01 the business
Regional general hospital
450 beds, 60 discharges a day
Junior doctors write discharge summaries at the end of busy shifts by scrolling through days of notes. Summaries are often late or thin, GPs chase for details, and some patients wait on the ward for their letter.
02 before
The problem
Junior doctors write discharge summaries at the end of a busy shift, pulling details from days of notes. Summaries go out late or thin, so GPs and community teams start without the full picture, and patients wait on the ward for paperwork.
- Summaries take 20 to 30 minutes each to assemble.
- Patients wait for paperwork after they are ready to leave.
- GPs receive inconsistent letters with missing medication reasons.
03 the build
What the AI does
- Step 1: Starts when a patient is marked as expected to go home, and gathers the admission notes, ward round entries, results and procedures from the record.
- Step 2: Lists the medication changes made during the stay, with the reason recorded in the notes for each one.
- Step 3: Drafts the summary in your hospital's template: reason for admission, what happened, follow-up and actions for the GP.
- Step 4: Links every statement to the note or result it came from so the doctor can check it quickly.
- Step 5: Writes a plain-language version for the patient, kept separate from the clinical summary.
paused: waiting for a person to approve
How it was put together
- Started the draft when a patient was marked as expected to go home.
- Gathered notes, results and procedures, and linked every statement to its source.
- Listed medication changes with the reason recorded in the notes, for confirmation.
- Used the hospital's existing summary template and added a separate plain-language version for patients.
04 human in the loop
Where a person stays in charge
The treating doctor checks every line against the record, edits and signs the summary before it is sent. Medication changes are confirmed by the doctor or pharmacist, never taken from the draft alone.
- The treating doctor checks and signs every summary.
- Medication changes are confirmed by a doctor or pharmacist, never taken from the draft alone.
- The clinical safety officer approved a hazard log before go-live.
05 rollout
From kickoff to live in 10–12 weeks
- Weeks 1–4Clinical safety case, information governance review and template agreement.
- Weeks 5–8Pilot on two medical wards, comparing drafts with summaries written by hand.
- Weeks 9–12Extend to more wards with weekly audits of a sample of summaries.
06 after
What changes
Summaries are ready when the patient is, and the doctors who write them spend their time checking rather than copying. GPs and community teams receive complete, consistent letters.
Assume 60 discharges a day, 25 minutes of doctor time each by hand and 8 minutes to check a draft.
60 × 17 minutes saved = 1,020 minutes, or 17 hours of doctor time a day across the hospital.
What to measure
- Time from decision to discharge to summary signed.
- Doctor time per summary.
- Corrections made to drafts, by type.
- GP queries about discharge letters.
07 evidence
What the research says
Observed physicians spent 27% of their office day on direct time with patients and 49.2% on the electronic record and desk work, plus 1 to 2 hours of after-hours work each night.
Around 1 in 10 patients is harmed in health care, and more than half of that harm is preventable.
World Health Organization, Patient safety fact sheet (opens in a new tab) · 2023
The global cost of medication errors has been estimated at US$42 billion a year.
World Health Organization, Medication Without Harm (opens in a new tab) · 2017
08 lessons
Mistakes to avoid
- Treating the draft as the record. Every line needs checking.
- Hiding sources. Links to notes are what make checking fast.
- Skipping clinical safety. Use your clinical risk process from day one.
09 questions
Common questions
- Will it get medication changes wrong?
- It can, which is why medication changes are listed separately with the reason from the notes, and confirmed by a doctor or pharmacist.
- Does it work with our record system?
- Epic, Oracle Health and MEDITECH can all supply the data, and the draft goes back as an unsigned document.