This article is part of our series, The Clinician’s Perspective, where we explore the intersection of AI and healthcare through the eyes of our team – former clinicians who understand the realities of patient care firsthand.
Making AI Work on the Ward: Lessons from the Frontlines of Secondary Care
It’s a familiar scene in most hospitals. Morning ward rounds begin with purpose—but quickly become a blur of motion, noise, and half-heard instructions. A junior doctor trails behind the consultant, steering a computer on wheels, trying to log in, find the right patient record, and type fast enough to capture the plan being dictated at speed. It’s not about forgetting—it’s about falling behind. The tech is slow, the interfaces clunky, and the pressure to “just get it down” means key clinical detail often slips through the cracks. This is where many of us start our day—not at the bedside, but battling the system that’s meant to support it.
This invisible weight defines much of modern medicine. As clinicians, we chose this profession to heal, connect, and lead. Yet, we’re spending nearly 40% of our time on documentation and admin tasks instead. In secondary care, this is not just frustrating—it’s dangerous. Burnout among junior doctors is endemic, waiting lists stretch endlessly, and the time of our most skilled specialists is increasingly hard to come by.
It’s no wonder that the adoption of AI medical scribes is taking off in primary care, where the efficiency gains are immediate and tangible. In fact, GPs are now the heaviest users of Tandem. But the area of greatest need—and greatest challenge—is secondary care.
The Challenge: Why Secondary Care Has Been a Tough Nut to Crack
Despite accounting for the largest share of the clinical workforce—over 130,000 specialist doctors compared to 36,000 GPs in primary care - hospitals have seen slower adoption of AI scribes. The reasons are not technical; they’re systemic.
Secondary care is complicated and fragmented:
- Many hospitals still rely on legacy computer systems that don't work well together
- Hospital doctors often can't choose their own tools, even when they are proven to help
- The approval process for new technology is lengthy, with decisions typically made by managers disconnected from frontline patient care
- Each speciality works differently and needs its own specific documentation approach
This complexity isn’t an excuse. It’s a reality we need to design for.
Our Approach: Built for the Reality of Hospital Medicine
At Tandem, we’ve taken a fundamentally different approach, shaped by clinicians like myself who have lived the secondary care experience.
Product
- Designed for legacy systems: We use intelligent screen reading technology to send notes directly to the medical record system, ensuring seamless integration without disrupting existing workflows.
- Built by clinicians, for clinicians: With deep roots in secondary care, we understand the nuances, from documentation habits to speciality workflows.
- Cross-platform support: Recognising the mobility of hospital clinicians, Tandem is optimised for use on the move—from handheld devices to shared terminals
Approach
- Speciality-led development: We work closely with frontline clinicians in targeted specialities, co-developing templates, vocabularies, and note styles that feel native.
- Engagement beyond the ward: Our commercial team actively partners with healthcare leaders, helping them understand the value and clinical impact of AI scribes.
- EMR partnership: We integrate with the existing electronic medical records and platforms hospitals already trust—lowering barriers to scale.
A Way Forward
This isn’t about replacing doctors. It’s about restoring their time, focus, and presence because those are the scarcest and most valuable resources in healthcare. If we get this right, AI scribes won’t just be another tool. They’ll be a quiet revolution in care delivery—lifting burdens, reducing errors, and letting clinicians do what we do best. Secondary care is hard. But it’s worth the effort. We’re not here to retrofit a GP tool into hospitals. We’re here to build the right thing for the people who need it most. Let’s get to work.
About Dr. Ian Robertson
Dr. Ian Robertson is a trained NHS surgeon with over a decade of experience in secondary care. He has worked at leading UK hospitals, including Charing Cross and St George’s, specialising in urology and robotic surgery. Ian also holds an MBA from London Business School, where he focused on healthcare strategy and was awarded the Healthcare Scholarship for leadership in medical innovation.
Before joining Tandem, Ian led national improvement programmes and advised major NHS trusts on clinical operations and service redesign. Drawing on his deep understanding of hospital workflows and system challenges, he now leads Tandem’s commercial efforts to bring AI scribe technology into secondary care, working closely with clinicians and NHS leaders to improve frontline efficiency, reduce burnout, and protect time for patient care.
If you’d like to explore how AI scribes can support hospitals, feel free to connect with Ian on LinkedIn.
