If you record your consultation using TORTUS, after the recording finishes you will be able to review:

• a transcript of the consultation
• a clinical note, using your choice of template
• any letters/communications required

You should check the outputs and edit them where necessary. If your TORTUS instance is integrated into your EHR, you should click “Approve and write to record” at the bottom of the consultation screen. Otherwise, copy your outputs using the “Copy note” / “Copy letter” button and paste them into the EHR in the relevant sections.

You should carefully review the output of the clinical note and letter. You can edit the contents in the box on the consultation screen, or by clicking “View full page”. In this new window, you can edit the contents of the clinical note and letter, before proceeding to copy and paste them into the record.

Each consultation from the past 24 hours (or your organisation’s configured retention period) is listed in the sidebar on the left-hand side of the TORTUS screen.

When you open a consultation:

• Transcript: Appears at the top of the consultation page.
• Clinical note: Displayed below the transcript. To expand it, click “View full page” beneath the window.
• Letter: Shown at the bottom of the consultation screen. You can also view it in full by clicking “View full page” beneath its window.

No, you must check carefully the content of the clinical note and letter prior to transferring either of these into a patient record. As a clinician, it is still your professional responsibility to ensure the validity of any documentation added to a patient record, just as it would normally be.

• Prior to starting a clinic, check your audio set up. Create a test consultation, ensuring your microphone is visible as an input, and the microphone audio bar is detecting audio. Record some test audio of at least 30 seconds and transcribe the content, review the transcription to confirm that audio input is functioning correctly.
• The transcription system is highly accurate, but requires a microphone of sufficient hardware quality to optimise. Most internal laptop microphones are sufficient. If your device has insufficient recording capabilities (i.e. fails to capture clear audio) consider purchasing an external USB microphone or webcam with an omnidirectional microphone. For the best results, we recommend these wireless lavalier microphones.
• During a consultation, try to ensure that only one person is speaking at any given time. Using closed loop communication, repeating back important pieces of information to the patient, also boosts performance.
• During a consultation, try to place the device or microphone as close to yourself and the patient as is practical, and ensure background noise is minimised where possible.
• Transcription errors may occur, you must thoroughly check through the generated clinical note and letter for errors.
• If a patient mentions medication names, we recommend repeating these back to improve transcription quality.
• You should use the edit function to correct any errors captured in the clinical note or letter.

The context box is located beneath the recording block. You can use it to type or paste any information that is relevant to the consultation and should be included in the note, but may not be possible or appropriate to say aloud.

Any information entered here will automatically appear in the clinical note and letter under the appropriate sections.

Please note that the context box cannot be used to give the model instructions or prompts on how to write or format the note or letter. Safeguards are in place to prevent this for clinical safety reasons.

To start recording a consultation, click the ‘Start consultation’ button on the TORTUS home screen or in the sidebar on the left-hand side of the screen. This will open a new consultation screen, and recording will begin automatically. To confirm that recording is active, check that the timer is increasing and that the audio waveform is moving in response to your speech (not remaining flat).

You can pause the recording by clicking anywhere within the recording bar area, and resume it by clicking again. Once the consultation is complete and you have added any necessary information to the context box, click “Finish and generate notes” to start generating the note.

Please note that once you click “Finish and generate notes,” the recording cannot be restarted.

The TORTUS web page will prompt you for microphone access the first time you start a consultation. If you accidentally deny access, you will have to grant permissions manually. How you do this will depend on your operating system, so please follow the appropriate guide below:

• Windows 10
• Windows 11
• MacOS

Some networks, particularly NHS or hospital networks, restrict which web apps can run. This can cause issues when you try to log in or use the app.

First, try these steps:

• Check you have an active internet connection and other websites are loading.
• Switch networks: try your home Wi-Fi or a phone hotspot. If TORTUS works there, your current network’s firewall is likely blocking it.
• Try an incognito/private browser window and sign in again.
• Use a modern, up-to-date browser (for example Chrome, Edge, or Safari).

If the issue may be a firewall or allowlisting requirement:

• You’ll need approval from your IT administrator before you can use the TORTUS web app on that network. We’ve prepared a guide you can share with them to get set up: https://www.notion.so/TORTUS-app-Setup-guide-External-4f9c676230844d91b55d69ca230ee879?pvs=21
• We’re happy to work with your IT team and provide any clinical safety or technical details they need. Email [email protected] and we can help facilitate.

If your account is deactivated:

• You won’t be able to log in until it’s reactivated. Please contact your organisation’s TORTUS workspace admin, or email [email protected] for assistance.

If your domain needs to be allowlisted:

• Some organisations restrict access by domain. Ask your IT team to allowlist the TORTUS domain as per the setup guide above. If they need help, put them in touch with us at [email protected].

Yes, although TORTUS may occasionally struggle to transcribe fully in particularly strong accents. If a patient has a strong accent, we recommend using closed loop communications, repeating back key parts of the consultation, and especially medication names.

If your organisation has enabled template customisation, then yes – you can create your own templates in TORTUS.

Creating a template is straightforward. When you first open TORTUS, you’ll be prompted to customise a template based on your speciality.

If you’d like to create another one, follow these steps:

1. Go to the “Templates” page from the user dropdown menu.
2. Click “+ Create New Template” at the bottom of the page.
3. Enter a name for your new template.
4. Choose an existing template to use as a starting point.
5. Adjust the style toggles to match your preferences.
6. If you want to change the headings, click “Advanced.”
7. Add or remove headings and edit the descriptions within the square brackets.
8. Save your template:
   
   • Click “Save” at the bottom of the form.
   • You’ll find your template under “My Templates.” You can edit it further at any time by clicking the pen icon.
9. Test your template:
   
   • Run a mock consultation to see how your headings and style appear.
   • Make further edits if needed.
10. Once you’re satisfied, your new template is ready to use in your consultations.

This is the list of officially supported browsers and versions:

• Microsoft Edge (129.0 and later)
• Apple Safari (17.6 and later)
• Google Chrome (130.0 and later)
• Mozilla Firefox (132.0 and later)

TORTUS web may still work in previous versions without issues, but we recommend updating your browser to the latest version.