Scottish National Users' Group (SNUG) Podcast

We have an interview this month with Dr Margaret McCartney, a Glasgow GP, broadcaster, and writer, who discusses her journey into media, the current challenges faced in general practice, and her views on technology, evidence-based medicine, and contemporary healthcare issues. Margaret shares how her media career began rather unexpectedly and gives some insights into her media engagement. She expresses significant frustration with outdated IT systems in Scottish general practice, in particular the current version of Docman, and argues for improvements and suggests integration of beneficial AI technologies could alleviate some of the administrative burdens. The conversation also covers broader healthcare themes, including the application of evidence-based medicine, highlighting the necessity for doctors to interpret guidelines flexibly, and consider patient-specific contexts and complexities. Margaret discusses the application of shared decision-making, including some situations when this may not be appropriate, the implications of fragmented healthcare teams for continuity of care, and the ethical dimensions of assisted dying, advocating caution against expanding medical powers without adequately considering vulnerable populations. Additionally, the discussion touches on concerns regarding social media's impact on young people's mental health, recommending evidence-based approaches to address negative influences effectively. Margaret McCartney Wikipedia page MedicsVoices: Holding medicine to account The Contented Clinician podcast series BBC Radio 4 Naked Week podcast BBC Radio 4 Inside Health Adolescence: what teen boys really think of girls, influencers and porn – Guardian Today in focus podcast Atul Gawande: Being Mortal Frontline TV Documentary Written submission by Dr Margaret McCartney to the UK Parliament's Public Bill Committee regarding the Terminally Ill Adults (End of Life) Bill Registration and Programme for the 2025 SNUG members’ day on May 29, 2025 at Westerwood Hotel

In this episode, we have the privilege of speaking with Professor Roger Neighbour, former GP and past president of the Royal College of General Practitioners (RCGP). We discuss how AI-powered tools like Heidi Health and Clinitalk are providing new opportunities for GPs and GP trainees. We discuss: The impact of AI scribes on GP consultations - are they are a game-changer? The benefits and risks of increased use of AI in consultations – will this enhance clinical decisions or deskill doctors? Training implications – can AI provide useful real-time feedback to trainees? The balance between transactional (efficiency-focused) and relational (patient-focused) medicine. “There’s a kind of schism developing between the transactional ways of conducting general practice and the relational ways. I can see that AI could be extremely useful in a transactional consultation to make sure that the actual clinical business got transacted efficiently and effectively …but if we have too great a reliance on that, it could potentially lead to an erosion or possibly an abandoning of some of the other human values, things like kindness, empathy, thoughtfulness, and the cultivating of a personal relationship with patients. And, if AI is sold on the basis of it will save you time, you don't need to write notes anymore, then something is at risk there…” Our conclusions? AI scribes can reduce the administrative burden, but we must ensure they do not remove the “thinking” process in consultations. AI may help reduce clinical errors and help standardize best practices but must be integrated carefully into workflows. AI tools like Clinitalk offer real-time educational feedback, helping trainees develop consultation skills. A significant risk for the future of GP consulting may be an over-reliance on AI, leading to a loss of skills like empathy, intuition, and relationship-building. BJGP Editorial: yesterday’s man? (By Prof Roger Neighbour) Consulting in a Nutshell: A practical guide to successful general practice consultations before, during and beyond the MRCGP AI Scribe compared in General Practice eGPlearning YouTube video comparing Kiwipen Tortus Anima and Heidi Health. Clinitalk Website Clinitalk: AI Empowered GP Training (Prof Anwar Khan) WilmslowGP YouTube video Clinitalk: Demo, Security & Pricing (Dr Nic Boeckx) WilmslowGP YouTube video Any feedback or comments are welcome via mail: alex.defranco@phs.scot www.snughealth.org.uk

We ponder the dramatic news that INPS has gone into administration and catch up on First Minister’s questions before our main discussion with Dr Colin Brown, a retired GP and now Healthcare Informatics Consultant. Colin takes us through the evolution of GP computing systems and reflects on the challenges of implementing technology in healthcare, recounting the early adoption of Gpass, the main GP system in the 1980s and 90s. He highlights its limitations, including frequent breakdowns and outdated infrastructure, and the attempts to modernise it in the F3 group’s efforts to redesign it with dual databases and a central server, which ultimately faced technical and logistical hurdles. The shift to off-the-shelf commercial systems in Scotland, the complexity of integrating systems across NHS sectors, and the overarching challenges of interoperability are key themes. In the latter part of the discussion, the potential of wearable health devices is explored, focusing on their utility for monitoring activity levels, sleep patterns, and even early disease detection. Colin highlights a German national initiative using over half a million wearable devices to gather public health data. He advocates for leveraging this type of data for predictive analytics and better clinical insights, emphasizing the need for accuracy and meaningful interpretation. The conversation also touches on the cautious adoption of AI, with specific examples like digital scribes for consultations, and raises concerns about over-reliance on technology without adequate supervision. Colin concludes by expressing optimism for modular, interoperable platforms to address these longstanding issues, stressing the importance of veracity and utility in health data. First Minister’s questions from Thursday, 19/12/24 (at 46:34) from Broadcasting Scotland Everyday data for COVID-19 from mHealth devices: The PAIDUR framework by Colin Brown. How many steps a day are enough? Preliminary pedometer indices for public health The history of Gpass Inside a Santa Claus academy

