radiology data standards phase 2 - ndc.scot.nhs.uk

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Radiology Data Standards Phase 2

September 2007

National Clinical Dataset Development Programme (NCDDP) Support Team Information Services Area 74A Gyle Square 1 South Gyle Crescent Edinburgh EH12 9EB Tel: 0131 275 7053 Email to: [email protected]

Website: www.clinicaldatasets.scot.nhs.uk/

mailto:[email protected]

http://www.clinicaldatasets.scot.nhs.uk/

Overview & Background.................................................................................................2 Overview ..................................................................................................................................2 Radiology Phase 2 Data Standards .........................................................................................2 Background to NCDDP ............................................................................................................3 Generic Data Standards...........................................................................................................3 Clinical Terminology .................................................................................................................3 Date Recording ........................................................................................................................3

Published Data Standards..............................................................................................5 Items from Radiology Core Data Standards.............................................................................5

Clinical/Care Process......................................................................................................6

Treatment(s) and Intervention(s) ...................................................................................6 1.1 Anaesthetic/Sedation Status ..............................................................................................6 1.2 Anaesthetic/Sedation Supervision......................................................................................6 1.3 Anaesthetic/Sedation Administration..................................................................................7 1.4 Anaesthetic/Sedation Supervision (Administration) ...........................................................7

Finding(s) and Result(s) .................................................................................................8 2.1 Procedure (Interventional Radiology) Complications .........................................................8

Care Planning, Management and Outcome(s)............................................................11 3.1 Research Status...............................................................................................................11 3.2 Research Type .................................................................................................................11 3.3 Research Impact – Additional/Extended Examination(s) .................................................123.4 Cancellation of List/Session Reason………………………………………………………….123.5 Sesion Type……………………………………………………………………………………...13 3.6 Session Descriptor………………………………………………………………………………13

Medication and Device(s) .............................................................................................15 4.1 Radiopharmaceuticals Name ...........................................................................................15 4.2 Radiopharmaceutical Administration................................................................................16

Documents and Correspondence................................................................................17 5.1 Image Copy Status...........................................................................................................17 5.2 Image Archive Type .........................................................................................................17 5.3 Image Type ......................................................................................................................18 5.4 Image Location.................................................................................................................18

Appendix 1 - Working Group........................................................................................19 Membership of Radiology Phase 2 Working Group ...............................................................19

Appendix 2 - Consultation Distribution List ...............................................................20

Radiology Data Standards Phase 2 1


Overview & Background

Overview The Scottish Executive Health Department commissioned the development of Radiology Data Standards for NHS Scotland to ensure a standardised approach to recording of the information used and communicated by various groups relating to Radiology. The Radiology Data Standards Clinical Working Group stemmed from the already established National Radiology Information Group in October 2006 to progress this work, supported by the National Clinical Dataset Development Programme (NCDDP) support team in ISD. The Radiology Phase 2 Data Standards will:

Define common data items recommended for collection in a wide variety of clinical settings Support the exchange of patient information between healthcare providers

Support the consistent recording of patient information throughout NHS Scotland

It is envisaged that the Radiology Phase 2 Data Standards will be recorded within clinical systems. The data standards contain data items from Generic Standards and other clinical area data standards, which have previously been developed through the NCDDP and are freely available in Clinical Datasets section of the web based Health and Social Care Data Dictionary. Feedback was sought from the wider clinical community in order to ensure that these data standards are fit for purpose. We invited all interested organisations and individuals to take part in the consultation by completing a Consultation Response Form. Comments on all or any part of the document were welcomed. Some background information on the NCDDP and the Radiology Core Data Standards development can be found below. If you have any further queries, please go to our website or contact [email protected].

Radiology Phase 2 Data Standards The membership of the Radiology Phase 2 Working Group is shown in Appendix 1. This group agreed the inclusion of individual data items using the following criteria:

1. Is the data item one which would reasonably be expected to be collected for Radiology patients?

2. Is the data item necessary for the on-going health and healthcare of patients attending Radiology Services?

3. Is the data item one which is likely to be shared among health care professionals? Once consultation is complete the Radiology Phase 2 Data Standards will be submitted to the NCDDP Programme Board for formal approval as a national standard. Once approved the Radiology Phase 2 Data Standards will be freely and widely available through publication in the Health and Social Care Data Dictionary. Where possible the data standards are UK compatible. It is expected that the Radiology Phase 2 Data Standards will be implemented within existing and emerging national clinical information systems and commercially procured national products, as well as being available to commercial developers to ensure the ability of their systems to support national information requirements.

