Clinical practice is in the midst of a profound digital transformation with a new wave of technology gaining increasing prominence: ambient scribes. These AI-powered tools streamline documentation by converting doctor–patient conversations into structured clinical notes in near real time.
Healthcare professionals spend a significant time per day on documentation tasks, time that could otherwise be devoted to improved direct patient care or even increased rest! This administrative burden contributes significantly to clinician burnout and reduces the quality of patient interactions. This review examines three prominent ambient scribe platforms currently available in the United Kingdom: Heidi Health, Tandem Health and TORTUS AI.
Understanding the administrative challenge
The increasing administrative burden in healthcare represents a well-documented global crisis. While documentation remains vital, the hours spent on these tasks reduce direct patient engagement and contribute to widespread burnout across healthcare systems.
Ambient scribe technology addresses this challenge by serving as a passive digital assistant. By autonomously generating notes, these systems allow clinicians to focus on patient care, improving both patient experience and clinical accuracy. The technology works by discreetly capturing conversations through a microphone, transcribing the audio, and identifying key information such as patient history, presenting complaints, examination findings, and treatment plans. The system then formats this information into a coherent clinical note, which a clinician must review before integration into letters or medical records.
Ambient scribe platforms
Heidi Health (www.heidihealth.com/uk)
- Generates structured notes, summaries in real time and has completely customisable templates as well as access to user generated templates.
- Registered as an MHRA Class I medical device for summarisation.
- Actively deployed in UK primary care, including large GP partnerships such as Modality.
- Prioritises ease of use and intuitive interface design, with strong standalone performance and optional EHR integration.
- Uses a copy and paste function to allow integration with other medical note systems.
- Free use tier for up to 10 patients per month.
Tandem Health (www.tandemhealth.ai)
- Powers Accurx Scribe, available to over 200,000 NHS staff Currently live in 4000+ NHS GP practices.
- Integrated directly into EMIS and SystmOne, offering seamless workflow compatibility.
- Customisable templates and output formats, suited for hospital trusts and larger organisations, these are centrally controlled by the company to allow for integration.
- Registered with the MHRA as a Class I device (progressing to Class IIa).
- Free 30-day trial.
- User interface is simple and unlimited minimalist.
TORTUS AI (https://tortus.ai)
- Distinguished by precision and low hallucination rates, valuable in specialties with complex terminology.
- MHRA Class I registered (progressing to Class IIa) and piloted at Great Ormond Street Hospital, Royal Devon Trust, and nine London NHS sites.
- Independent evaluations show a 23.5% increase in clinician–patient contact time and reductions in appointment length and clinician overwhelm.
- Recently integrated into X-on Health’s Surgery Intellect platform for primary care, offering live note and referral generation with coding.
- User interface is sleek and minimalist, but accuracy and regulatory focus make it attractive for clinicians prioritising safety and fidelity.
User perspective
Over the last few months, I’ve been using three different AI scribe platforms in my private outpatient consultations, at times directly comparing their outputs for the same consultation on the same laptop and browser (MacBook Pro and Google Chrome). While all three platforms have their pros and cons, the feature I rely on most is the customisability of the templates used to generate patient notes. In this area, Heidi Health is the clear winner, offering the most template customisation. This flexibility allows for individual choice when generating a patient letter and prevents my letters from sounding overly formulaic.
While Tandem offers a urology template and TORTUS AI has customisable variations of one, neither is completely customisable from the ground up. A standout feature in TORTUS AI, however, was its use of a glossary at the end of the letter – a great touch for patients. Another powerful capability across all these platforms is the ability to convert a basic consultation letter into a referral letter for another specialist, or to simplify or translate it into other languages.
My only hesitancy with Heidi Health’s customisability was wondering if my own template prompts might alter the accuracy of the summary. However, in practice, I didn’t find any real difference in the number of errors or ‘hallucinations’ between the platforms. In my view, the greatest weakness of all the AI scribes is how they handle a lack of context. In a follow-up setting, for example, the AI tends to guess the most likely reasons for things (as the original consultation is not linked) and will write these guesses into the letter as fact. As the clinician checking the note, it can be very difficult to spot these errors. When 95% of the text looks completely correct, you naturally start to assume that you’ve remembered something wrongly, especially since there are no warnings or highlighted sections for text the AI is less sure about.
AI scribes represent a paradigm shift by replacing the need for post-consultation dictation. My own NHS clinics, which still operate without this technology, feel noticeably more draining than my private clinics where I only use AI scribe technology. Looking ahead, the next challenge is to expand their application to further reduce the administrative burden, with potential uses including the automatic generation of results letters, completion of request forms, and deep integration with hospital EPR systems for documenting ward rounds and even creating operative notes.
Conclusion
By reducing administrative burden, these systems allow clinicians to redirect their focus to the patient. The adoption of ambient scribes marks a major shift towards more efficient and patient-centred care. AI scribes will soon become part of every clinician’s workflow, and their successors will have even greater built-in functionality and allow the automation of repetitive tasks.