Dr Beth Kerr, a GP in the Scottish Borders, discusses her involvement in digital dermatology on this month’s SNUG podcast. She explains her role as a clinical lead in the development of a digital dermatology pathway in collaboration with the Centre For Sustainable Delivery (CFSD). The project is part of the Accelerated National Innovation Adoption (ANIA) Pathway and aims to address the significant backlog in dermatology care across Scotland by implementing a streamlined process for GPs to send triage-quality images with referrals via a secure app. This app, integrated with the SCI Gateway referral system, allows images to be taken and uploaded directly to the National Digital Platform without storing data on personal devices. The project was developed in response to the increasing demand for dermatology services, with long waiting times and unfilled specialist posts posing significant challenges. The digital solution, allows GPs to easily attach images to referrals, reducing the need for patients to wait for face-to-face appointments. Beth highlighted the app's benefits, such as faster treatment, better allocation of resources, and the flexibility for GPs to use their own devices. Training resources, including videos and virtual sessions, are planned to ensure smooth adoption across Scotland. Evaluation of the project’s impact will be ongoing, with regular reporting on key performance indicators to measure success and guide further development. Centre for Sustainable Delivery Introducing the Centre for Sustainable Delivery video Developing a national Digital Dermatology Pathway Video The Scottish Health Technologies Group's assessment of Store and Forward Teledermatology for triage of primary care referrals. Teledermatology Register for this year’s SNUG conference Traditional Scottish Ceilidh Band

In this episode, we speak to Dr Hannah Allen, a GP with extensive experience in digital health and AI. She discusses her current role with Heidi Health, who developed Heidi, an AI-driven tool designed to assist clinicians. Hannah explains that her interest in Heidi was sparked by its potential to impact healthcare at scale, driven by the needs of clinicians and developed by a doctor. Heidi was originally aimed at enhancing pre-consultation processes but evolved into a comprehensive AI assistant that supports clinicians during and after consultations by automating tasks like note-taking and document generation. This evolution was influenced by a growing appetite for innovation in healthcare, especially following the COVID-19 pandemic, which highlighted the need for efficient, tech-driven solutions. Hannah details how Heidi functions in a clinical setting, describing it as a tool that transcribes consultations and automates the creation of clinical notes and other documentation. This allows clinicians to focus more on patient interactions rather than administrative tasks. She notes that Heidi is customizable, adapting to individual clinicians' preferences in how they document and manage patient care. The tool’s ability to accurately transcribe and generate structured notes has been widely appreciated, with users reporting significant improvements in workflow efficiency and reduced stress. Additionally, Hannah touches on the importance of data security and compliance, explaining that Heidi adheres to GDPR and NHS standards, with robust measures in place to ensure patient data is protected. She also mentions ongoing efforts to integrate Heidi more deeply with GP systems, which would further streamline its use in clinical practice. Heidi website Resource Centre Medical use cases Dr. Tom Kelly, CEO & Co-founder @ Heidi introduces Heidi v2.0 UCSF Grand Rounds: Generative AI in Healthcare: Is This our Hemingway Moment? Diagnosis: Teaching, Measuring, Innovating Info matters podcast: Artificial intelligence in health care: Balancing innovation with privacy Any feedback or comments are welcome via email: alex.defranco@phs.scot www.snughealth.org.uk

In this episode, we shift our focus from GP IT Re-provisioning to another major change for practices: the upgrade from Docman 7 to the cloud-hosted Docman 10. We've previously discussed Docman's vital role in document management and the GP2GP system for records transfer. Docman is indispensable for handling the influx of results and letters we receive daily. However, like everything else, it’s about to undergo an upgrade across every practice in Scotland. At our recent SNUG Members’ day, Judith Milligan from National Services Scotland outlined how the initial practices were selected for the move to Docman 10 and highlighted the NSS GP IT website as a resource. Today, we hear from the One Advanced Healthcare team, who presented at the SNUG virtual members day. We'll hear from Greta Henderson, Programme Lead for Docman 10 migration; Dianne King, Head of Training and Education; John Galvin, Deployment Manager; and Paul Chenoweth, Senior Training Consultant. Paul demonstrates how Intellisense can streamline filing, using a hospital discharge letter as an example. Prepare for the transition over the next 2 years, as 900 practices in Scotland adopt Docman 10. Access to an e-learning portal and Familiarization environment will be provided shortly before a practice upgrades, but you can also visit the NSS GP IT site now (via a SWAN connection) to see a video demo of Docman 10. Subscribe to the SNUG podcast on Apple or Spotify to stay updated. OneAdvanced Document Workflow National Services Scotland GP IT page (SWAN connection) NSS GPIT Document Management site - with Docman 10 video (SWAN connection) SNUG Virtual Members’ day videos 2024 (SNUG membership needed) Changes – David Bowie Boris forgets his photo ID