CLEARnotes FAQs
- Log in securely via your internet browser at the start of your clinic.
- Ask for patient consent.
- Click ‘record’ at the start of the consultation.
- Click ‘end’ at the end of the consultation.
- Review and edit the autogenerated summary if needed.
- Click ‘copy’ and paste it into your EPR.
CLEARnotes has been designed for clinicians to remain in the driving seat. Every section of the clinical summary is editable once it has been generated.
Since the transcript serves as an intermediate step in generating the clinical summary, it is not editable. However, during the pilot, clinicians will have the option to view this transcript to understand the underlying process.
CLEARnotes was developed as a productivity tool tailored for clinicians, ensuring they remain in control. We follow a rigorous iterative process to review and improve our prompts, ensuring they meet clinical standards. This process is informed by feedback from users and insights from domain experts.
Although CLEARnotes is designed to enhance productivity, clinicians are required to review the outputs before finalising them in the patient’s record to maintain clinical safety.
Our initial focus is on pre-operative assessment clinics. We have plans to expand into additional clinical areas soon. If you are interesting in piloting the tool in a different area, please get in touch.
CLEARnotes is focused on face-to-face consultations at present but has the capability to be used in virtual consultations. If your organisation requires CLEARnotes for virtual consultations, we will work with you to tailor CLEARnotes so it integrates seamlessly with your current virtual consultation systems and processes.
A combination of hardware and software methods is employed to optimise CLEARnotes, improving the quality of recordings for maximum accuracy of outputs. At present, CLEARnotes is targeted for use in clinic environments where noise levels are more contained, before extending to other settings such as wards.
CLEARnotes is continuously improving, and so far, it works well with various regional accents across the country, effectively handling a wide range of accents. Results have been promising for various languages (other than English) too, but this will require further testing and validation to optimise outputs.
Direct integration is being explored as part of our product pipeline to create a more seamless user experience, including the ability to handle checkbox forms. However, it will not be available for this NHSE-funded pilot project.
Our team of over 70 specialists, comprising mostly of clinicians, have successfully completed over 60 projects in healthcare transformation and workforce redesign projects, improving patient care and productivity across England. This is all underpinned by our national CLEAR Programme and is a testament to our commitment to enhancing clinical productivity and patient care through innovative and tailored solutions.
We stand out from other AI clinical summarisation tool providers because we come at this knowing how to design and implement new processes and tools in the NHS. Hosted within the NHS and free from external investor influence means that CLEARnotes aligns perfectly with NHS needs. It is designed by clinicians who understand the demands of NHS working systems, ensuring it meets the specific requirements of our fellow colleagues.
2. NHS funded pilot project (June 2024)
For this project, we will need patient consent. CLEARnotes includes features to facilitate the consent process.
Patients will be given information before their clinical appointment and provided with a privacy notice from the trust. We recommend starting the consent process when patients arrive for their appointment by giving them the privacy notice and explaining the planned use of CLEARnotes and the need for their consent.
During the consultation, the clinician will not be able to activate the recording function until they confirm on the tool that the patient has read the privacy notice and has given consent.
As an initial pilot, CLEARnotes is not yet integrated with hospital EPRs and requires users to copy and paste notes into their local systems. A comprehensive clinical safety assessment has been conducted, incorporating mitigation measures into the CLEARnotes pilot project. These include user training during clinician onboarding and additional pop-up questions to ensure patient details between CLEARnotes and the local EPR match.
In the future, CLEARnotes will be integrated with hospital EPRs, eliminating the risks associated with copying and pasting.
Yes, our tool is designed to generate outputs tailored to various trusts. We will collaborate with you to ensure the outputs produced are formatted to suit your local workflow.
We will involve clinicians closely in the development process to help mitigate biases. We have an iterative quality assurance framework to enhance our AI, reduce bias, and improve the clinical safety of CLEARnotes. This includes clinical risk assessments, monitoring and evaluation to ensure the tool’s quality and safety.
As part of the CLEARnotes pilot, we will explore this further with participating sites – working together to identify any areas of bias and to address them in future iterations of the tool.
Our goal is to reduce costs and make this technology accessible to the NHS while maintaining high-quality standards. As such, CLEARnotes will be priced at £10 per clinic post-pilot. Unlike other companies that typically charge per user, our pricing model is based on usage.
There are several key considerations, primarily focused on the questions asked in the EOI form. These include local pre-operative assessment pathways, informatics infrastructure, and support from the wider hospital team, including information governance lead and service managers.
Our CSO, Dr Tai Ken Ting, is the Clinical Informatics Lead at 33n and currently practices as a consultant anaesthetist at the Royal National Orthopaedic Hospital. He has led multiple clinical transformation projects in elective recovery, urgent and emergency care and intensive care which have involved the extraction, safeguarding and analysis of patient level data.
The wider clinical safety team includes Sarah Ali, a practicing physiotherapist and clinical lecturer at St. Mary’s University, and Dr James Kelly, an anaesthetist and clinical lecturer at UCL. Development of the tool is also supported by a wider team of clinicians and engineers experienced in risk management and delivery of projects involving patient level data within the NHS.
For any questions regarding clinical safety, please reach out to our Clinical Safety Officer, Dr Tai Ken Ting, at ken@33n.co.uk.
We are currently working to comply with Web Content Accessibility Guidelines (WCAG) 2 Level AA and expect it to be completed by September 2024.
As you are the data controller you will determine the lawful basis for processing. We recommend, however, that consent is the most suitable lawful basis as confidential patient information will be processed. We have set CLEARnotes up to support you in collecting consent.
Yes, based on the assumption that processing will rely on consent we have prepared a privacy notice you can use to help ensure patients have been provided with all appropriate information.
A separate privacy notice for consultants using CLEARnotes is available on the CLEARnotes platform.
3. Compliance and safety
- As this is a recording tool, the data captured will encompass anything that the clinician and patient says. In this context, this will contain special category data which includes, but is not necessarily limited to, data concerning health.
In addition to the audio recording, the patient’s name, date of birth and NHS number, will also be entered. This is to help ensure recordings can be matched to patients.
33n does not share or sell data processed in CLEARnotes with any third party for any purpose other than the delivery of the product itself.
Data generated by CLEARnotes will be retained for 7 days on the user’s interface and retained by 33n for the duration of the project. 33n retain the data for the duration of the project to perform a comparative analysis between original summary outputs and final outputs. This analysis will provide insight into how much post-processing editing was performed by the consultant and help improve the build of CLEARnotes.
This will be discussed and agreed upon with the relevant teams in each trust.
CLEARnotes sits on a cloud-based solution, utilising OpenAI product hosted on Microsoft Azure. This is accessed via our secure 2FA portal.
33n is currently working toward DCB0129 compliance as part of the DTAC.
No, currently CLEARnotes is designed purely as a transcription tool and so is not used to diagnose, prevent, monitor, treat, or alleviate a disease, injury, or handicap, or otherwise act in a way that the Medical Device Regulation defines as a medical device.
It is possible future developments of CLEARnotes may work to provide clinicians with recommendations based on the content of the consultation. 33n will ensure CLEARnotes is suitably compliant with the Medical Device Regulation and with the Medicines and Healthcare products Regulatory Agency before any such features are deployed.
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