http://www.datadictionary.scot.nhs.uk/


http://www.show.scot.nhs.uk/clinicaldatasets/

mailto:[email protected]



Background to NCDDP The National Clinical Dataset Development Programme (NCDDP) supports clinicians to develop sets of interoperable national datasets to facilitate the implementation of the integrated care records across NHS Scotland. These standards will: • Support direct patient care, by reflecting current best practice guidance • Facilitate effective communication between health care professionals • Improve data quality and support secondary data requirements where possible including

data to support clinical governance • Be freely and widely available through publication in the web based Health & Social Care

Data Dictionary • Incorporate agreed national clinical definitions and implement national terminology • Be UK compatible where possible The Chief Medical Officer established the programme in 2003 to support clinicians developing national clinical data standards, initially to support the national priority areas. These standards are an essential element of the Electronic Health Record, a central aim of the National e-Health Strategy. More information can be found on our website.

Generic Data Standards Data standards which are relevant to all patients and are used across specialties, disciplines and settings have already been developed by wider Generic Data Standards clinical working groups and approved as national data standards for NHS Scotland. The Radiology Phase 2 Data Standards working group identified several generic data items as appropriate for inclusion in their standards. These data items are indicated next to the data item name and definition, which are listed in this document for information. The full detail of these existing standards are published on the web based Health and Social Care Data Dictionary.

Clinical Terminology The strategic standard for clinical terminology in NHS Scotland is SNOMED-Clinical Terms. This means that over the next few years, clinical information systems will progress to record clinical data using this international standard. The NCDDP Support Team will commence development of recommended SNOMED CT specifications as part of the data standards and datasets it supports.

Date Recording It is good record-keeping practice always to identify the date of recording of any clinical information e.g. date of receipt of request for radiological investigation, date radiological report generated, etc. It is expected that all clinical information systems should include ‘date stamping’ as standard functionality; therefore the Radiology Phase 2 Data Standards do not deal with this issue. In many clinical situations, the date of an event, investigation, etc. is required for clinical purposes and should be visible to the health care professional. This date may not be the same as the date on which the data are entered onto the system. In these instances the system must allow the health care professional to enter whichever date is appropriate. These issues must be addressed during system specification and development. The date format for storage and management within a system should conform to the Government Data Standards Catalogue format: CCYY-MM-DD. However, this does not preclude entry or display of data on the user interface using the traditional DD-MM-CCYY format.

http://www.show.scot.nhs.uk/clinicaldatasets/


http://www.isdscotland.org/isd/4048.html


An example of a date & time in correct format is: 1997-07-16T19:20 +01:00 (CCYY-MM-DDThh:mmTZD) It is recommended that a time should always be recorded with the appropriate date and not on its own, however it may not be necessary to display the date along with the time. This is of particular importance where any calculations or analyses are likely to be performed. Automated times recorded by IT systems should include all elements of the time, i.e. hours, minutes and seconds, and are expected to be actual. Where times are entered manually, it is likely that only the hours and minutes will be required, although in some circumstances only hours may be required. Time, or any element of the time (hours, minutes or seconds) may be actual or estimated. In some circumstances only an actual time may be acceptable, whilst in others an estimated time may be allowed. In the latter situation, it may be necessary to identify whether the time recorded is actual or estimated. Times identified as actual may be used in calculations and analyses. Times marked as estimated should be treated with caution and the implications of undertaking any calculations or analyses should be considered in the particular context within which the time is recorded or to be made subsequent use of. Where an estimated time is allowed, the appropriate degree of verification detail required should be decided, again dependent on the context in which it is recorded and how the time is to be used. Government Data Standards Catalogue1. All times must be expressed in the 24 hour clock format, e.g. one minute past midnight is 00:01:00. 2. Values of any element less than 10 should be entered with a zero in the first position. 3. All times for UK transactions/events will be assumed to be GMT. 4. Systems should record whether the time is Coordinated Universal Time or British Summer Time in the “Time zone designator”. This will allow time elapsed to be calculated correctly, for example for A&E waiting times.


