104710Decisions.HealthClosedCollaborative R&DInnovate UK"Over 10 million operations were performed in the NHS in 2015/16 which was 40% more than in 2005/6 (http://www.nhsconfed.org/resources/key-statistics-on-the-nhs). Currently, consent for surgery is typically performed using a handwritten consent form completed adhoc, often on the day of surgery. This system is prone to errors of omission and illegibility whilst not being compatible with the NHS vision to go paperless by 2020\. Our smart consenting platform digitises this process whilst harnessing artificial intelligence and distributed ledger technology to enable informed, shared decision-making and creation of immutable, auditable records of both the decisions made and consent given. Our vision is to ensure that every decision a patient makes about their surgical care is the right one for them. Decisions.Health is a collaboration between Surgical Consent, a clinician-led team with close working ties to Imperial College and Imperial College Healthcare NHS Trust, who will provide research and an NHS pilot site for the developed technology; and innovative healthcare software development company and blockchain specialists, Dovetail Digital. Led by surgeons, and co-created with patients, this project aims to translate the research evidence of transformative individual and system benefits of shared decision-making into practice. It will also explore the integration of patient-reported outcome and experience measurement to drive personalised, preference-sensitive, shared decision-making. Immutable digital records of all interactions along the patient journey will be created, with key decisions recorded on a distributed ledger. Informed explicit consent will always be available helping to overcome privacy challenges associated with managing, sharing and utilising data as a record of the decision. The developed technology will deliver a worldleading, equitable, intelligent, data-driven, clinical decision-making support platform to democratise high quality shared healthcare decisions. The proposed Artificial Intelligence output, maturing over the project duration, will increase efficiency by reducing dependence on human-to-human interaction at multiple touchpoints along the patient journey, allowing consultant surgeons to provide input at the points of most value. The product will help eliminate the high administrative costs associated with the current paper-based system (e.g. £500k-£1m per hospital trust for paper storage alone); and mitigate costs related to medical negligence claims resulting from poor clinical decisions and consent issues (estimated £46m in 2016/17 for consent-related settlements only). The potential for savings associated with an effective, supported shared decision-making tool are even greater, estimated by the Kings Fund to be up to £10bn p.a. as a result of up to 20% of operations being appropriately avoided."