---
title: "PatientOS — AI Consultation Assistant"
description: "AI consultation assistant that reads the patient record, drafts prescriptions and test orders from chat, and writes them to the encounter on confirmation."
date: 2026-08-17
lastModified: 2026-08-17
category: "opd"
author: "Dr. Umesh Bilagi"
beta: true
---

## Overview

PatientOS is an AI consultation assistant for doctors. Instead of filling forms by hand, the doctor chats with an AI that has already read the patient's full record — demographics, vitals, past encounters, compositions, and lab orders. The AI converses about the case, drafts a prescription or test order, and shows the doctor exactly what it will write **before** anything is saved. Nothing is written to the record until the doctor confirms.

The AI never writes to the database directly. Every save goes through the same FHIR-native doctor APIs the rest of NICE HMS uses, on the doctor's own authenticated session.

## Prerequisites

- **An open OPD encounter** for the patient. PatientOS attaches new records to the latest open encounter. If none is open, the assistant shows a warning (but still lets you converse).
- **AI credit tokens.** PatientOS runs on your organisation's AI token balance. If tokens are exhausted, access is blocked with a prompt to purchase more.
- **Active subscription** and an **active, in-organisation patient**.
- **PatientOS permission.** Available to admin, director, doctor, accountant, receptionist, receptionist_accountant, visitor, HR, insurance_executive, insurance_lead, and nurse roles.

## Opening PatientOS

1. Open the patient's management page (search the patient, then click their ID).
2. Click **Open PatientOS**. PatientOS opens in a new tab as a three-pane screen:
   - **Conversations** (left) — past consultations for this patient.
   - **Chat** (centre) — the streaming conversation with the AI.
   - **Documents** (right) — the patient's real documents (reuses the standard Patient Composition view).

## Workflow

### 1. Start a consultation

Click **+ New** (or just type) and describe the patient's complaint. PatientOS first validates access (subscription, tokens, patient status) and loads the full record before the AI responds.

### 2. Converse with the AI

Ask questions, summarise findings, or give instructions in plain language. The AI reads the loaded record and responds in the chat. Use **Consider new docs** at any time to re-scan the patient record for newly added documents.

### 3. Draft a prescription, test order, or consultation

The quick-action buttons above the message box speed up the common actions:

- **Prescribe…** — opens the medication picker (your personal medicine library). Choose medicines, then **Add to existing** or **Replace all existing**.
- **Order tests…** — opens the lab test picker, grouped into **Tabular** and **Descriptive** tests. Tick the tests and click **Order selected**.
- **Signing consultant…** — pick a consultant to attach to the record.

You can also type the instruction directly, e.g. "save this prescription" or "order CBC and LFT".

### 4. Review the proposal before it saves

When you ask to save, edit, order, or finalise, the AI extracts a structured draft and shows it back to you as a before/after proposal (for edits) — **nothing is written yet**. Review it carefully.

### 5. Confirm to write

Reply **confirm** (or yes / proceed / finalise). Only then does PatientOS write the record:

| Action | What is written | Status |
|--------|----------------|--------|
| New prescription | Prescription record | Draft |
| Edit prescription | Updates the same prescription in place | Draft |
| Consultation note | OPD consultation record | Draft |
| Tests ordered | Service request (lab/radiology) | — |
| Finalise | Marks the record final | Final |

### 6. Finalise

When the record is ready, ask PatientOS to **finalise** it. Finalising sets the record to a final status so it can be shared (for example via ABDM).

## Editing an existing prescription

When you say "edit the latest prescription, add…", PatientOS reads the current medication list, applies your change, and shows the **complete** resulting list as a before/after before you confirm. Append, remove, and full-replace are all handled the same way — the AI produces the full final list for your approval.

## Common Issues

- **"No active encounter found"** — open an OPD encounter for the patient first, then re-enter.
- **"Insufficient AI tokens"** — the organisation's AI token balance is empty; purchase more.
- **Blocked on subscription** — the organisation's subscription validity has lapsed.

## FAQ

**Q: Does PatientOS write anything automatically?**
A: No. It only proposes. A record is written only after you reply to confirm.

**Q: Where do the saved records go?**
A: To the patient's record via the same doctor APIs the browser uses — prescriptions, consultation notes, and service requests appear in the patient's documents and encounters as drafts, then final when you finalise.

**Q: Can I resume a past consultation?**
A: Yes. Select it from the **Conversations** sidebar; the full chat history is restored.

**Q: Is my data safe?**
A: PatientOS acts on your own session token and never stores credentials. Records are written through NICE HMS's existing authenticated endpoints.