Published Data Standards Items from Radiology Core Data Standards Person Demographics Urgency of Referral Structured Name Referral Urgency Reason Person Full Name (Unstructured) Referral Type CHI Number Assessed Priority of Appointment Health Record Identifier Height Address (BS7666) Weight Postal Address Body Mass Index Postcode Systolic Blood Pressure UK Telephone Number Diastolic Blood Pressure Internet Email Address Pregnancy Status Person Birth Date Date of first day of last period Person Death Date Preparation (Patient Administered) Person Sex at Birth Preparation (Patient Administered) – Instructions

Followed Person Current Gender Imaging Modality Person Marital Status Procedure (Clinical Imaging) Type Patient Admin Status Contrast Agent Administered Status Ethnic Group (Self Assigned) Procedure (Clinical Imaging) Preferred Language Procedure Status First Language Procedure (Clinical Imaging) - Reason

Abandoned Associated Person Relationship to Client/ Patient Procedure (Clinical Imaging) Complications Associated Person Role Radiation Dose - Total Administered (Non-

Therapeutic) Specified General Medical Practitioner (Specified GP)

Radiation Exposure Data (Non-Therapeutic)

Registered GP Practice Code General Radiography Exposures GP General Medical Council Number General Radiography Exposures - Non

Contributory Specified General Medical Practitioner Role General Radiography Exposures – Reason for

Non Contributory General Practice Registration Status of Patient Clinical Need Outweighs Risk to Pregnancy Associated Professional Magnetic Resonance Imaging (MRI) Warnings Associated Professional Identifier Personal History of Specific Interventions

{Radiology} Associated Professional Group Record of Specific Conditions {Radiology} Associated Professional Employing Organisation Name

Preferred Communication Method

Associated Professional Employing Organisation Type

Interpretation Assistance Indicator

Associated Professional Role {Radiology} Associated Professional Post Descriptor Impairment Patient Held By Mobility Status Referral Source {Radiology} Medication and Device(s) Referring Specialty Medication or Device Name Clinical / Care Process Medication or Device Code Referral Response Medication Dosage Availability Status Code Medication or Device Status Arrival Mode Route of Administration Transport Mode within Hospital Date(s) and Time(s) Reason Referral Declined Date and Time of Booking {Radiology} Justification - IR(ME)R Date of Referral Reason for Referral Date Referral Received Contributing Factor The Radiology Core Data Standards are available in the Health and Social Care Data Dictionary.

http://www.datadictionaryadmin.scot.nhs.uk/isddd/ISD_DT_TOP_Home.jsp?p_applic=CCC&p_service=Content.show&pContentID=9215&/

http://www.datadictionaryadmin.scot.nhs.uk/isddd/ISD_DT_TOP_Home.jsp?p_applic=CCC&p_service=Content.show&pContentID=9215&/


Clinical/Care Process Treatment(s) and Intervention(s) Data Item Number Anaesthetic/Sedation Status 1.1 Anaesthetic/Sedation Supervision 1.2 Anaesthetic/Sedation Administration 1.3 Anaesthetic/Sedation Supervision (Administration) 1.4

1.1 Anaesthetic/Sedation Status Definition: A record of the type of anaesthetic and/or sedation used during the current episode of care. Format: Characters Field length: 2 Codes and values: Code Value Explanatory Notes 00 Not required 01 Analgesics only 02 Sedation only 03 Sedation and analgesics 04 Local anaesthetic 05 General anaesthetic 06 Sedation and local anaesthetic 07 Regional anaesthetic This includes spinal, epidural and nerve block. 99 Not known

Related data items: Anaesthetic/Sedation Administration, Anaesthetic/Sedation Supervision (Administration) Recording guidance: Systems should default to ’00 Not required’ until anaesthetic or sedation is used. Systems must allow for the recording of multiple types of anaesthetic/sedation 1.2 Anaesthetic/Sedation Supervision Definition: A record of the supervision given to the patient when anaesthetic/sedation is in place. Format: Characters Field length: 2 Codes and values: Code Value 00 No supervision 01 Supervision


Related data items: Anaesthetic/Sedation Status, Anaesthetic/Sedation Administration, Anaesthetic/Sedation Supervision (Administration) 1.3 Anaesthetic/Sedation Administration Definition: A record of who administered the anaesthetic/sedation. Format: Characters Field length: 2 Codes and values: Code Value Explanatory Notes 01 Radiologist/Operator Operator includes any other individual carrying out a

procedure or intervention 02 Anaesthetist 98 Other healthcare

professional

Related data items: Anaesthetic/Sedation Status, Anaesthetic/Sedation Supervision (Administration), Associated Professional 1.4 Anaesthetic/Sedation Supervision (Administration) Definition: A record whether or not the healthcare professional administering the anaesthetic/sedation was supervised. Format: Characters Field length: 2 Codes and values: Code Value 00 Not supervised 01 Supervised

