Scottish National Users' Group (SNUG) Podcast

Using a magic wand to fix the NHS in Scotland

Dr Steve Baguley is a consultant in Sexual Health & HIV and has been Chief Clinical Digital Officer for NHS Grampian since 2010. This episode features a discussion in which he compares Estonia's effective digital health system, which requires providers to submit care summaries to a central repository, enabling seamless data sharing and full transparency for citizens (who can view their records), and Scotland’s NHS, which struggles with fragmented IT systems and unfulfilled promises, failing to meet its 2017 pledge for citizen data access by 2020. There have been significant delays in GP IT Re-provisioning, electronic prescribing  and other digital transformation efforts.

Steve also discusses the role of AI in healthcare. He highlights ambient scribe technology as a major breakthrough for reducing clinician administrative burden while maintaining documentation quality. However, he strongly advises caution regarding AI tools like ChatGPT for direct clinical decision-making. For critical applications, he recommends a dual-AI verification system to enhance safety and reliability. Steve argues for a pragmatic, needs-based deployment strategy for AI tools (such as ambient scribes and Microsoft Copilot), prioritizing specific use cases and user requirements.

Spending time where it counts – an AI strategy for Health & Social Care in the North of Scotland 2023-27

Health and social care - data strategy: 2024 update - progress and priorities

Interesting times for Scottish GP IT (Peter Cairns blog)

There's only one team in Tallinn

To join the NHSS Scottish Digital Health and Care Network, access Teams and use the Join Code b7tk31u. (NHS Scotland M365 account needed).

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A conversation with Dr Margaret McCartney

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 She expresses significant frustration with outdated IT systems in Scottish general practice, in particular the current version of Docman, and argues for improvements and suggests integration of beneficial AI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

Lexacom’s new functionality

Lexacom began as a simple audio recorder program created by former GP , Dr Andrew Whiteley, originally devised to save time by sending recordings across a network to a secretary. Over two decades, the company has grown organically, serving over 60% of GPs with its digital dictation, transcription, and speech-recognition solutions. In this episode, Dr. Whiteley describes how this developed. Lexacom is now expanding its feature set beyond traditional dictation, focusing on secure cloud-hosted platforms, sophisticated speech-recognition designed for medical terms, and dynamic workflows that tailor letters, reports, and consultation notes to individual practices.

A key new focus is the integration of ambient AI, which captures and processes everything said during a GP consultation, then automatically produces a structured note. This enables clinicians to focus on patients rather than data entry. Additional modes can transform dictated text into patient-friendly wording or code it into existing clinical systems. Dr. Whiteley emphasizes patient confidentiality and data security, noting that all data remains encrypted on UK-based servers. The latest version of Lexacom also offers mobile app functionality for home visits, offline work, and seamless syncing, reflecting the company’s continued commitment to developing efficient, user-driven solutions for clinicians.

Lexacom website

Video demo of Lexacom Echo (GP Templates YouTube video)

Lexacom Guide: Brief Review for General Practice (Dr Gandalf YouTube video)

Star Trek Voice First Computer

Roger Neighbour on using AI in GP consultations

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 

Let’s Salsa with Weatherburn into 2025

Dr Chris Weatherburn discusses his productive year, focusing on maintaining a work-life balance and the value of effective habits and shares insights on managing innovation responsibly within healthcare, advocating for new technology to be implemented safely. Reflecting on challenges in the GP IT landscape, he expresses confidence in overcoming uncertainties surrounding the future of the Vision system and emphasizes adaptability to change, citing the resilience and camaraderie of the GP community as key assets in navigating potential transitions.

We discuss resilience, humour, and the satisfaction of patient interactions in general practice. Chris underscores the joy and impact of face-to-face consultations compared to remote methods, advocating for person-centred care despite rising pressures in Primary care. Sharing book recommendations like A Path Through the Jungle by Steve Peters, Unlock Charisma by Vanessa Van Edwards and Feel Good Productivity by Ali Abdaal, he offers insights into managing stress, maintaining curiosity, and achieving intrinsic motivation. Chris also touches on AI tools like Storm Genie and their implications for accuracy and truth in knowledge sharing. He concludes with personal reflections on avoiding news for well-being, recommending podcasts like Sliced Bread, and recounting his enjoyment of dancing!

