Kirsty is the Clinical Review and Assurance Manager for HHSJ, overseeing clinical care and contributing to organisation-wide improvements in clinical practice. Kirsty is a Paramedic with extensive prehospital experience. She has her Postgraduate Diploma and is undertaking a Master of Philosophy, focusing on paramedics’ ability to recognise metabolic emergencies.
Sovereign AI and Automated Auditing: The Future of Clinical Auditing
Mrs. Kirsty Reekers1, Mr Jon Moores1
1HHSJ – Hato Hone St John, New Zealand
Abstract
Background
Hato Hone St John (HHSJ) interacts with nearly 700,000 patients annually. Clinical audit and peer review are essential for ensuring safe, effective care and meeting contractual, accreditation, and legislative requirements. A volunteer-based review process covers 5% of electronic patient records (ePRFs) and 1% of clinical conversations undergoing peer review. Expanding this process will help align with safety, quality, and compliance targets. Furthermore, HHSJ aims to enhance auditing capabilities through improved real-time data collection to support clinical decision-making and safeguard at-risk patients. Generative AI presents a transformative opportunity to enhance clinical audits’ efficiency, compliance, and effectiveness.
Actions
Clinical Governance initiated a Proof of Concept (POC) utilising Generative AI to audit simulated cases based on the “Falls” Clinical Practice Guideline (CPG). A specialised large language model (LLM) was developed to align with HHSJ’s CPGs and Peer Review/Clinical Audit protocols.
Results
Generative AI successfully processed clinical records, producing insightful peer reviews to support clinicians. The LLM’s capabilities can be expanded to include peer review of audio records and serve as a foundation for advanced clinical decision support. With proper training, this system could autonomously review all ePRFs, enabling HHSJ to:
- Achieve full compliance with regulatory requirements
- Improve audit quality and clinical oversight
- Enhance data security
- Optimise resource efficiency and cost-effectiveness
- Drive continuous clinical improvement
Conclusion
This pioneering LLM marks a significant advancement in clinical governance. Its implementation will enhance patient safety, optimise audit accuracy, and support data-driven decision-making, reinforcing HHSJ’s commitment to delivering high-quality healthcare.