AI Scribes – high potential, but thinking still required

AI Scribes are hailed as a game-changer for NHS services, but let’s put execution before excitement, writes Jenny Partridge, innovation manager for Health Innovation Kent Surrey Sussex

Ambient voice technology (AVT) –  sometimes called AI-scribes or notetakers – is a current poster child of NHS transformation – namechecked in both the NHS 10 year health plan and the medium-term planning framework.

The promise is clear: automated notetaking that saves clinicians time, reduces administrative burden and delivers cost efficiencies.

Our independent evaluations show that these benefits are real. But as anyone who has battled ChatGPT over a basic fact knows, technology makes mistakes. So do humans.

The question isn’t whether to use AVT, but how to use it well.

Getting real about outcomes

To get the most from AVT, users must understand what the technology can – and cannot – do.

In my work supporting innovation across health and care systems, I consistently see three types of users:

• Resisters – who fear new technology, particularly AI, and refuse to use it, citing clinical safety and information governance (IG) concerns
• Pioneers – who use new technology as much as they can, pressing for more uses, but can overuse it, for example expecting it to make clinical decisions
• Pragmatists – who use technology carefully, testing and checking while gradually building their usage

These patterns emerge when any new technology is introduced. Do you remember the stories of people driving their cars into deep fords, or to a cliff edge, because ‘the GPS said so’? Sometimes we’re too ready to outsource judgement.

The equivalent for AVT is the user who expects the system to write up and file consultation notes without human review. When the tool fails to deliver, it is seen as faulty.

This can be avoided with training that sets expectations, especially (and importantly) around who is responsible for the final clinical record.

Making it official

Attend any healthcare conference today and you’ll find AVT suppliers showcasing impressive tools and quoting ambitious savings. At the same time, many users are ‘unofficially’ adopting AVT via freemium models or integrations with phones and messaging systems.

As evidence grows and integration with electronic patient records improves, NHS trusts are beginning to procure AVT at scale.

Whether it achieves the promised benefits depends largely on implementation:

• Do the users know what to expect and what their responsibilities are?
• Do potential users require training to improve IT literacy?
• Who is training users and auditing output?
• How robust is the IT infrastructure?
• What risks have been identified as part of clinical safety and IG reviews?

There is more to success than buying the right tool. AVT must be configured for specific use-cases. For example, optimal microphone quality and placement vary drastically between a quiet consultation room and a busy community setting with multiple speakers.

‘Like my right arm’

Independent evaluations by Health Innovation Kent Surrey Sussex show that AVT delivers meaningful benefits: saving time for A&E staff booking patients in, reducing pressure on paramedics and improving clinicians’ work–life balance.

Community settings, in particular, have seen strong returns on investment, with AVT dramatically reducing the time spent writing up lengthy mental health assessments.

To quote one GP: “AVT has very quickly become a natural extension of me, it’s now like my right arm”.

How do we get the most out of AVT?

There is no doubt that AVT is already changing how work is done for early adopters. I have rarely seen such positive sentiment towards an innovation from users.

Perhaps surprisingly, this also includes patients/service users who report better face-to-face interactions because their health and care worker isn’t occupied with form-filling.

But to achieve these results, organisations must invest in change as much as in technology. Here are just a few steps:

• Build the right project team, including technical sceptics and those who are not IT literate. This will avoid assumptions in system design
• Be clear about what you need AVT to do
• Choose technology that fits your setting and workflows and is easy to implement
• Ensure templates capture the right information and integrate cleanly
• Complete full clinical safety and IG checks – and audit regularly
• Communicate with everyone affected, including patients and admin staff
• Train users thoroughly: in the technology, in AI risks and in the safety checks required
• Ensure clinicians understand that they remain liable for the clinical record

AVT is a powerful tool, but it works best when paired with human judgement, clinical expertise and thoughtful implementation.

Jenny Partridge is an innovation manager for Health Innovation Kent Surrey Sussex. As part of the Innovation and Enterprise Team, she has run independent evaluations of AVT technology in multiple health and care settings. She is the author of Are you listening carefully? How to implement AVT in health and care.