AI scribe and clinic software for diabetes and endocrinology

The endocrinology note, built around the result and the dose

Built in wai's clinic template library, the diabetes template opens with the type and duration of diabetes, then the HbA1c trend with dates, the glucose data the endocrinologist reads aloud from the sensor or meter report, hypoglycaemia and its awareness, the treatment and every dose, injection sites, and complication screening for eyes, feet, kidneys, blood pressure and lipids. Thyroid, pituitary and adrenal templates follow the hormone axis in question, with doses, results and the next test. The clinic's template and phrase library are shared across every clinician, and the Clinician Plus plan adds bespoke templates.

Targets are set in figures. NICE says to support adults with type 1 diabetes to aim for an HbA1c of 48 mmol/mol or lower, and to offer a choice of continuous glucose monitoring.⁴ For type 2 diabetes, NICE sets 48 mmol/mol for people on diet or a medicine not associated with hypoglycaemia, and 53 mmol/mol for people on a medicine associated with hypoglycaemia.³ The draft records the target the clinician sets for that patient. wai does not read a sensor or pump download itself, so the data enters the note when the clinician reads it aloud.

Codes are suggested from the note, each beside the line it rests on. In ICD-10, used in the UK and the Gulf, typical codes are E10.9 for type 1 diabetes mellitus without complications, E11.9 for type 2 diabetes mellitus without complications, E03.9 for hypothyroidism, unspecified, E05.0 for thyrotoxicosis with diffuse goitre, E22.0 for acromegaly and pituitary gigantism, and E27.1 for primary adrenocortical insufficiency. US ICD-10-CM adds Z79.4 for long-term current use of insulin, and a US clinic confirms the full CM form of each code. SNOMED CT is suggested beside them, and procedure codes, CPT in the US and OPCS in the UK, stay with the clinic's coder.

Letters with doses, sick day rules and driving advice

Most endocrinology letters go to the patient with a copy to the GP. The Academy of Medical Royal Colleges recommends writing outpatient letters directly to the patient, makes that the default setting for an AI scribe, and says the clinician checks every document a scribe produces.⁶ The letter gives the result against the target, every dose in full, when to change it and the date of the next test. A medication change letter goes out from the same consultation when a dose moves.

Adrenal patients need written safety advice. NICE says to tell people with adrenal insufficiency how to obtain an NHS Steroid Emergency Card, when to take extra glucocorticoid and how to seek help when unwell.⁵ In the UK, a car driver on insulin must meet the DVLA criteria and must notify the DVLA, must not have had 2 or more episodes of severe hypoglycaemia while awake in the past 12 months, and must check glucose at the start of the first journey and at least every 2 hours while driving.² The licence holder carries the legal duty to tell the DVLA, and the clinician advises them of it.⁷ wai records the advice exactly as given.

Diabetes and thyroid care in the patient's own language

Self-management is most of diabetes care, and it depends on the patient understanding the dose, the sick day rules and the hypo plan. wai captures consultations in 60 languages, among them English, Arabic, Spanish, French, Portuguese, Italian, Russian, Polish, Turkish, Urdu and Mandarin. English can be mixed in one consultation with Spanish, French, Portuguese, Russian, Italian, Dutch, German, Hindi or Japanese, and the other languages are captured in that language, so a conversation about fasting in Ramadan can happen in Arabic or Urdu.

The signed note is written in English for the record, or in another language the clinic chooses. The patient's summary, with each dose and the sick day rules, can be translated into their language beside it, with emergency numbers kept exactly as written. The multilingual scribe page explains how each language is handled.

Clinic software for endocrinology clinics, from blood tests to recalls

Endocrinology runs on the next result. wai Admin sends recalls for the repeat HbA1c, the thyroid test after a dose change and the annual complication review, each message approved by a person. In the UK, pathology orders go out and results come back through TDL, and each result reaches the patient with the endocrinologist's own comment and a plain explanation of each marker.

Patients request appointments through booking links that read each clinician's calendar, cancellations backfill from the waitlist and reminders go out. Private prescriptions in the UK are issued and signed through SignatureRx. Calls, email, web forms and WhatsApp land in one thread per patient, and the patient memory brief shows the current doses, the last HbA1c and the last letter, each traced to its source.

After the visit, the signed plan goes home in plain words and each prescription, referral and follow-up is tracked until it is done. Memberships, deposits and payment links run through the clinic's own Stripe account, and family members can see results and letters with the patient's consent. The clinic management software page covers the full front desk.

One type 1 diabetes review, start to finish

Take a 41-year-old woman with type 1 diabetes for twenty years, on basal and mealtime insulin with a glucose sensor. Her HbA1c is 62 mmol/mol. The endocrinologist reads her sensor report aloud, with lows most nights around 3am and highs after breakfast. She still feels her hypos coming and has needed no one's help with one. She drives to work. They agree to reduce her basal insulin by 2 units and to adjust her breakfast ratio, and the endocrinologist reminds her of the DVLA rules for checking glucose before and during a journey.

The draft records the HbA1c trend, the sensor findings as read, hypoglycaemia and awareness, both dose changes with units, the injection sites, the driving advice and the plan to recheck in three months. wai suggests E10.9, beside the line it came from. The endocrinologist corrects the new basal dose, which the draft had misheard, and changes the code to E10.3 for type 1 diabetes with ophthalmic complications, because she mentioned background retinopathy at her last eye screening. Then she signs.

The medication change letter and the letter to the patient, copied to the GP, go out with both doses in full. The front desk sets the recall for the HbA1c in three months, ordered through TDL, and the result will reach her with the endocrinologist's comment.

The evidence behind wai's method

The note is one part of the day the evidence measures. In a randomised trial of 238 outpatient physicians across 14 specialties at UCLA Health, the ambient scribe with a significant effect cut the time spent writing each note by about 41 seconds, against 18 seconds in usual care.¹ Endocrinology is a results specialty, so wai also takes on the recalls, the results and the medication letters.

Endocrine guidance sets the content in figures and rules. NICE sets HbA1c targets for type 1 and type 2 diabetes,⁴³ lists what people with adrenal insufficiency must be told,⁵ and the DVLA sets the monitoring a driver on insulin must practise.² wai drafts to that content and holds every draft until the endocrinologist signs it.

Language changes outcomes. In a systematic review of 33 studies, 76% found at least one outcome better when patient and physician shared a language other than English.⁸

Measured in a working clinic. At The Wellness in London, which runs on wai every day, every clinician has 15 hours a week back, as published in the customer story.⁹

Where to start

Start with diabetes reviews for one endocrinologist. Build the template around the HbA1c trend, the glucose data, hypoglycaemia, every dose and the driving advice, run it for two weeks, and count corrections to doses and units. In the second week, switch on the recall for repeat HbA1c and results explained for the same patients.

Then add the thyroid, pituitary and adrenal templates and the medication change letter. The wai Clinicians page shows the scribe, the specialties hub lists the other specialties, and dietitians, podiatry and nephrology cover the teams that share diabetes care.

Frequently asked questions