Executive summary
The clinical AI market for doctors has matured rapidly. In 2025, it's no longer a collection of speculative pilots but a bifurcated landscape of five distinct, practitioner-relevant domains: evidence & reference, ambient documentation (AI scribes), diagnostic/differential support, training & OSCE comms, and regulated imaging/diagnostics. We are now seeing the launch of powerful new generative AI tools from major incumbents, such as UpToDate Expert AI and EBSCO's Dyna AI, which are competing directly with high-growth, AI-native platforms.
For UK clinicians and procurement teams, this explosion of choice makes governance more critical than ever. The key to safe adoption is to screen all new tools for their compliance with DTAC, their alignment with NICE's Early Value Assessment (EVA) pathway, and their regulatory status, particularly in emerging sandboxes like the MHRA AI Airlock for AI as a Medical Device (AIaMD).
How to read this review
This review is structured by clinical domain—the "job-to-be-done"—rather than by brand alone. A tool that is excellent for documentation (an AI scribe) may be unsuitable for diagnostic support. We evaluate tools on a common set of pillars:
- Evidence base & citations: Is the knowledge source clear and verifiable?
- UK-source coverage: Does it understand and prioritise UK guidelines (NICE/CKS/SIGN/BNF)?
- Integration: How easily does it fit into an EHR (EMIS/SystmOne) or mobile workflow?
- Governance & assurance: Are there clear signals of DTAC, MHRA, or NICE alignment?
- Cost & access: Is it a free tool, an enterprise licence, or a per-user subscription?
Evidence & reference (Q&A over guidelines and summaries)
Use-case: Getting fast, cited answers to clinical questions during a ward round, clinic, or for exam revision.
- UpToDate Expert AI: The new generative AI layer built on top of the trusted UpToDate editorial corpus. It's an enterprise-oriented solution designed to provide conversational, evidence-grounded answers within the UpToDate ecosystem.
- DynaMedex + Dyna AI: EBSCO's generative AI assistant, which provides RAG-based (Retrieval-Augmented Generation) answers from the curated DynaMedex and Micromedex content. It has recently become available for individual clinician subscriptions.
- OpenEvidence: A powerful AI-assisted evidence synthesis tool that is free for verified healthcare professionals. It excels at summarising peer-reviewed literature from a global perspective.
- iatroX (UK-centric, free): A clinical assistant built for UK practice. Its Ask iatroX feature provides citation-first answers from a "walled garden" of UK guidance (NICE, CKS, SIGN, BNF) and peer-reviewed research. It's free and includes integrated CPD logging and an adaptive quiz engine.
Editor’s note: For any UK NHS use, procurement teams must require citation-linked outputs and clear source provenance as part of the DTAC due diligence process.
Ambient documentation & AI scribes
Use-case: Reducing the administrative burden of note-taking to free up time for direct patient care.
- Microsoft Dragon Copilot (Nuance DAX): The market incumbent, combining its long-standing Dragon Medical One dictation with the ambient DAX Copilot. Its UK launch into NHS systems in 2025 makes it a major enterprise-grade option.
- Abridge: A high-growth ambient intelligence platform adopted across over 200 US health systems, known for its deep EHR integrations and proven productivity gains.
- Suki: A voice assistant with ambient note generation and multi-EHR integrations (Epic, Oracle Cerner, etc.), which is now expanding into features like ambient order staging.
- Augmedix: Offers a portfolio of solutions, from fully AI-driven scribing to hybrid models that include human quality assurance support.
- Nabla Copilot: A European-grown ambient scribe that has gained significant traction for its clinician-friendly user experience.
- NHS evidence signals: The AI scribe space is supported by strong local evidence. An HSJ report on the largest NHS ED ambient-voice trial (involving Tortus) modelled potential staff-time savings of ~£834m nationally and a 13% increase in A&E throughput.
Diagnostic & differential support
Use-case: Augmenting a clinician's reasoning to broaden differentials, counter cognitive biases, and highlight "don't miss" conditions.
- Isabel DDx Companion: A mature, ML-based differential diagnosis engine with a long history of validation. It is designed to retrieve relevant diagnoses from a brief clinical summary.
- Glass Health: A popular AI CDS tool designed to help clinicians scaffold a differential diagnosis and draft a full management plan, with inline references.
- DxGPT: A GPT-4-based tool specifically focused on supporting the diagnosis of rare and paediatric diseases. It has been notably piloted in Spain’s public health system (SERMAS).
- iatroX Brainstorm (UK): An educational and reference tool that generates a structured differential and investigation plan, with "don't miss" flags, all contextualised to UK guidance and linked to the iatroX Knowledge Centre for verification.
Training, OSCE & communication practice
Use-case: Rehearsing for high-stakes practical exams (like PACES/SCA) and improving communication skills in a safe, simulated environment.
- BMJ OnExamination PACES (AI-powered): A dedicated OSCE simulator co-developed with SimConverse that allows candidates to practise communication and clinical reasoning stations for the PACES exam.
- Geeky Medics AI Virtual Patients: A library of conversational, AI-powered virtual patients designed for practising OSCE and CPSA-style encounters via voice or text.
Imaging & diagnostics AI
Use-case: Accelerating diagnostic pathways and improving detection rates.
- HeartFlow FFRCT: A long-standing example of a NICE-approved AI (MTG32). It provides a non-invasive analysis of coronary CT scans, with a proven cost-saving of £391 per patient in its 2021 model.
- Qure.ai qXR: A chest X-ray triage tool that has been rolled out in several NHS pilots, designed to reduce turnaround times and prioritise significant findings.
iatroX at a glance (UK-centric value)
- Ask / Knowledge Centre: Provides citation-first answers grounded in NICE, CKS, SIGN, BNF, and peer-reviewed research.
- Brainstorm: An educational tool that structures differentials and investigation plans with a clear UK context.
- Quiz: A free adaptive and spaced-repetition engine mapped to UK curricula to make revision more efficient.
- Positioning: iatroX complements paid enterprise references by providing a free, UK-specific "front door" to guidance, combined with integrated learning and CPD tools.
UK governance & procurement checklist
For any tool to be safely deployed in an NHS setting, it must be assessed against this framework:
- DTAC: Does the vendor have a passed Digital Technology Assessment Criteria pack?
- NICE EVA: Is the tool on a NICE Early Value Assessment pathway, requiring evidence generation in practice?
- MHRA AI Airlock: For novel AIaMD, has the vendor participated in the MHRA's regulatory sandbox?
- Clinical Safety: Does the vendor have a DCB0129 safety case, and have you completed your local DCB0160 case?
Price & access notes
- Free to start: iatroX (free, UK-centric) and OpenEvidence (free for verified HCPs).
- Enterprise licences: This is the standard model for UpToDate Expert AI, Dyna AI, Dragon Copilot, Abridge, and most other integrated scribe and diagnostic tools.
FAQs
- Are ‘AI scribes’ proven in the NHS?
- Yes, early multi-site trials (reported in the HSJ and from GOSH) have shown material time savings and provider throughput gains. You must validate these claims locally and follow all NHS England guidance on safe deployment.
- Which reference AI is “best”?
- It depends on your needs. UpToDate Expert AI and Dyna AI offer unparalleled depth of content. iatroX is the a leading free, UK-centric option for answers grounded in national guidelines. OpenEvidence is an excellent free tool for US-led literature synthesis.
- Is differential diagnosis AI safe?
- It should only be used as an assistive tool. Always prefer validated platforms like Isabel DDx, or use newer tools like DxGPT and iatroX Brainstorm for educational "brainstorming" where all outputs are verified by a senior clinician.