Chris Weatherburn’s website

Feel-Good Productivity: Ali Abdaal - Summary

Unlock Charisma: Vanessa Van Edwards Cues Book Summary

Storm LLM: Putting AI to the Test—Is It Accurate?

Sliced Bread podcast on BBC Sounds

Chris and Caroline salsa in Blackpool

Storm Eowyn: Glasgow shuts down due to red weather warnings

The ghost of Gpass

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

Moving from EMIS to Vision

In this episode, we discuss migration to the Vision system for EMIS users in Scotland, focusing on key aspects of preparation. Some advantages of the new hosted environment include automatic backups, improved access to clinical systems across multiple sites, more collaborative working, and the ability to use non-medical prescribing with barcoded scripts. Vision Anywhere provides a secure backup system, and offers offline access to patient records, and can be used for home visits. Preparatory steps for migration include the management of non-DM&D drugs, addressing unissued acute scripts, and understanding the Vision system's "Preferred Pharmacy" approach.

The migration process involves a structured pre-go-live period with data validation, training, and familiarization with the Vision interface and functionality. GPs are encouraged to complete training, utilize the trial system for their practice, and familiarize themselves with system basics. Transferring methods of working can start now, as users understand how they need to use the new system, re-build data entry templates, appointments, recall and messaging systems.

We speak to Dawn Ellis, one of the IT Facilitation Managers working with the NSS GP IT Re-provisioning Team, about how practices, and GPs in particular, can start to approach preparation for migration. We also hear from Dr Mark Kirk, of the Avon Practice in Lanarkshire, which is the first practice to have completed the migration from EMIS to Vision, about how he feels about the move.

By accessing the NSS GP IT practice toolkit and actively engaging in available training resources, GPs can effectively adapt to the new system, ensuring improved efficiency and minimizing potential anxieties associated with this significant change.

Detailed notes from this podcast discussion with Dawn Ellis

NSS GP IT site   EMIS to Vision GP Practice toolkit (only accessible via SWAN)

Process and preparation PPT – detailed overview of process at practice level with overview of Vision  (only accessible via SWAN)

Vision 3 Quick Reference Guide for Clinicians

Cegedim Learning Zone

It will all be alright in the end…

Any feedback or comments are welcome via email: alex.defranco@phs.scot    www.snughealth.org.uk 

Digital Dermatology in Scotland

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

GPIT, wine and farming in Dumfries and Galloway

In this month’s episode we visit Dumfries and Galloway, the latest stop in our trip around the regions. We speak with Dr Neil Kelly, a familiar voice on the SNUG podcast, and discuss life in the South of Scotland and how things are going with preparations for GP system change, how the local project team and facilitators have become  confident in managing the change, and the importance of supporting staff during the transition.  Neil has reduced his GP leadership workload and developed a new interest in farming, but still has plenty of reflections on the evolving nature of general practice, the increase in telephone consultations, the occasional trivia of eConsult requests and why video consultations haven't taken off.

We discussed some of the difficulties with integrating systems like digital dictation, ECGs, and spirometry into the new IT environment, due to budget limitations. He’s impressed by Heidi Health, which shows promise in saving time through note-taking and digital dictation, and also discusses the potential benefits of Digital Dermatology, with his practice being one of the early adopters.

Neil remains optimistic about the future of general practice in Scotland, contrasting it with the more corporate approach in England. He points out the positive impact of additional support staff like pharmacists, mental health nurses, and the importance of having GPs handle complex tasks. Despite fears of GPs being replaced by other practitioners, Neil believes GPs remain highly efficient and cost-effective.

Listen to the end for some wine and book recommendations!

Travel Scotland guide to Dumfries and Galloway

Things to do in D&G

Advice for beginning farmers

The Wine Society

The Partisan – a book review

Now I’m a farmer – The Who

Meet Heidi, your digital scribe

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