So welcome to this webinar sponsored by Covet on how we move from having feelings of, of being burnt out in veterinary medicine to something that can help us have a bit more breathing room and breathing space. Start with who I am, Doctor Adele Williams X Xavier. I am a vet, and I, I'm a veterinary AI expert in, in the industry, and I am a UK country representative for COVED.
Just to talk you through my career pathway so far and, and how I came to be working in AI. I graduated from the University of Bristol in 2003. I did a, a small stint in, mixed animal first opinion practise before going to the RBC to do an internship there.
I then after that, locumed for a while in, first opinion practise and worked in private referral equine practise before going on to the University of Liverpool to do. A residency in equine internal medicine. At the end of that I attained my, diploma status as a, as a specialist in equine internal medicine with the European College of Equine Internal Medicine.
Following that, I did some locuming in first opinion practise, referral practise and did a PhD in equine asthma at the University of Manchester. Following on from that, I went to work at the University of Surrey, where they were starting to set up a veterinary degree and I was the er lecturer in equine medicine at the University of Surrey and helped to set up the equine part of the degree course there. Following on from that, I did some er locuming in small animal first opinion practise and equine practise, both first opinion and referral before going to the University of Pretoria, where I worked as a senior clinician in equine medicine, teaching students, doing clinical research and working in the busy, equine referral clinic.
following on from that, I had some health issues which led me to needing to do a job which was more computer and home-based. And so I started working for a company called Vet AI and I started working with them on their AI projects. I became the director of research and development in that company and I was with them for 5 years and I was overseeing all the AI projects that that they were building, .
Coming up with new ideas for AI tools that would be helpful in in the. Animal health space and sort of being the, the clinical oversight to, to those tools. So that led me into the, the AI world.
Subsequently, after Vet AI I started up my own, independent AI consultancy for the veterinary, profession, AIWX Limited, and I started working to increase AI literacy within the veterinary profession to support, . Vets and and veterinary businesses on their AI adoption journeys, and also started consulting for veterinary technology companies on how to make their AI product best for what's needed in in the animal health er markets. And that's where I came across CVt and started working for them as an external consultant.
Before deciding that I really liked their team and and the product that they have, and so came on board with them part time er last year. Er so I now work with CVD, I've worked in the medical team. I work on the partnerships team and I'm the UK veterinary lead for COVID.
So what I'm gonna talk about today. Is the burden that we face every day in the consult room in veterinary practise, and, . And why that that is a burden within our clinical workflow, and then point to a solution where AI can actually help really reduce some of this burden and support us to stay doing what we actually want to be doing.
In er in our clinical working day, and then finish with what we can take, take away straight away as a result of this, and, and this is sponsored by Covert, but the, the advice that I give is, is to all agnostic, so, yeah, just, just bear that in mind as we go through. I think the the first thing to confirm is that documentation, admin stuff that we have to do as part of our daily lives when we're consulting is clinical work. So .
From making notes, taking histories, summarising what our thinking is, creating instructions for owners that are owner friendly, writing referral letters to referring vets or or referring vets, writing letters back to, to referring vets, is all, a heavy burdenous thing that we that we, we do as as a natural part of our, of our daily work, but doesn't necessarily. Give us the same reward as, doing the clinical examination and thinking about how to treat the patient and and speaking with the owner. But they're they're things that we have to do, and then, you know, following the, the appointment, the follow-ups, they all carry weight clinically, .
But we don't necessarily have time during our consultation to to do all of them and push it to the end of the day or or during our lunch break, our coffee break time, you know, it all gets eaten up by doing the the admin side of things and or it gets, you know, pushed to the weekend when we when we're catching up. So this this makes it feel really heavy. So, you know, if we think about.
A standard veterinary consultation, and that the stuff that we do in that, the, the first thing that we do is we have to take a history, we have to understand what's going on with that patient, . Ideally before the owner and the patient comes into the room or before we speak to them, because we need to start assessing mentally what what could be going on with that patient by getting the relevant history. So that starts before we even see them, and then it's the first part of the conversation that we have with the client as well is is finding out what's gone on in the long term past of the patient, but also, you know, the immediate, you know, reason that they're presenting to us today.