Related data items: Anaesthetic/Sedation Status, Anaesthetic/Sedation Administration, Associated Professional


Finding(s) and Result(s) Data Item Number Procedure (Interventional Radiology) Complications 2.1

2.1 Procedure (Interventional Radiology) Complications Main source of standard: Society of Interventional Radiology Complications Master List, Society of Interventional Radiologists Definition: A record of whether or not the patient had any complications that occurred as part of an interventional radiology procedure. Format: Characters Field length: 2 Codes and values: Code Value Explanatory Notes 00 None No complications occurred. SCT specific code(s)

SCT specific term(s) for specific complication Patient known to have had specific complication(s)

99 Not known Attributes: ***For EACH identified complication***

Laterality Right Left Bilateral Midline

Severity Mild Moderate Severe

Chronicity Acute Chronic Recurrent Sub data items: ***For EACH identified complication*** Verification level 0 Unverified 1 Verified Date recorded/extracted (if applicable) Radiology specific interventional radiology procedure complications: Vascular Haematoma/bleeding at needle, device path: nonvascular procedure Haematoma /bleeding, puncture site: vascular procedure Haematoma/bleeding, remote from puncture site

http://www.sirweb.org/


Arterial occlusion/thrombosis, puncture site Arterial occlusion/thrombosis, remote from puncture site Venous occlusion/thrombosis, puncture site Venous occlusion/thrombosis, remote from puncture site Vasospasm, severe Intimal injury/dissection Pseudoaneurysm Arteriovenous fistula Vascular perforation or rupture Arterial embolisation Ischemia/infarction of tissue or organ Pulmonary embolism Device-related Migration Malposition Device malfunction with adverse effect Contrast-related Allergic/anaphylactoid reaction Renal failure Other dose-dependent complication Tissue extravasation Medication-related Incorrect drug Incorrect dosage Incorrect site of administration Idiosyncratic reaction Neurologic Transient ischemic attack Stroke Seizure Peripheral nervous system complication Other central nervous system complication Cardiac Hypotension, profound Cardiac Arrest Vagal reaction Arrhythmia, significant Angina/coronary ischemia Myocardial infarction Congestive heart failure Respiratory/pulmonary Hypoxia, profound Pulmonary oedema Pulmonary embolism Respiratory arrest Contamination of pleural cavity (urine, bile, empyema, malignancy, etc.) Pneumothorax Infectious/inflammatory Local infection Septicemia/bacteremia Septic Shock Pancreatitis


Peritonitis Abscess General nonvascular Fluid/electrolyte imbalance Non-infected fluid leak Unintended perforation of hollow viscus Death Death related to procedure (<30-day mortality) Death unrelated to procedure Recording guidance: This data item should be applied using a complete list of the SNOMED-CT (SCT) codes for the key conditions that relate to the clinical area in question. As an interim measure, until a robust method of using SCT to code the absence of complications is agreed, the value '00' should be recorded in this field. Systems must allow for the recording of multiple occurrences of interventional procedure complications. Interventional complications during an episode of care should be recorded with the date of the procedure.


Care Planning, Management and Outcome(s) Data Item Number Research Status 3.1 Research Type 3.2 Research Impact – Additional/Extended Examination(s) 3.3 Cancellation of List/Session Reason 3.4 Session Type 3.5 Session Descriptor 3.6

3.1 Research Status Definition: A record of whether the imaging or interventional investigation is part of a research study including a clinical trial. Format: Characters Field length: 2 Codes and values: Code Value 00 No 01 Yes 99 Not known

Sub data items: Start Date End Date 3.2 Research Type Definition: A record of research types. Format: Characters Field length: 3 Codes and values: Code Value Sub

code Sub value Explanatory Notes

01 Commercial fully funded/sponsored 02 Research council Includes Medical Research

Council, Cancer Research Council and Wellcome

A Part funded 03 Other health service research B Non funded

04 Small projects Local projects 99 Not known


3.3 Research Impact – Additional/Extended Examination(s) Definition: A record of whether participation in a research study, including clinical trials, has resulted in additional or extended examination(s). Format: Characters Field length: 3 Codes and values: Code Value Sub

codeSub value

00 No A Extended examination 01 Yes B Whole examination

99 Not known Related data items: General Radiography Exposures - Non Contributory, Procedure (Clinical Imaging), Radiation Dose - Total Administered (Non-Therapeutic) 3.4 Cancellation of List/Session Reason Common name(s): session cancellation reason, list cancellation reason Definition: An explanation of why a list or session did not take place as planned. Format: Characters Field length: 3 Codes and values: Code Value Sub code Sub value Explanatory Notes 01 Public Holiday

