Digital Child Health and Maternity Update Briefing 15 May 2017 - - PowerPoint PPT Presentation

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Digital Child Health and Maternity Update Briefing 15 May 2017 - - PowerPoint PPT Presentation

Aug 18, 2023 376 likes •1.15k views

Digital Child Health and Maternity Update Briefing 15 May 2017 Agenda 14:00 14:30 Digital Child Health overview 14:30 15:15 Child Health Information Standard and Events Catalogue 15:15 15:30 Break 15:30 16:00 Alpha phase 16:00

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Digital Child Health and Maternity

Update Briefing – 15 May 2017

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Agenda

14:00 – 14:30 Digital Child Health overview 14:30 – 15:15 Child Health Information Standard and Events Catalogue 15:15 – 15:30 Break 15:30 – 16:00 Alpha phase 16:00 – 16:30 Maternity 16:30 – 17:00 Questions

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Digital Child Health – National overview

Presented by Thomas Burnett Digital Child Health Programme Manager

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Background to programmes

Healthy Children: Transforming Child Health Information, a strategy commissioned by NHS England September 2015, delivered July 2016, published November 2016. NHS Digital work began July 2016 (Discovery) Maternity Transformation Programme, formed on the back of the National Maternity Review (Feb 2016). 9 Workstreams, 2 dedicated to information services and technology. NHS Digital handed remit for a Discovery period for Workstream 7: Harnessing Digital Technology in September 2016.

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Healthy Children – strategy vision

‘Knowing where every child is and how healthy they are’ ‘Appropriate access to information for all involved in the care of children’

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A number of current challenges

  • National Personal Child Health Record (PCHR) still on paper
  • Limited capability to manage children unregistered to GPs and offer them

preventative services

  • Deficiencies in managing local populations highlighted by National Incident

Team report, children at risk of missing out on preventative services

  • Healthcare professionals don’t have access to a core summary of child health

information, records are fragmented across systems

  • Services still very paper driven and manually intensive
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0d 5d 8d 11d 7w 9w 12m 13m 24m 40m 4y 5y NIPE Bloodspot Hearing New Baby Review 6-8 Week Exam 8/12/16 wk Imms 12 mth Review 12/13 mth Imms 2/2.5 yr Integ Review 3yr 4mth Imms 4-5yr eyesight check School Entry Chk Year 6 Check Year 8 HPV Booster Imms Public Health England Personal Health Professional Health Public Health Commissioners Directors of Public Health & Children’s Services Delivery of Healthy Child Programme (All Children) Delivery of all other care services (Some Children) CHIS / CHRD CHIS / CHRD CHIS / CHRD CHIS / CHRD CHIS / CHRD CHIS / CHRD School Nursing Primary Care Health Visiting Midwifery Education Services Voluntary Services Mental Health Services Emergency & Acute Services Justice Services Social Services Community Services Neonatal Services Maternity Information Systems Screening Information Systems Primary Care Systems GPES CYP Dataset CAMHs Dataset PCHR 90 CHRDs Research & Policy Maternity Dataset SCR National Audit

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Healthy Children – where do we start?

With the basic building blocks:

  • A first layer of essential child health information for exchange
  • A first phase of systems exchanging that information - Maternity, Child Health

GP systems and Personal Child Health Records

  • A roadmap for growing the scope and sophistication of the information

exchange

  • Adding in new services as they become available, for example, national

Failsafe for Healthy Child Programme

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How it works

Primary Care Maternity Health Visitors 0-5 Child Health Records School Nursing 5-19 National Screening Services ePCHR

National Events Management Service

National Failsafe Management Service

Hub Registration Authority Events Design Authority

Citizen Identity Relationship Management

Public Health Other New Services

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Regional support

Primary Care Maternity Health Visitors 0-5 Child Health Records National Screening Services ePCHR Public Health

National Events Management Service

National Failsafe Management Service

Hub Registration Authority Events Design Authority

Citizen Identity Relationship Management

Integrated Digital care Record

School Nursing 5-19 Local eP(C)HR

Local Events Management Service

Local Failsafe Management Service

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Timeline touch points

2017/18 2018/19 2019/20

Key Event Go Live date

NEMS and FPM Beta complete Programme Business Case approved by TDIB NEMS & FPM Business Case Development Complete NFMS Business Case Development Complete NEMS and FPM Alpha complete NFMS Alpha complete NFMS pilot complete Events Catalogue published by PRSB ISN Interoperabi lity and FPM Published NEMS and FPM pilot complete NEMS used by the first organisations to share data from the events catalogue ePCHR available to first Parents/Carers/ Children with national health record access NFMS Beta complete Events Catalogue development complete NFMS used by the first

  • rganisations to get

failsafe alerts ISN for Failsafe Published

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Implementing the Strategy

Philip M.J. Graham Health Informatics Programme Director Blackpool Teaching Hospitals

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Where were we?