So, so that needs to be documented, it needs to be summarised mentally by us and it needs to go into the notes. The notes obviously are the foundation of the clinical record. And these are something that need to be clear, need to be concise, need to be something that the next person or or when we view it, the next time we see this animal, we can easily understand what has happened the last time the animal was seen.
And they are a a legal sort of record of of what happened during that that consult conversation as well, and also a record of what your clinical thinking was. So it's foundationally that the notes are, are, are clinical work and it's important that they reflect. What we think clinically, so they have to reflect, you know, our, our own words and our own thinking.
So, so when we've done the, the history taking and we've done the, the, the speaking to the client and the clinical examination, we start to formulate in our minds . What we think the problem could be, what our next actions should be in terms of the diagnostic plan, what the plan is for for management and and we need to synthesise this all into a summary, so we need to summarise the history, the, the clinical examination findings, we need to summarise our problem list and our differential diagnoses, what, what the potential differential diagnoses are, we need to . Indicate what our plan is going forward and, and what the how the conversation has gone with, with the client.
So that all comes into summarising in, in the notes. We then have to consider discharge instructions, you know, how are we going to Get all this information, this conversation that we've had with the client into into a format that the client is going to take home with them and remember. And traditionally, you know, we say there's a there's a huge amount, number of things that that can be said during a consultation and recommendations that we give to a client about how to take care of the patient and what the next steps are between the end of the consultation and when we're going to catch up with them next.
And. We know that the owners regularly fail to remember everything that's said to them. In fact, probably if we say 5 things, they're they're going to only remember 1.
So, we either live, live with that situation, which isn't great, aftercare for the patient, or we find a way of putting our spoken word and our recommendations into. Written format for the owner to refer back to at the end of the consultation after they've left the practise. And and so if we make that into written format, there's an extra burden there of creating these discharge instructions and what you put into them and how you do it in an owner friendly.
Terminology, and then there's the follow-ups afterwards and, and our communication with clients going on from there and, and what of that goes into the record, you know, if we, if we ring an owner. Does that conversation get logged and go into the records so that when somebody else picks up the case or me in a week's time when I've forgotten what I said, you know, can refer back to actually in the notes, oh, this is what's happened subsequently to the last time the patient was examined. And getting all of these things down.
Is really important part of clinical work, but it also feels, you know, it's quite admin heavy, some actually, you know, the recording of this stuff in the traditional way that we're used to doing in practise. So, you know, there's a lot of requirement for us to remember a lot of things and to get them down, electronically into the, into the patient's record on the practise management system. And then there's there's extra burdens like .
Insurance claim forms and letters to referring vets if we've got to refer something, you know, people sometimes want other summaries of things and so there's a lot of things that we have to do outside of the 10 or 15 minute consultation time that we have. That just adds on time somewhere else in our day. With me, that would normally be, I would just lose my lunch time.
I would be eating and typing at the same time or or I'm going back onto my computer later in the day. So, you know, just remember all this. So, so that's what I mean by the work then follows you home.
There's this second shift. It's not just the time where you're spent in the consult room speaking to the owner. And, thinking about things and writing things down, that this stuff, this stuff follows us home or eats into, other time that should be protected during the day.
So, so time for for coffee breaks and time for for having a lunch hour. And . You know, that that that's that's an extra burden and it and it becomes reality, it becomes everyday normal, it's normalised that we work through our lunchtimes, we work past the end of the day or we come back to stuff later on in the evening or on the weekend.
And it's clear to see that that's part of why we become burnt out in veterinary practise, because there's this extra. Work on top of just as the natural worry about our patients and are we doing the right thing and, you know, that there's all those extra thoughts that that come into your mind. What this looks like in reality, it depends on how you work during your day.
And there's different ways of of vets working, and either you're somebody that tries to type your notes while you're having the consultation with the client, which then ends up with you typing with your back to the client and not engaging with them and, and actually focusing on the patient in front of you. And then you're, you're probably typing and not focusing on what you're typing and your notes have full of spelling errors and . And omissions and and not nice and easy to follow the next time you pick up the case or someone else picks up the case, or you're the sort of person that waits until the client has left the room and then you're summarising your notes, which then pushes your consult time up and stretches you and pushes your your your consultation list into into .