A Annual/Planned leave B Sick leave C Maternity/paternity leave D Special leave E Study leave

02 Staff leave

Z Other leave 03 Lack of skill mix 04 Training Includes continuing

professional development This does not include Study Leave

05 Meeting/Conference This does not include Study Leave

06 Staff vacancies A Equipment failure 07 Equipment issues B Equipment unavailable/shortage

08 Administrative error 09 Maintenance/Decontamination 10 Inclement weather (visiting clinicians only)

A Ward beds 11 No beds available B High Dependency beds


C Intensive Care beds 12 On call 98 Other reason for cancellation 99 Not known Related Data Item: Associated Professional Recording guidance: Only one item to be recorded. More than one may be recorded for local purposes. Users may wish to augment code 98 -“Other reason for cancellation” with a free text field. Study Leave should always be recorded as Code 02E. 3.5 Session type Definition: The type of session time allocated to a consultant or healthcare professional. Format: Characters Field length: 3 Codes and values: Codes Value Sub


A Planned 01 Scheduled B Emergency

02 Unscheduled This will include On-call Related data item: Session Descriptor 3.6 Session Descriptor Definition: A description of the type of session allocated to a consultant or healthcare professional. Format: Characters Field Length: 2 Codes and values: Code Value Explanatory Notes 01 Routine 02 Teaching 03 Out of Hours 04 Waiting List Initiative 05 Additional Session Not Waiting List Initiative 06 Research 98 Other, specify 99 Not Known

Related data item: Session Type


Further Information: This data item can be used in circumstances where there is a need to further qualify the description of a session, allocated to a consultant or healthcare professional, in order to record differing types of activity. For example, it may be necessary to record that the session was Scheduled, Planned and a Teaching List. Recording guidance: Users may wish to augment code 98 -“Other”-specify” with a free text field for recording other Session Descriptors.


Medication and Device(s) Data Item Number Radiopharmaceuticals Name 4.1 Radiopharmaceutical Administration 4.2

4.1 Radiopharmaceuticals Name Common name: nuclear medicine radiopharmaceuticals, radioisotopes Definition: The generic or proprietary name by which a radiopharmaceutical or radioisotope is known. Format: Specific term for SNOMED Clinical Terms (SCT) Dictionary of Medicines and Devices (DM&D)* Or free text where clinical term unavailable Field length: 255 Codes and values: * Specific term(s) for READ v2, Snomed Clinical Terms, Dictionary of Medications &Devices Code Value Explanatory Notes SCT Concept ID, DM&D Specific Code(s)

Name of radiopharmaceutical

98 Other, specify Where clinical code unavailable Related data items: Route of Administration, Procedure (Clinical Imaging) Type Further information: NHS Data Dictionary Connecting for Health http://www.dmd.nhs.uk/ The British National Formulary (BNF) “Guidance on Prescribing- General Guidance” gives guidance on best prescribing practice. It states that in most cases generic titles should be used in prescribing rather than proprietary ones. The generic name is the International Non-proprietary Name. Recording guidance: Users may wish to augment code 98 -“Other, specify” with a free text field for recording other radiopharmaceuticals or radioisotopes. Appropriate codes and values should be developed locally for specific healthcare professionals, services or organisations. IT systems should allow for multiple recording of radiopharmaceuticals or radioisotopes. In the future, systems will use SNOMED Clinical Terms Dictionary of Medicines and Devices for coding of Medication or Device Name.

http://www.bnf.org/


4.2 Radiopharmaceutical Administration Common names: Activity, Frequency Definition: A description of the quantity and frequency of a Radiopharmaceutical administration and when it was given/taken. Format: Characters Field length: 198 Codes and values: N/A Sub data items: Date and Time of Radiopharmaceutical Administration (See data standard for “Date and Time”) Related data items: Radiopharmaceuticals Name, Route of Administration, Radiation Dose - Total Administered (Non-Therapeutic) Further information: Frequency is the split dose as part of examination or radiopharmaceutical therapy. Recording guidance: Activity to be recorded using kilobecquerel (kBq) and megabecquerels (MBq). A Date and Time must always be recorded for Radiopharmaceutical Administration. Systems must allow for the recording of multiple Radiopharmaceutical Administrations with associated date(s) and times.