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Tech UK – Dec 2016

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Tech UK – Dec 2016

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Tech UK – Dec 2016

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Tech UK – Dec 2016

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Tech UK – Dec 2016

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Maternity Systems GP Systems Community Systems CHIS National Screening Systems Registration SCR/PDS Local IDCR / Interface Local Access Management

Health National Partner Personal

Local failsafe management

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Where are we now?

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STP Programme Mandate

(Events Model)

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What next?

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What next?

  • Governance
  • Build on the infrastructure
  • Implement the phases
  • In partnership
  • To implement the Strategy
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Maternity Systems GP Systems Community Systems CHIS Education Systems ePHR National Screening Systems Local Authority Systems Failsafe Management Registration SCR/PDS Local IDCR Access Management

Commissioning

Population Management

National events hub Local events hub

Health National Partner Personal

LPRES

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Strategy Care Pathway

Supported phases

Current Design

Governance

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Events Catalogue

Presented by Silas Collinge Lead Business Analyst

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We will cover

  • Event definition
  • Event content
  • Professional Records Standards Body (PRSB) consultation
  • Timelines
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Where did it all start?

The strategy: “Parents, families and carers will have an online record of their child’s health and development” “Professionals will have access to a core view of child health information at the point of care” But where do you start? How do you define a Core View?

  • Maternity Dataset v1.0 and Children and Young Persons
  • PCHR (Personal Child Health Record)
  • OBS 2015

NHS Digital created the starting point around the events that should be exchanged for Professional, Personal and Public Health

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Digital Child Health approach to events

  • Something happens in the life of a child
  • It may or may not be in the Healthy Child Programme or recorded in

the Red Book

  • We call this a clinical intervention or occurrence

A visit to the GP Newborn Infant Physical Examination Birth Writing a comment in the child’s ePCHR MMR immunisation

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Digital Child Health approach to events

  • Once this clinical intervention or occurrence has happened any number
  • f events are produced
  • These are published to the National Events Management Service (NEMS)

HCP Clinical Intervention: Newborn Physical Examination Referral Measurement

Physical Examination:NIPE

A Newborn physical examination is performed – this is the clinical intervention After the clinical intervention a series of events may be triggered

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Digital Child Health approach to events

Professional, Personal and Public Health will be able to see the events in the events catalogue

A GP may want to see to all events relating to all children under their care Public Health may

  • nly want to see

certain events such as ‘measurements’ or ‘immunisations’ Parents may want to see all events relating to their child

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Example event contents

Birth Details Measurements

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What is an events catalogue?

  • One document containing all ‘events’ based on the Healthy Child

Programme and the scope of the PCHR

  • Gives enough information for all involved in the care of children to

understand the strategic direction, the current ways of working and data flows

  • Contains all clinical and non clinical data items broken down into each

event

  • In future will allow public, professionals and personal health to decide

which events they want to send/share/publish and what events they want to ingest/view/subscribe to

  • The document will be iterative and future work will continue into the

Maternity and National Failsafe work

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PRSB consultation

  • Scope split down into 3 packages to be consulted upon covering all elements
  • f the PCHR and Healthy Child Programme
  • 3 large consultations planned with health professionals, parents, public

health and suppliers with over 70 people attending

  • NHS Digital provided the starting point of what information should be

exchanged

  • Gain agreement on what clinical data items should be shared across

professional, personal and public health

  • PRSB to gain sign off from Academy of Royal Colleges for a Community

Child Health Record structure and where each data item sits within the record

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PRSB consultation

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PRSB consultation

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Timelines

  • Draft FHIR resources for Package 1 online now (feedback welcome!)
  • Alpha design phase has begun on NEMS (collaboration welcome!)
  • Package 2 and 3 consultation in June and July
  • Events catalogue to be finalised by October and shared via GitHub

alongside draft FHIR resources

  • ISN to be released in February 2018
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FHIR profiles

Presented by Dave Barnet Interoperability Lead

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Interoperability uses

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Resources

http://hl7.org/fhir/DSTU2/resourcelist.html

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Resources

Patient Practitioner Diagnostic Report Observation

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Profiles

  • Profiles are resources that have been constrained for a use case

– Cardinality – Optionality – Terminology – Extension

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Birth details

Location Related person Procedure Observation Conditions Observations Referral

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Bundle example

DCH-BirthDetailsEvent-Bundle-1

This 'DCH-BirthDetailsEvent-Bundle-1' Bundle resource profile is used as a container to collect a combination of the following resources, as ordered below, to fulfil the information requirements of a Birth Details Event:

