed a cloud-based data warehouse to store and transform incoming data for use in custom dashboards.
• Established robust pseudonymisation and patient matching logic to ensure privacy and accuracy.
• Delivered eight bespoke dashboards that visualise referral trends, capacity, utilisation, turnaround times, and cross-boundary travel behaviours for diagnostics.

These dashboards provide actionable insights into MRI, CT, and non-obstetric ultrasound services, giving ICS leaders a clear, near real-time view of activity across the region.

Why InterSystems?

The decision to use InterSystems Health Connect Cloud was pivotal to the success of the project. Its healthcare-native architecture allowed Answer Digital to rapidly build and deploy interfaces to each trust’s existing system, whether Intersystems, Rhapsody, or Mirth—ensuring minimal disruption. It also enabled real-time ingestion and transformation of HL7 messages, ensuring that operational data could be harnessed to power sophisticated analytics at scale.

InterSystems' flexibility meant that each trust could maintain its preferred clinical systems while still contributing to a unified, region-wide dataset. It also gave the ICS a future-ready platform to support additional data flows and diagnostic modalities beyond the initial scope.

Results

In its early stages, the RBM implementation has already demonstrated significant value:

• Increased diagnostic capacity: Trusts are now able to identify and respond to bottlenecks faster, ensuring patients are directed to services with available capacity.
• Improved visibility and control: The ICS can monitor referral trends, appointment conversions, and test turnaround times, enabling smarter resource planning.
• Greater regional collaboration: Trusts can see when patients travel across boundaries, promoting mutual aid strategies and shared accountability.
• Near real-time insights: Dashboards update hourly, providing operational teams with timely data for proactive decision-making.
• Scalable foundation: The architecture supports future additions, such as advanced analytics, predictive modelling, and new imaging modalities.

A strong partnership for the future

The RBM project exemplifies how technology and collaboration can transform healthcare systems. Answer Digital’s delivery expertise, combined with InterSystems’ powerful healthcare integration platform, has laid the groundwork for a more responsive, efficient, and data-driven diagnostic ecosystem across North East and North Cumbria.