Add us as a preferred source
Morgan Daly, Deputy Digital Director (Transformation) at One Care, the member-owned general practice federation for Bristol, North Somerset and South Gloucestershire (BNSSG) speaks about how, thanks to AI platform Heidi, doctors have more time to dedicate to their patients.
At One Care, we spend a lot of our time talking to practices about the challenges they face in delivering care and then finding solutions. About two years ago, our conversations with GPs and practice managers kept coming back to three things: rising demand from patients, workforce pressures and the quality of care.
Practices were dealing with the Monday morning rush, and appointment books were filling up weeks in advance. Alongside this, there was more work around patient care, from processing test results to reviewing people with long-term conditions.
At the same time, practices were finding it increasingly difficult to recruit and retain staff at all levels, from GPs to practice managers and administrative assistants.
Then there was the pressure on the quality of care. Clinicians felt they had to move through consultations as quickly as possible, sometimes turning away from the patient after a few minutes to start typing their notes, to see as many people as they could.
We decided to explore whether technology could help. After looking at the options against criteria including cost, quality and safety, we chose to trial Heidi with our member practices.
Before we started the rollout, we sent a survey to staff of all levels, asking them to score themselves against some criteria. Questions included how often they felt burnt out or overwhelmed, how often they felt they had enough time to provide good quality care, and how long different types of consultations were taking.
We then repeated the survey during the programme and at the end. For context, 55 practice partnerships were onboarded across BNSSG, with more than 700 clinicians adopting Heidi, using it to, for example, transcribe consultations, condense notes and draft letters to hospitals. The results of the survey showed a significant reduction in feelings of burnout and being overwhelmed, particularly among GPs, alongside an improvement in perceptions of the patient experience.
GPs estimated that they were saving around 45 seconds on a straightforward ted-minute consultation and around a minute on a complex consultation.
The time savings have been even more striking for some of the administrative processes around care. Previously, GPs would dictate a referral letter, which would then be transcribed by a medical secretary. We estimated that this could take around 15 minutes per letter. Some practices are now using Heidi to draft the letter, with the GP checking it before sending it to the secretary to post, bringing the process down to around 40 seconds.
More time to get to know patients
It has also helped practices tackle backlogs and delays in referrals, while reducing the burden on secretaries. The amount of time practice managers spend on administration following meetings has also been cut significantly, from three hours to 45 minutes, thanks to Heidi.
Getting to that point required more than simply switching on a new piece of technology. My team and I coached staff in three cohorts, beginning with those who were the most keen, meaning they could then help those who were more unsure.
We also held monthly clinical drop-ins and made ourselves available to answer questions throughout the rollout. Practices could share what was working and learn from each other’s experiences.
We asked every practice to identify a clinical and a non-clinical champion who would be the point of contact for questions day-to-day. We also provided materials so they understood the process.
Keeping patients safe throughout
Patient safety was central throughout the pilot. We carried out the necessary digital clinical safety and assurance work and established clear rules for how Heidi should be used; one of the most important being that there must always be a human in the loop. The output from Heidi is checked by a clinician every time, and they remain responsible for ensuring that the information produced is accurate and appropriate.
Patients were also kept informed about the transition, with the option to opt-out available. We agreed that practices would use a consent script explaining that an AI product was being used to listen to the consultation and that patients could say no. Information was also provided through posters, screens in waiting rooms and practice websites.
To us, the pilot shows AI-scribe content still needs review, and organisations wanting to adopt the technology must ensure they have robust governance arrangements in place.
‘Game changing’ effects
For many staff, the impact has been significant.
GPs tell me they have a better relationship with their patients. One said she is a better doctor now because she has the time to find out more about her patients’ lives and what is going on with them, rather than just going straight to the medical issue.
I have heard from GPs and nursing staff who previously stayed until eight, nine or even 10pm because they were catching up on notes and administrative work. They are now able to leave roughly on time and get home to their families, and that’s a game changer. They can start to enjoy their jobs again.