  • DCH-BirthDetailsEvent-MessageHeader-1
  • CareConnect-DCH-BirthOccurrence-Encounter-1
  • CareConnect-Organization-1
  • CareConnect-DCH-Baby-Patient-1
  • CareConnect-DCH-LengthOfPregnancy-Observation-1
  • CareConnect-DCH-NumberOfFetusesInConfinement-Observation-1
  • CareConnect-DCH-ActualDeliveryPlace-Organization-1
  • CareConnect-DCH-ProblemsInBirth-Condition-1
  • CareConnect-DCH-AbnormalitiesDetected-Condition-1
  • CareConnect-DCH-ProblemsInPregnancy-Condition-1
  • CareConnect-DCH-TypeOfDelivery-Procedure-1
  • CareConnect-DCH-Delivery-Encounter-1
  • CareConnect-DCH-Mother-Patient-1
  • DCH-MotherAndBaby-RelatedPerson-1
  • CareConnect-Location-1
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Bundle example

MessageHeader Encounter Patient Responsible Organisation Healthcare Professional Location Service Provider Observation

(Length of pregnancy)

Procedure

(Type of delivery)

Observation

(Foetuses in confinement)

Related Person Mother

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Bundle example

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Bundle example

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Bundle example

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Alpha ways of working

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Break

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Alpha works overview

Presented by David Nevill Senior Project Manager, Digital Child Health

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Alpha scope

  • Who’s here
  • What we’ve done so far
  • What next?
  • What are the risks / dependencies?
  • How can you engage?
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What we’ve done so far

Alpha Scope Definition

Strategic Alignment

Verifying the Use Cases

Delivery Alignment

When What

Early 2017

  • Ongoing Strategic Alignment
  • Architecture / conceptual

exploration

  • Project Scope clarification

April

  • Through the DDC “Front Door”,

tactical alignment, planning

  • Defining a manageable Alpha

scope

  • Approach to requirements

management

  • Defining ways of working as part
  • f the Digital Interoperability

Platform agenda

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Realigning the Alpha scope

  • National Events Management Service (NEMS)
  • National Failsafe Management Service (NFMS)

– Limited short term scope: child population tracking of contact with health services:

  • Child Health Record Department
  • Health Visiting Service
  • Primary Care Service (GP)
  • School Nursing Service

– Longer term scope – Full failsafe management

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Verifying and elaborating use cases

dfd Birth Notification DFD Midwife Search for Mother Maternity System Maternity System (Non PDS) PDS Find Mother's NHS Number Birth Notification Application Enter Birth Details Send Child's NHS Number Link Mother to Baby Submit Birth Notification CHIS ONS Registrars Online National Screening Store Create Child's NHS Number Child's NHS Number Mother's Details Mother's Details Mother's Details Mother's Details Mother's NHS Number Mother's Details Mother's NHS Number Mother's NHS Number Birth Notification Birth Notification Birth Details Child's NHS Number Child's NHS Number Birth Details Child's NHS Number Birth Notification Birth Notification Child's NHS Number Birth Notification Birth Details Birth Details Birth Details Child's NHS Number Birth Details dfd Vitamin K DFD Midwife Maternity System Vitamin K administered PCHR CHRD Vitamin K Admin CHIS Further Doses (Oral) GP Health Visitor Additional Vitamin K doses Health Visiting System GP Administration Details Flimsy Administration Details Notified of additional doses Administration Details Vitamin K consent Administration Details Administration Details Administration Details Notified of additional doses Administration Details Administration Details Administration Details
  • Ensuring NEMS / NFMS requirements

align with events

  • Data flows (publishers and subscribers)

for events in scope elaborated

  • Building a solution as agnostic as we can
  • f the Business system / organisational

model to make it more sustainable

dfd Vitamin K DFD Midwife Maternity System Vitamin K administered PCHR CHRD Vitamin K Admin CHIS Further Doses (Oral) GP Health Visitor Additional Vitamin K doses Health Visiting System GP Administration Details Flimsy Administration Details Notified of additional doses Administration Details Vitamin K consent Administration Details Administration Details Administration Details Notified of additional doses Administration Details Administration Details Administration Details
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Alpha timeline – what next?

When What

May

  • Requirement Elaboration
  • Resource Allocation and prep for Sprint #1

June

  • Development
  • Ongoing Requirement Elaboration
  • User Research / Service Design (in parallel /

collaboration)

July – Sept • Iterating the above October

  • Refinement / consolidation

November • Alpha Closure – checkpoint

  • Prepare for Beta

Engage Users Manage Expectation Articulate the direction Get feedback ONGOING… Engage Suppliers Strategic Alignment Transparency

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What next - Healthy Child events in early scope

  • Birth Notification
  • Bloodspot
  • 8-week immunisations
  • HPV
  • Population failsafe

Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5 Failsafe

?

