AI scribe and clinic software for geriatric medicine

The geriatric note, domain by domain

The British Geriatrics Society defines comprehensive geriatric assessment as a multidimensional, multidisciplinary process that identifies a person's medical, social and functional needs and develops a coordinated plan to meet them. Its six domains are physical, psychological, functional, social, environmental and future wishes.¹ The template follows those domains, so the draft lands as a problem list with an action for each problem, and the conversation can wander as conversations with older patients do.

Frailty is scored on the Clinical Frailty Scale, a 9-point scale from very fit to terminally ill, judged from the person's baseline, how they moved, functioned, thought and felt over the last two weeks, rather than how they look while unwell.² NICE's 2025 falls guideline advises against using falls risk prediction tools to predict a person's risk of falling, and lists what a comprehensive falls assessment includes, among them lying and standing blood pressure, cognition and mood, gait, balance and strength, vision, continence, bone health and a medication review.³ The draft records each item as it is examined or discussed.

The medication review is often the longest part. STOPP/START version 3 holds 190 criteria for potentially inappropriate medicines and potential omissions in older people.⁴ The draft lists every medicine with its dose and indication, the ones the geriatrician decides to stop, reduce or start, and the reason given for each, so the deprescribing decisions survive into the letter. Guideline lookup answers questions in the room with cited sources, and risk scores are suggested for the clinician to apply.

In England and Wales, the Mental Capacity Act 2005 says a person is unable to make a decision if they cannot understand the information relevant to it, retain it, use or weigh it, or communicate the decision, and that a person is not to be treated as unable to understand if they can understand an explanation given in a way that suits them.⁵ A capacity note is about one decision at a time. The draft records the decision, the information given, how it was explained and what the person said against each of the four elements. Scotland has its own law, the Adults with Incapacity (Scotland) Act 2000, and US states set their own rules on surrogate decision makers.

Older patients often come with a son, a daughter or a paid carer. The template carries a separate field for the carer's account, and the geriatrician checks before signing that each statement sits with the person who made it. Where the patient agrees, the carer receives a copy of the plan and can have access to letters and messages.

Codes are suggested from the note with the line each rests on, for the geriatrician to confirm. In ICD-10, the edition used in the UK and the Gulf, typical codes are R29.6 Tendency to fall, not elsewhere classified, R54 Senility, I95.1 Orthostatic hypotension, F03 Unspecified dementia and M81.0 Postmenopausal osteoporosis. US practices see ICD-10-CM titles that differ, R29.6 Repeated falls and R54 Age-related physical debility, and can add Z91.81 History of falling. SNOMED CT concepts are suggested alongside, and procedure codes, CPT in the US and OPCS in the UK, stay with the clinic's coder.

The letters a geriatric clinic sends, and to whom

The Academy of Medical Royal Colleges recommends writing most outpatient letters to the patient with a copy to the GP, and says this should be the default setting for an AI scribe.⁶ For an older patient the letter sets out the problems found, what will change and who will do what, in plain words, with a copy to the GP and, with the patient's consent, to the carer or care home.

The medication change letter goes to the GP with each medicine to stop, reduce or start, the reason and what to monitor, so the repeat list changes and the decision is not reversed at the next prescription request. Referral letters go to the falls and strength and balance service, a memory clinic, community therapy, or a specialist colleague, each carrying the question for the specialist and drafted from the whole record. The structure is in the referral letter, and the end-of-life conversations that often follow are covered in AI scribe for palliative care.

Geriatric medicine in the patient's own language

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 the language spoken.

Older patients who learned English later in life may be most at ease in their first language, and a family may want the plan explained in the language spoken at home. The signed note is written in English for the record, or in another language the clinic chooses, and the patient's summary, with the medicine changes, can be translated beside it for the patient and the family. Crisis and emergency numbers stay exactly as written. The detail is on the multilingual AI scribe page.

Clinic software for geriatric medicine clinics, with the family in the loop

Geriatric practice runs through families as much as patients. In wai Admin, calls, email, web forms and WhatsApp messages land in one thread per patient, whether they come from the patient or a daughter, and replies are drafted in the clinic's voice for a person to approve before they are sent. Family and carer access is set up with the patient's consent. Booking links read each geriatrician's calendar, cancellations backfill from the waitlist, and reminders go out. Reviews for housebound patients can run on video, with the scribe joining the Google Meet, Zoom or Microsoft Teams call.

The after-visit companion sends the signed plan home in plain words and tracks each prescription change, referral and follow-up until it is done, so a deprescribing plan does not stall between the clinic and the GP's repeat list. Proactive care sends the recall for the medication review, the repeat bloods or the bone density scan, each approved by a person. In the UK, pathology orders go out and results come back through TDL, and private prescriptions are issued and signed through SignatureRx. Each result reaches the patient with the doctor's own comment and a plain explanation of each marker.

Before each visit the geriatrician sees a sourced brief of the patient, each fact traced to the letter, result or visit it came from, so the hospital discharge letter, the last falls assessment and the cardiology opinion are summarised in one place. Deposits, invoices, memberships and insurer invoices run through the clinic's own Stripe account. The full front desk is on the clinic management software page.

One falls consultation, start to finish

Take an 84-year-old woman with two falls in three months, on eleven regular medicines, who comes with her daughter. The geriatrician takes the falls history, scores her at 5 on the Clinical Frailty Scale, living with mild frailty, records a lying blood pressure of 148/82 and a standing one of 122/74 after three minutes with dizziness, tests gait and balance, and goes through every medicine. They agree to stop doxazosin and oxybutynin, taper zopiclone over four weeks, refer to a strength and balance programme and arrange a bone density scan. She has capacity for these decisions and agrees that her daughter can see the plan.

The draft holds the six domains as a problem list, the frailty score, both blood pressure readings, the medicine list with the three changes and the reason for each, and her consent to share with her daughter. Suggested codes are R29.6 Tendency to fall, not elsewhere classified, and I95.1 Orthostatic hypotension, tied to the lines where each was found. The geriatrician moves one statement, that she gets up twice at night to pass urine, from the patient's account to the daughter's, where it belonged, confirms the codes and signs.

Four documents go out. The letter to the patient explains the plan in plain words, with copies to the GP and the daughter. The medication change letter asks the GP to remove doxazosin and oxybutynin from the repeat list and sets out the zopiclone taper. The referral goes to the strength and balance programme. The front desk grants the daughter access, books the bone density scan through a booking link, and sets a recall for a medication review and repeat lying and standing blood pressure in six weeks, approved by a person.

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.⁷ wai is built on that finding, so it takes on the letters, the carer messages and the medication follow-up as well as the note.

Geriatric medicine is defined by a structured assessment. The BGS sets six domains for comprehensive geriatric assessment,¹ NICE sets the items of a falls assessment,³ and STOPP/START sets 190 prescribing criteria.⁴ A template built on those structures means each domain is either documented or visibly empty.

A draft stays a draft until a person signs it. The Academy of Medical Royal Colleges says the clinician checks every document a scribe produces,⁶ and wai holds every draft until the geriatrician signs it. 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 new patient falls or frailty assessments for one geriatrician. Build the template on the six domains with fixed fields for the frailty score, lying and standing blood pressure and the medicine list, run it for the first week, and count corrections to speaker attribution and doses. In the second week add the medication change letter and switch on carer access and medication review recalls in wai Admin.

Read patient consent for AI scribes before the pilot, since carers are often in the room, and compare other specialties on the specialties hub. The scribe is described on the wai Clinicians page.

Frequently asked questions