AI in the clinic
Why we'll never let the AI sign a note
Human-in-the-loop isn't a compliance checkbox, it's the design decision everything else follows from.
8 min read
Drug–drug and drug–allergy checks run on every prescription. A dangerous combination blocks; where the prescriber goes past the block, the override is logged with the reason. That is the mechanism this article describes — what it reads, what it stops, and what it writes down afterwards. It starts on the Pro plan.
The block, and the reason beside it
The check runs on every prescription, and a dangerous combination blocks. It is not a note at the edge of the screen that the prescription completes around: the checker's output is a blocking alert, and a dangerous combination is blocked.
The second half of the mechanism is the override. Doctopass logs it with the prescriber's reason: where you judge that this combination is the right one for this patient, the decision is recorded next to the block that preceded it. A barrier that cannot be crossed stops care; a barrier crossed with no written reason is one nobody can explain a year later.
How often the block fires follows your prescribing rather than our software. The arithmetic is yours to run: the number of prescriptions you write in an ordinary week, set against the share of your patients carrying more than two long-term medicines. That is the surface the check works across.
What the check has to read
The checker cross-references every prescription against the patient's current medication and recorded allergies, via RxNorm and the local formulary. Two pair types are checked: drug against drug, and drug against a recorded allergy.
RxNorm is a normalised drug vocabulary that gives every medication a stable identifier independent of its brand name. The Tunisian formulary completes it; together they are the reference the checker crosses each prescription against. The record side of that — how the prescription itself is stored, signed and verified — is the subject of electronic prescribing.
The other half of the input is the record. Unlimited patients and an 11-section medical history are on all three plans, Essential included — that is the one record the prescription is written beside, and without it the check has nothing to read.
Where the override goes afterwards
The override is logged with the prescriber's reason. That is one fact. Here is a second, separate one: full audit logging records every access to patient data — who viewed it, who changed it, and when — and the trail is searchable by the doctor, so "who saw this record?" has a precise answer.
They are two mechanisms rather than one, and they answer two different questions: the first says what happened at the moment of prescribing, the second says what happened to the record around it. Both turn on one computerised patient record.
The trail has a plan line of its own. The full audit trail is on Pro and Premium. Audit log search and the investigation UI — the tools that turn a trail into an answer — are on Premium only. That is the kind of thing better known before the question is asked than during it.
A check is not a decision
Every AI output in Doctopass is a draft. The doctor reviews it and explicitly signs before anything enters a patient record; there is no automatic finalization, no silent write, and no AI decision that reaches a chart without a physician's name on it. Nothing is saved to the record until you sign.
AI-drafted content is visually distinct, marked in violet and framed as a draft until you approve it; on approval the draft converts to a finalized record under your name. Elsewhere in the product the same rule shows in the shape of the output: image assist returns a ranked list of differentials with its reasoning rather than a verdict — a second pair of eyes that informs judgement and does not diagnose. That is why the AI never signs.
We will not publish a list of combinations that should stop a prescription, and we will not tell a doctor what to check before writing one. The clinical judgement is the prescriber's, and the reference that binds is the prescriber's own. What we describe is the software's behaviour at the moment of prescribing: it crosses, it blocks, it records the reason.
What Essential does not check
On Essential the prescription is signed and QR-verifiable, and the checking layer is not included. The digital prescription — SHA-256 signed, QR-verified PDF — is on all three plans. The interaction checker and the allergy safety block start on Pro. The chain from the check to the record it is written into reads like this:
| Capability | Plan |
|---|---|
| Digital prescription, SHA-256 signed, QR-verified PDF | Essential, Pro, Premium |
| Drug–drug and drug–allergy interaction checker (RxNorm + Tunisian formulary) | Pro, Premium |
| Allergy safety block | Pro, Premium |
| Full audit trail | Pro, Premium |
| Audit log search + investigation UI | Premium |
We would rather write that limit down here than let it be discovered after signature.
Worth remembering
Write the prescription with the record open, so the check has something to cross it against; where you go past a block, the reason goes into the record with you. The checker reads two pair types — drug against drug, and drug against a recorded allergy — via RxNorm and the Tunisian formulary, and it starts on Pro. Doctopass blocks the combination and records the override; it does not decide the prescription.
Frequently asked
What happens when the software blocks a prescription I intend to write?
The prescription does not complete on autopilot: the dangerous combination blocks. The path past it is the override, and the override is logged with your reason. Doctopass records the block and the reason beside it and stops there — the decision to proceed is yours, and it stays yours.
Does the check know what the patient is already taking?
It cross-references every prescription against current medication and recorded allergies, via RxNorm and the local formulary. That is why the record matters: unlimited patients and an 11-section medical history are on every plan. Two pair types are crossed, drug against drug and drug against a recorded allergy.
Does an override count against me?
Doctopass logs the override with your reason, which is what makes a decision taken knowingly still look like one a year later. Separately, full audit logging captures every read and every write on the record; that trail is on Pro and Premium, and audit log search with the investigation UI is on Premium. We would rather name that gate here than let it be found on the day someone asks who saw a record.
What does the checking cost?
Essential, at 69 DT, signs the prescription and makes it verifiable, without the checking layer. Pro, at 159 DT, adds the drug–drug and drug–allergy interaction checker and the allergy safety block. Premium, at 269 DT, adds audit log search and the investigation UI. Per doctor, per month, billed annually, with a 14-day free trial; the full comparison is on the pricing page.
A check that arrives after the signature is an archive, not a safeguard. To watch the block fire and the reason land beside it, request a 30-minute demo — and bring two prescriptions you have actually written for a patient on four long-term medicines.