Exchange by mandate, exchange by market: what Abu Dhabi requires, what a US vendor sells and what NHS England assured

A health product that needs data from the records around it has to connect to something, and who decides that it must differs from place to place. This article sets three arrangements side by side, each from its own sources: in Abu Dhabi, the Department of Health (DoH) requires applicable healthcare facilities to submit data to one health information exchange, Malaffi; in the United States, Redox sells connection to healthcare providers' record systems as a commercial service; in England, NHS England announced in June 2025 that it had assured a new GP record system through its Tech Innovation Framework. The three are not legally equivalent, and nothing here suggests they are: one is a regulator's condition, one is a contract, one is a procurement assurance. Recent has not tested any of the systems described.

Three arrangements in brief

Abu Dhabi. The DoH's public standards page for Malaffi says the DoH “mandates the use of specific coding standards, units of measurement, and data classification protocols”, and “enforces a Minimum Data Set” and the “2026 Data Standards” for information sent “from source EMRs and Reference Lab Information Systems to the Malaffi exchange”. The DoH describes Malaffi as “the region’s first Health Information Exchange (HIE) platform”, launched in 2019 and operated by Abu Dhabi Health Data Services (ADHDS), “established as a Public-Private Partnership (PPP)” with the DoH.

The United States. Redox describes itself as “your interoperability partner” and offers software vendors a way to “Connect to multiple EHR systems via Redox’s single standardized API”. The relationship its website describes is commercial: a vendor shares its integration needs, and “a Redoxer will reach out for a custom consultation”.

England. NHS England's announcement of 26 June 2025 says Medicus Health “is the first new supplier to be fully assured through NHS England's Tech Innovation Framework”, that it integrates “with 24 national NHS services”, and that it is “the first to implement five new national open standards for information exchange”.

Abu Dhabi: what the Department of Health requires, and of whom

Three 2026 circulars set the requirement out in more detail. The DoH marks its circulars as intended for regulatory procedures and not for media publication, so they are cited here by number, title and date as the DoH's public listing gives them, and described in Recent's own words.

Circular USO/10/2026, “Mandatory On-boarding - Minimum Required Dataset with Malaffi Platform for All Healthcare Facilities in Abu Dhabi”, listed on 20 January 2026, requires healthcare facilities to meet Malaffi's data reporting requirements and to have the attached minimum datasets connected and transmitting within six months. Each facility is to confirm with ADHDS which datasets apply to its type, and a facility that does not comply risks its licence renewal. The attached list is expressed as HL7 message types, covering admissions and discharges, laboratory and radiology results, medication, clinical documents and appointments, with e-prescription listed as an API integration.

Circular USO/30/2026, on the “Mandatory Use of Health Information Exchange (HIE) Malaffi” by clinicians, listed on 22 February 2026, requires clinicians, including doctors and nurses, to use Malaffi before requesting any laboratory or radiology examination. Circular USO/171/2026, “Mandatory Onboarding with Malaffi and Submission of Patients Data”, listed on 7 September 2026, extends integration and data submission to traditional, complementary and alternative medicine centres, with a twelve-month grace period after which a non-compliant centre's licence is not renewed.

These are not the first. A keyword search of the DoH's listing for “Malaffi” on 23 September 2026 returned 24 circulars, the earliest dated 1 September 2020 and concerned with onboarding.

What these documents support, stated narrowly: the DoH requires applicable Abu Dhabi healthcare facilities to follow specified data standards and to submit applicable datasets through Malaffi, and requires clinicians to consult Malaffi before ordering laboratory or radiology examinations. What they do not support is that every use of Malaffi is mandatory, or that any particular Malaffi feature is compulsory. The documents read address facilities and clinicians; none addresses a software vendor directly.

The operator and the regulator give different sizes for the network. Malaffi's own site reports “3147 Signed Facilities” and “3144 Connected Facilities”; the DoH's page says Malaffi connects “over 2700 facilities”. Recent records both and does not reconcile them. What the submitted data is used for is visible in a release of 21 July 2026 on Malaffi's site, from the DoH and the Abu Dhabi Public Health Centre with ADHDS, which says 12 disease registries were completed and “are fully automated, leveraging data from Malaffi”.

The United States: what Redox offers, in its own words

Redox's website presents connection as a service. It reports “12,200+” connected healthcare organizations and “14,900+” live integrations, and describes “Secure, HIPAA-compliant infrastructure”. These are the company's statements, and Recent has not verified them. In a release of 28 October 2025, Redox said its core platform, Redox Engine, “will now include powerful enrichment and orchestration capabilities”, and its chief product officer said:

A regulator does appear in Redox's material, but as a requirement the customer carries and Redox offers to help meet. The homepage says “CMS ACCESS participants must handle several types of data exchange” and that Redox “partners with you to set up compliant data flows without building point-to-point connections to each CMS endpoint”. The pages read describe Redox as an alternative to building each connection separately; nothing in them says any product must use Redox.

England: what NHS England assured

NHS England's June 2025 announcement concerns a supplier being assured, and it looks ahead: it says “more core GP IT systems ... will become available by April 2026”. Recent has not checked whether that happened, and this article says nothing about which practices or integrated care boards have bought any system. Nothing in the passages cited requires a practice to adopt one.

The supplier has since changed hands. Doctolib announced on 6 May 2026 that it was establishing itself in the United Kingdom with the acquisition of Medicus, that it would invest more than £100 million in the UK over the coming years, hire 150 people there and create an R&D centre dedicated to primary care, and that Medicus would continue to operate with its British teams under its founder; Medicus's own site now says it is part of Doctolib. HTWorld, reporting the deal the same day, described the amount as undisclosed.

Recent analysis: what “integration” means in each place

“We integrate” means three different things in these three places. Four questions separate them.

Who requires the connection, and what follows if it is missing? In Abu Dhabi, under the circulars, a facility's licence renewal. With Redox, a commercial relationship that either exists or does not. In England, as NHS England describes it, whether a supplier is assured.

What exactly must flow, and in what form? The DoH names coding standards, a minimum data set and HL7 message types. Redox says the translation is its work, behind one API. NHS England's announcement names a count of national services and open standards; the passages cited here do not list them.

On whom does the obligation fall? The DoH's documents address facilities and clinicians. A company selling a record system to Abu Dhabi facilities would, on Recent's reading, meet the requirement through its customers' obligation rather than its own; the documents do not say this, and a team should confirm it with ADHDS or the DoH rather than assume it.

What stays optional? In Abu Dhabi, data submission and consultation before ordering are required; nothing read makes any other Malaffi feature compulsory. Using Redox is a purchasing decision. The NHS England passages cited describe a system becoming available, not one a practice must take.

None of this ranks the three. A mandate gives a product team one known destination and a published specification, which the DoH tells providers to monitor for changes; a market gives it choice and terms to negotiate; an assurance gives a supplier national requirements to meet and a public announcement when it has. Each leaves different work on the team's side of the line.