Original Alpha Scope Possible Updated Approach

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Alpha ways of working

  • Following the Government

Service Design Manual.

  • Where applications are stood

up to explore an issue, these will be made available for experimentation, with test data.

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Alpha ways of working

  • All latest developments

available through GitHub

  • All discussions,

communications and points of view contributed by suppliers and users will be openly available online

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Alpha outputs

  • One or more prototype(s)
  • Documented evaluations of the prototypes from

business and technical viewpoints

  • A recommendation of which approach is the best,

viable option to progress to beta phase

  • Documented design of the best viable option, in

sufficient detail to support approvals by architecture governance

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What are our risks and dependencies?

  • It’s part of a wider Digital Interoperability Platform
  • The strategy encourages local equivalents (still aligning

to national standards)

  • Ongoing feasibility and viability
  • Citizen Identity dependency (and wider P2020 agenda)
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Invitation for involvement in Alpha

  • Opportunity for supplier and user communities to become

involved to both influence and learn

  • Seeking different levels of involvement
  • Open to the all supplier and user communities
  • No financial support to suppliers or users to become

involved in Alpha

  • If a future procurement is authorised a notice will be

published advising all strategic suppliers that a procurement has commenced. Consequently there will be no impact resulting from participation in the Alpha

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Levels of involvement in Alpha

  • Doers - suppliers and users who are willing to get their hands

dirty trying out aspects of the Alpha work

  • Thinkers – suppliers and users who are willing to publically offer

views, advice or critiques

  • Watchers – suppliers and users who just want to follow progress
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Request for user involvement

  • GPs
  • Health Visitors
  • School Nurses
  • Other interested Health professionals
  • Supplier user groups

dch@nhs.net

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For more information

  • Email:

– dch@nhs.net

  • GitHub:

– https://github.com/DigitalChildHealth/Discovery-Alpha

  • Health Developer Network:

– https://developer.nhs.uk/downloads-data/digital-child-health-fhir/

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Supporting women, helping professionals

Harnessing digital technology in maternity transformation

Presented by Helen Harger Senior Clinical Product Manager

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What are we trying to help with?

  • Numbers of births are increasing
  • A changing profile in users of maternity services
  • Changes in service usage and access
  • Increasing demand for personalisation of care
  • Wide variation in maternity pathways and their

effectiveness

  • Recognition of a lack of access to mental health

services

  • Missed opportunities relating to still birth and

appropriate interventions

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Digital challenge

  • Cultural reliance on paper notes, digital often used only for booking

and hospital care around birth and the early post-natal period

  • Few building blocks for digital innovation, e.g. legacy maternity

systems, limited mobile working, variance in digital maturity

  • Lack of reliable information reflecting national UK care provision and

consistency of access to national guidance on birth and care choices for women

  • No standards or core dataset for interoperable maternity systems
  • Women-held maternity notes still on paper
  • Time to administrate paper/technology interface is impacting time to

care

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Three things

Digital tool

Initially, an app to improve personalisation and choice by enabling access to unbiased, evidence based and locally specific information about their own circumstances, choices available and their own personal care plans Behind the scenes ‘machinery’. Replacing paper processes with point-of-care accessible electronic maternity records. The enabler for consistent capture and movement of maternity pathway information between and within local maternity systems, professionals and with women

Standards & interoperability Digital maturity

Making life easier through appropriate adoption and uptake of technology. Create a supportive framework for growing digital maturity and capability in maternity services

> > >

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Problems and priorities for professionals

73

National Maternity Transformation Stakeholder Survey for WS 7 - Oct-Feb

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Getting it right for women

What are the 3 biggest complaints you hear from women receiving your care?

Poor Support/Communication Lack of continuity of care Delayed Care Not enough time with HCPs Lack of consistent advice/info Having to repeat their history Poor Accessibility Too much Admin Other

Technology should never be the entire solution… but can play a huge part

National Maternity Transformation Stakeholder Survey for WS 7 - Oct-Feb

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A record: standards and interoperability

  • Standards needed to bring together the

multitude of supplier systems in use across and within local maternity systems

  • Create a safe continuity of care and

‘continuity of carer’ approach whilst maintaining choice

Improved choice for women: example Provider 1: antenatal Provider 2: intrapartum Provider 3: postnatal

  • Enabling ‘capture once, re-use many’
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What’s next?

Share your views www.industrybriefings.co.uk

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www.digital.nhs.uk @nhsdigital enquiries@nhsdigital.nhs.uk 0300 303 5678

www.techuk.org @techUK 0207 331 2000