Getting rid of the mouse
I remember writing my first cheque in the middle of the 1980s, however, I cannot remember when I wrote the last one. Cheques were replaced with cards and now my children only use their phones to carry out almost all their financial transactions. They do not know what a cheque is.
When I started as a GP, I would record consultations by writing on small pieces of card, stored in a patient envelope, kept behind the reception desk. Currently I type my notes and they are stored electronically. Early next year we will start the next step in the evolution of medical record keeping by trialling a new computer programme that will produce a transcription of the consultation as our patients leave the room.
As GPs we are at the start of a patient’s journey. For the vast majority of patients this is a one stop shop; we see and we successfully treat. However, for patients who need further investigation our role is to transfer the information we have gathered to the hospital team. This takes us a lot of time. Three hours of a GP consulting with patients will typically generate one hour of administrative work, the bulk of which is writing letters.
At medical school doctors learn the language of medicine. The way in which we record a patient’s story follows a set pattern. A lot of this medical shorthand is now familiar to everyone from the medical dramas that are ever present on television. The new computer programme takes advantage of this predictability; it recognises patterns that regularly occur in GP consultations and links them together. A transcription of a consultation can be analysed in seconds by the algorithm and no matter how complicated and circuitous the conversation, no matter how many possible diagnoses may have been alluded to, it is able to produce an outline written recording in a ‘doctor-speak’ format. This is a draft summary for the record that can be checked and edited, however it is remarkably accurate. The programme then allows the GP to package the information extremely quickly for onward communication, such as a referral letter.
As far as practising medicine nothing will change; knowing your patients, asking the right questions, performing the examination are not something the computer can do. However, no typing, no dictation, just editing will give GPs more time to spend with patients.
In 1992 Wyndham House was the first practice in Devon to stop using paper notes in consultations, in 2016 we were the first practice in Devon to convert all medical records into a digital format and in 2025 we are going to be one of the first practices to start the process of removing the computer keyboard from the consulting room.
Anthony O’Brien
Wyndham House