Lunch breaks and and you have the stress of a waiting room full of people because, because you're running behind all the time, you're trying to play catch up. Or you're you're doing this at the end of the day. So, so, you know, often I think of myself, particularly as a working mum, and I have a time at the end of the day where I have to leave because I've got to go and get my children from childcare before the childcare facility closes.
So then at the end of the day when I'm Physically and mentally exhausted from the work that I've done during the day and I see a case and I'm I'm in a rush to get those notes done because I've got to leave on time. So then I write my notes quickly just to be able to get the consult finished and because I've got another deadline that I've got to get to and you know, as a mum is one example, but we all have, you know, outside of work commitments to get to. Or if we don't, we then sacrifice the time that we're finishing and we're staying late and we're not necessarily getting compensated for staying late as well.
And then I'll be driving home or picking up the kids or something and then I'll realise, oh, I forgot to put that in, or. Oh, you know, I dispensed this medication and I forgot to charge for it, and things like that where I've I've forgotten to add important details. So then I have to somehow make a note on my phone or or later in the evening, open my computer again and get those notes in and either do it at home on my laptop or on my phone and send it over, or actually, you know, reopen work software in the evening.
And for me, I have to prioritise getting my kids to bed, so then then I'm working late into the night to do these things and and it's just it it doesn't feel like a very sustainable way to work and that's just how we have been working for so long and I know I'm not alone in in that description. So this is where, you know, one of the things that really excites me about AI is that there are AI solutions that can really help with this and that can make our working lives better and get us time back and reduce that pressure and help us to remember stuff and help us to get our notes in order and, and, and just really be an assistant during the time of the consultation. There's loads of of value that an AI tool can can pick up from the data, the information that we share.
In our, the way that we speak to the client and the client speaks up to us, that means that we can now do all those things that I've listed at the touch of a button, it can be automated, it can be so much smoother than what we've been used to doing, and that saves us that time. It gets us our coffee breaks and our lunch breaks back and gets us leaving better, but it also means that we don't have the risk of forgetting to add things into the notes because everything has been captured, and I think that that is, you know. It it's a phenomenal change in the way that we can potentially be working.
In veterinary medicine. So there there are great ways that AI can help. There are also places where, where it shouldn't be taking over as well, and I think it's important to remember that.
So the, the, the place where AI can help is, is, particularly with the AI scribes listening. So ambient listening to the conversation between the, the vet and or the vet nurse and, and the client and capturing all of that information. The AI scribes are really clever that they will cut out the irrelevant part of the conversation that's not relevant to .
To the conversation, so when clients start talking about their personal problems, what they're doing on holiday at the weekend, etc. That doesn't make it into the clinical records, which is, you know, really important that that that is, it is cut out, but they do capture the whole conversation, so everything that you've said to the client is, is there and recorded and transcribed into written word, but then not only transcribed into written word, summarised into. Into nice formatted notes that are structured, .
That are easy to review. What's really important in this is that you do check that the notes reflect what your clinical thinking is, that they reflect the way the conversation went and your clinical judgement remains part of it. What you don't want to do is use an AI scribe to capture the conversation, summarise it, and then you don't check it and there's an error in there, because AI like any other tool, it can be prone to error, and so it's really, really important that .
The decision making remains yours, that the clinical interpretation of the case remains yours, that you have your say, so use AI to capture the conversation, summarise your notes. Have a look at it, check it, add in anything, take away anything that you think is not right, and then you can get that put directly into the the the medical record of the patient. At the same time, you can also get it to generate discharge instruction for the owners in lay terms, so at an owner understandable level.
So the owner can take that away with them after the consultation as well. The other thing that you can do with the. With COVID as an AI scribe is, is after the consultation, if you have a follow-up phone call, you can get that transcribed, and then you can get it summarised at the click of a button and put into the the medical records as well.
So you've then got continuity of all the communications about that patient in the medical records where they need to be, and not just in your head that you forget to to put the detail. Because the whole of the conversation is captured, it helps you remember exactly what was, was said and done. There can be reminders about billable things that you've done, so you're you're less likely to forget to put something in.
COVET has a tool for, for listing tasks, so every, if you've, if you've spoken about things that you're going to do after the consultation, you can have a, you know, some tick lists to remind you of the things that you said you'd do, which just helps you, organise your day and not forget to do things that are important. So it takes away that burden of worry when you're driving home and you've got the kids, oh gosh, I forgot to do that. There's reminders already built in for you, which is really, really helpful.
