‘Way more meaningful’: How Dragon Copilot is enabling more human healthcare across the NHS
Clinicians across the UK’s National Health Service (NHS) are using a new AI-powered way to capture the patient story, enabling them to spend more time listening and less time typing. And the new technology could have much wider applications across the NHS.
In consulting rooms and outpatient clinics across the NHS, a familiar pattern plays out: a clinician talks with a patient, but their eyes keep returning to the computer screen: patient notes need to be read, understood, and written up afterwards, and letters must be written and forms completed.
This necessary but time-consuming admin can detract from the human-to-human experience and prevent clinicians from doing what they do best.
Now Microsoft Dragon Copilot, an AI clinical assistant, is capturing these conversations, generating clinical summaries, and drafting the necessary documents and letters for clinicians to review and sign off.
“The level of sophistication which having an ambient scribe with me in the room has added almost defies description really,” reflects Dr Rachel Hilton, a consultant nephrologist (kidney specialist) at Guy’s and St Thomas’ NHS Foundation Trust in south-east London.
“Essentially, I’m now able to talk to the patients face-to-face, looking them in the eye, and really listening.”
Dr Hilton spends most of her clinical time in outpatient clinics, seeing people with kidney disease across “the whole spectrum… from the very mild… to people whose kidneys have failed,” including patients who have had transplants or returned to dialysis.
“I’ve been looking after some of these people for well over 20 years,” she says. “So I have very long relationships with a lot of them.”
But although many hospitals like Guy’s and St Thomas’ have used electronic records for years, the digital admin load has steadily increased.
‘Less anxiety’
Dragon Copilot is addressing that issue.
The phone app syncs with her desktop computer and records the consultation “unobtrusively,” she says, then creates a transcript that captures many important details she might otherwise have been lost “because I can’t type that fast.”
“It breaks it down nicely into the different healthcare topics we covered and comes up with a plan,” she says. With Dragon Copilot “I can then turn that into a GP letter or a referral letter to another specialist, and alter the tone and detail according to what I think is right for my consultation.”
Dragon Copilot pulls out what matters clinically and shapes it into a draft note that she can check over and edit.
Dr Hilton, who now works 20 hours a week part-time, estimates she’s saving about two hours a week in admin – time she can spend offering a better quality of service to her patients and to the hospital, without feeling constantly up against it.
“Clinics are way, way less psychologically hard work for me,” she says. “I’m feeling much less anxiety and stress because I know I can just sit and relax.”
As a result, “the contact I’m having with the patients is way more meaningful”.
Unexpected side-effects
Over at Imperial College Healthcare NHS Trust, Deirdre Lyons, a consultant gynaecologist and divisional Chief Clinical Information Officer, has also been using Dragon Copilot. She agrees that it is “certainly saving time” and is a “a big, big plus”.
“Now that I have a lot more confidence in it, you can actually sit and look at a patient rather than thinking, ‘How am I going to type this and get all this down, so I’ll remember it?’”
She adds that the technology is not just enabling consultants to offer a more attentive service to patients, but to “think about other things like research, audits, training and teaching.”
And reducing the after-hours “slog” is a benefit in its own right, she argues.
Another interesting side-effect of the technology is that clinicians are finding they have to say things out loud for the recording that might otherwise remain unsaid.
So if a patient nods in answer to a question, “you have to say: ‘Yes, you do have high blood pressure…or not, as the case may be’, so Dragon Copilot can record the answer,” says Dr Lyons.
This is encouraging clinicians to be more precise and thorough in their consultations, both doctors agree.
Guardrails and fine-tuning
Dr Lyons emphasises the need to use such AI tools responsibly, which is why her Trust set up an AI Steering Group to establish proper “lines of governance, so that people don’t get caught out and bring in anything that they shouldn’t.”
Dr Simon Wallace, Chief Clinical Information Officer, Microsoft UK & Ireland, acknowledges that good governance is crucial rights across the NHS. While there is “a tidal wave of enthusiasm” for ambient voice technology, the priority is making sure “the regulations are adhered to,” he says.
He points out that Microsoft is a listed supplier on the NHS England AVT [Ambient Voice Technology] Registry and Dragon Copilot is fully compliant with NHS AVT standards.
Importantly, clinicians using Dragon Copilot stress that AI is not replacing the need for judgement and oversight. Changing how you record a document doesn’t remove responsibility for the record, as Dr Lyons puts it.
“One thing that we’ve learned over the last twelve months… is that it’s very important to be able to train the language models to meet the needs of different clinical specialities,” says Wallace.
“Neurology needs to be more verbose and have more of what the patient actually said, for example, whereas orthopaedics needs to be really quite concise.”
Liberating innovation
But he’s clear about Dragon Copilot’s potential to have a big impact not just in hospitals and GP practices, but across the wider healthcare system.
“Dragon Copilot could and should be used by all healthcare professionals – this includes all doctors, not just consultants, but nurse practitioners and allied health professionals, such as speech therapists, physiotherapists, and occupational therapists,” he says.
“We started by using the quill, then the pen, then typing hunched over a keyboard. Now clinicians are being liberated to use their voice as the ‘smart’ tool to record patient interactions and engage with the electronic patient record.
“We will all benefit as a result.”
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