1. Content CreatorContent Consumer Content Updater Consume WD Create WD Update WD XDW WD Consume Document Create Document CDA Content Document Profile Pull Push Pull Push Pull Push Pull Push XDS.b

2. Document-based Workflow Workflow Participant Document Repository inputoutput Workflow Participant Workflow Document Input and Output Documents input Workflow Participant input Workflow Participant output RequestSchedulePerformComplete XDW Content Consumer Content Consumer Content Consumer Content Creator Content Creator Content Creator Content Creator

3. Newborn Hearing Screening Workflow Participant Document Repository inputoutput Workflow Participant Workflow Document Input and Output Documents input Workflow Participant output Request NHSSchedule NHSPerform NHSComplete NHS XDW Content Consumer Content Consumer Content Consumer Content Creator Content Creator Content Creator Content Creator Procedure Results Procedure Results NHS Result Report Workflow Participant Standing Order

4. Do Develop Early Hearing Care Plan Workflow Participant Document Repository inputoutput Workflow Participant Workflow Document Input and Output Documents input Workflow Participant output Request NHSSchedule NHSCreate EHCP XDW Content Consumer Content Consumer Content Creator Content Creator Content Creator Standing Order EHCP NHS Result Report input Workflow Participant output Update PFCP XDW Content Consumer Content Creator EHCP PFCP EHCP

5. Newborn Hearing Referral Document Repository inputoutput Workflow Participant Workflow Document Input and Output Documents input Workflow Participant input Workflow Participant output Create PofCUpdate PFCPDo Basic e-ReferralUpdate PFCP XDW Content Consumer Content Consumer Content Consumer Content Creator Content Creator Content Creator Content Creator NHS Result Report Content Consumer Workflow Participant EHCP PFCP EHCP PFCP EHCP PFCP Consult Note Consult Note EHCP PFCP Consult Note EHCP

6. Basic e-Referral Workflow Participant Document Repository inputoutput Workflow Participant Workflow Document Input and Output Documents input Workflow Participant input Workflow Participant output Request ReferralSchedule ReferralPerform ReferralComplete Referral XDW Content Consumer Content Consumer Content Consumer Content Creator Content Creator Content Creator Content Creator XDS-MS Referral XDS-MS Referral XDS-MS Referral Consult Note