So it's great for doing all these things. There's additional things that can be done with that information. So like I said, writing a letter to a referring vet, and writing a letter to an insurance company can all be done at the click of a button at the end of the consultation rather than you having to think about what you're writing and finding time to do that as well.
You then just need to check through that it is in alignment with what you were you were saying and thinking, and then you can send it, which is great. So, The way that this sort of works with, with the AI scribes is you. Just allow it to record during the consultation, so you speak naturally.
The more that you say that's in your mind, the more that you verbalise for the benefit of the AI scribe, means that everything will be recorded. If you, if you use an AI scribe but you don't say very much, then it's not gonna be able to make notes on stuff that isn't said. So it's important to speak naturally, but describe to the client everything that you're doing, and .
And it will all be captured and then the notes can be made from it. And what's great is that the AI scribes can work in multiple languages as well. So you can produce outputs for clients that aren't necessarily native English speakers in their own language, which is, which is super helpful as well.
You generate, at the end of the consultation, you generate what is, what is what you need. So if you need soap notes, if you need an owner discharge, if you need a referral letter, you can just click the boxes and it will generate those. You then.
Refer you then look at all of those, you review them. Check, edit, approve, what is, and then the notes get finalised and you put it into the practise management system. And you can not only put them into the practise management system, you can share with your admin team for them to send off to people.
You can share directly with the client by emailing them directly. You can have it put into different places, you know, at the click of a button. So it's a really nice.
Smoother way of working and and just allows you to get those things done that otherwise you would have been going into your lunch break to do or doing at the end of the day or on the weekend, which is, which is great. What this looks like inside the consult room. Is that you can have a device, be that a browser on your computer or a tablet or even on your phone, you can have that just listening to the conversation with the client, while you have your hands on your patient and you're engaging with the client.
And this actually really improves engagement of vets with clients and what we see is that there are happier clients. And, and stickier clients, they're much more loyal customers because. They feel that the vet is talking to them and explaining things to them much better and isn't stood with their back to the vet while they're to the to the client while they're typing.
And they are explaining all the elements of the clinical examination and what they're finding and what it means, for the benefit of getting the notes right, but also it's for the benefit of the client as well. And the added bonus is that the conversation is logged, so if there are any disputes that arise from clients. You can go back and review the notes that were made from the audio transcription, and you can see exactly what was or wasn't said, and that helps to resolve disputes really quickly, which is nice.
So, so that's great. So I think that there's there's 3 takeaways from this, from this webinar, really, the small things that you can take away and and think about immediately for, for today, tomorrow, next week, for, for, for using these AI tools. Is that er documentation is clinical work, it should support care and not compete with it, but at the same time, there is now a way, there is a solution to make that documentation less burdensome.
It doesn't need to come after the the clinical examination and the history taking, it can happen at the same time. It can happen in parallel. So, so that really, really helps to to make us work in a better way and engage better with our clients on what we're doing.
It's really, really critical to remember that the responsibility for the notes remains with you as the veterinary nurse, the veterinary surgeon, and that you have to check what the AI scribe has produced, and you have to make any edits and you have to approve it before you send it into the, into the medical records. That's really important to remember that any tool can make a mistake and you have to check. The, the output of the tool and you remain responsible responsible for, for what is written.
And you know, the easiest way to start working with with AI, in veterinary medicine is to, to choose something that is gonna help immediately reduce the burden and . And you know, tackling that thing that's causing a real problem at the minute that we've just all naturally just taken on has become part of natural life working as vets, that we eat into our lunch hours and we work on the evenings and weekends. So let's start with something where there is an available solution and start from there and it will.
Help us all feel better about coming to work, engage better with our clients, give us time back that otherwise is taken up doing these extra burdens outside of compensated working hours, and also has, you know, extra bonuses of helping us, do itemised billing better by remembering stuff that we might otherwise forget, by having structured notes that are easier to review next time. Also, there are tools for helping us summarise long medical history, so that's time saving as well. So, so there's lots of ways that we can start using these AI tools, .
To help reduce that burden and and reduce the, the burnout that we feel in the veterinary profession. And that is me done, so thank you very much.
