1. The EHR Simulator Objective: To show that an EHR can be derived and maintained as a consequence of messages and transactions.

2. EHR Management Domain EHR Service Domain Work-flow Negotiation & Auditing Registration System Clinical Support Systems EPR EHR Publication System Patient data repository EHR Portal/Hub EHR workflows Audit trails EHR Gateway Clinical register Patient consent EPR system register EHR Access Systems Tokens EHR resource distribution

3. Gateway services Consent Register User Register Trusted Third Party Server Call Handling & Triage User (E) Pharmacy System EHR Publication System PCT System EHR Portal EHR Publication System Clinical Service System User (H) Hospital Clinical System EPR Bookings User (P) G G G G G G G G User (GP) Practice System EPR Rules EHR Portal

5. Registrations Prescription 1 Consent registration GP Publication GP eczema Referral to Cardiologist Radiology Referral Lab Orders Cardio Appointment Radiology Appointment Lab Results ECG Result CXR Result Ambulance Call Ambulance Results A&E Triage A&E Orders A&E Radiology A&E Rad Results A&E Lab Results Hospital Discharge Referral for Exercise Test Simulator Messages and transactions Each message has an XML schema and a publication rule which defines what data will be recorded, where it will be recorded and how the root publication server will be notified.