Documents and Correspondence

Data Item Number Image Copy Status 5.1 Image Archive Type 5.2 Image Type 5.3 Image Location 5.4

5.1 Image Copy Status Definition: A record of whether or not copies have been made of an image captured during a clinical imaging procedure. Format: Characters Field length: 2 Codes and values: Code Value 00 No 01 Yes 99 Not known

5.2 Image Archive Type Definition: A description of the type of media used to record images captured during a clinical imaging procedure. Format: Characters Field length: 2 Codes and values: Code Value Explanatory Notes 01 Images sent to PACS 02 Digital storage e.g. CD, DVD, optical disk03 Film 04 Laser film 05 Video 06 Thermal paper 98 Other, specify

Recording guidance: Systems must allow for the recording of multiple Image Archive Types. Users may wish to augment code 98 -“Other”-specify” with a free text field for recording other Image Archive Type(s).


5.3 Image Type Definition: A description of the type of image captured during or following a radiological procedure. Format: Characters Field length: 2 Codes and values: Code Value 01 Primary Image 02 Copy of Image

5.4 Image Location Definition: A description of the current location of the image(s) captured during a clinical imaging procedure. Format: Characters Field length: 3 Codes and values: Code Value Sub


A Short Term B Long Term

01 Physical archive

Z Other

e.g. Film store for analogue images

02 Destroyed 03 Sent to other hospital 04 Sent to other department within current establishment

A Local 05 Picture Archiving and Communications System (PACS)

B National

06 Other digital file server/independent work station 98 Other, specify 99 Not known

Sub data items: Date and Time of Image Archive Location (See data standard for “Date and Time”) Related data items: Location Code Recording guidance: Users may wish to augment code 98 -“Other”-specify”, Codes 01, 03, 04 and 06 with a free text field to record the exact Image Location.


Appendix 1 - Working Group Membership of Radiology Phase 2 Working Group Name Position Organisation Elizabeth Robertson Associate Medical Director Acute

Sector NHS Grampian

Paul Allan Clinical Director of Radiology, Royal Infirmary of Edinburgh

NHS Lothian

Penny Bridger Public Health Consultant NHS NSS ISD Jim Cannon Superintendent 1 Radiographer NHS Fife Mandy Crighton Superintendent Radiographer NHS Lothian Bev Dodds Diagnostics Collaborative

Information Manager Scottish Executive Health Department

Shelah Dutta Programme Manager, Scotland National Benchmarking Project

Scottish Executive

Donald M Hadley Consultant Neuroradiologist & Professor of Radiology

NHS Greater Glasgow & Clyde

Graham A McKenzie Radiology Strategic Development Manager

NHS Grampian

Hamish McRitchie Consultant Radiologist NHS Borders Margaret Sherwood Data Development Manager NHS NSS ISD Douglas Aitken PACS Radiographer NHS Greater Glasgow &

Clyde John Dewar Consultant NHS Tayside Mark Sanderson Bench Marking Project NHS NSS ISD Maureen McGurk RIS/PACS Manager Golden Jubilee National

Hospital Leigh Brown Information Manager, NCDDP NHS NSS ISD Katy Rangeley Data and Terminology Developer,

NCDDP NHS NSS ISD


Appendix 2 - Consultation Distribution List Chief Executives Medical Directors Directors of Public Health Chief Medical Officer Chief Nursing Officer National Advisory Committees Managed Clinical Networks (MCNs) NCDDP Stakeholders • Clinical eHealth Leads • Community Nursing Network (CNN) • Electronic Clinical Communications Implementation (ECCI) • Health & Social Care Information Centre, Datasets Development Programme (England) • Improving Mental Health Information Programme • Information Services Division, NSS • Information Standards Group • NHS Health Scotland • NHS Quality Improvement Scotland (QIS) • NHS24 • Open Scotland Information Age Framework (OSIAF) • Royal College of General Practitioners (Scotland) • Royal College of Nursing (Scotland) • Royal College of Physicians • Royal College of Physicians and Surgeons Glasgow • Royal College of Physicians, London • Royal College of Surgeons • Royal College of Psychiatrists • Scottish Clinical Information Management Practice (SCIMP) • Scottish eHealth Nursing Forum • Scottish Executive Delivery Unit • Scottish Executive Data Standards Branch • Scottish Executive Health Department • UK Data Standards Forum • Voluntary Health Scotland Radiology Specific • Diagnostic Managers Group • Royal College of Radiologists • Scottish Radiological Society • College and Society of Radiographers • Therapeutic Radiographers NCDDP Reference & Working Groups