EMMA is mishearing or misrecognising medication names during calls

Purpose of Document

Medication name misrecognition complaints carry clinical safety implications. They must be handled carefully, factually, and with full awareness of what EMMA can and cannot do. Support staff must be able to reassure practices accurately, respond to clinical safety concerns without dismissing them, and escalate appropriately when needed. This article provides the complete internal reference for these situations.

Critical Context: What EMMA Can and Cannot Do With Medication Data

Before triaging any medication-related complaint, every support staff member must be clear on the following.

EMMA cannot:

Access any prescribing system
Access a patient's medication history or clinical record
Add, change, or remove any medication from a patient's record
Order or approve a prescription
Make any clinical decision about medication

EMMA can:

Hear and transcribe what a patient says about their medication
Capture the medication name as spoken and submit it on the consultation form
Ask a patient to clarify or repeat a medication name if she cannot hear it clearly
Signpost repeat prescription requests to the NHS App via the Pathways feature

EMMA is a message-taking and routing system. She captures what the patient tells her and passes it to the practice team. A clinician always reviews the submission and makes any clinical decision using the patient's full medical record. EMMA's transcription of a medication name, even if imperfect, does not directly cause a clinical harm event because a human always reviews the request at the other end.

This context is essential when responding to practices who have read media coverage suggesting AI systems can change patient prescriptions. EMMA cannot do this.

Background: The March 2026 Clinical Safety Fix

On 13 March 2026, QuantumLoop AI released an important clinical safety fix following the identification of a significant risk.

What was happening before the fix: In some cases, EMMA was misinterpreting a spoken medication name and suggesting an alternative name to the patient. In one documented instance, EMMA suggested a controlled medication that the patient had not mentioned. This created a risk that a patient could unknowingly confirm an incorrect medication name during their call, which would then appear on the submitted form.

This was a clinical safety issue and was treated as a priority fix.

What changed after the fix (13 March 2026):

EMMA will no longer suggest or substitute any medication name that differs from what the patient has explicitly spoken
Controlled medications are fully blocked from being introduced by EMMA unless the patient has explicitly stated them during the call
Additional safeguards prevent incorrect transcriptions from propagating into form submissions
All other call flows and prescription workflows remain unchanged

If a practice raises a medication safety concern and the incident predates 13 March 2026, this fix is directly relevant context. If the incident postdates 13 March 2026, it requires immediate investigation.

Additional Speech Recognition Improvements (March 2026)

On the same date as the clinical safety fix, a broader speech recognition accuracy improvement was also released. This specifically addressed medication name mishearing, which had been causing:

Incorrect medication information appearing on submitted forms
Clinical enquiries being routed to administrative pathways incorrectly
In some cases, call loops where EMMA could not resolve the medication name and the call did not progress

After this improvement:

Medication name recognition accuracy was significantly improved
Clinical enquiries are less likely to be misrouted
Safeguards prevent incorrect transcriptions from reaching form submissions

Clear Voice (V12, May 2026): Further Medication Recognition Improvement

As of EMMA V12 (May 2026), Clear Voice is now the core speech recognition layer. Clear Voice was trained on NHS primary care clinical vocabulary including the medication names and phrasing patients use when describing their prescriptions. This represents a further step forward in medication name accuracy beyond the March 2026 improvements.

Medication names are particularly challenging for speech recognition because:

Many medication names are long, complex, or Latin-derived
Patients often use brand names, generic names, abbreviations, or informal names interchangeably
Patients may not know the correct name and describe the medication by colour, shape, or purpose
Some medication names sound very similar to each other

Clear Voice has been trained specifically to handle these real-world scenarios in NHS primary care settings.

Common Causes and What to Check

1. A medication name appeared incorrectly on a submitted form

This is the most common complaint. A patient called about a medication, EMMA captured what she heard, and the name on the form does not match what the patient actually takes.

What to do:

Review the call recording to confirm what the patient said
Assess whether the patient said the medication name clearly or used an informal description
Check whether the submitted name is close to what the patient said or significantly different
If the patient said the name clearly and EMMA transcribed it significantly differently, check whether this occurred before or after 13 March 2026
If after 13 March 2026, escalate to engineering with the call ID
Reassure the practice that the clinical team reviewing the submission will cross-reference the patient's actual medication record and can identify any discrepancy

2. A practice has read media coverage and is concerned EMMA could have changed a patient's prescription

This is an objection requiring a clear, confident, factual response.

What to do:

Be direct and clear: EMMA has no access to any prescribing system. She cannot add, change, or order any medication.
EMMA captures what the patient tells her and submits it as a written request to the practice
A clinician always reviews the request using the patient's full medical record and makes all prescribing decisions
Even if EMMA transcribes a medication name imperfectly, the clinician sees the patient's actual record and can identify what the patient is actually on
The March 2026 fix adds a further layer of protection: EMMA cannot introduce a medication name that the patient did not explicitly mention
Use language from the Objections and Response Playbook if needed but do not read from it directly. Speak naturally.

3. EMMA misrecognised "subscription" or "description" as "prescription" or vice versa

STT (Speech to Text) mishearings of similar-sounding words are a known area of improvement. The word "prescription" in particular can be misheard as "subscription" or "description" when spoken quickly or in a noisy environment.

The Newgate Surgery enhancement (March 2026) addressed this for Newgate callers specifically. EMMA now recognises a broader range of medication-related phrases and uses a confirmation step when indirect phrasing is detected.

What to do:

Check whether the affected surgery has the Newgate-style enhanced prescription recognition configured
If not and if this is causing routing issues, raise a configuration request for the surgery
Review the call recording to identify the specific mishearing

4. A medication query was routed to the admin inbox instead of the clinical inbox

Before the March 2026 speech recognition fix, clinical enquiries including medication-related calls were occasionally being misrouted to the administrative pathway. This meant the request landed in the admin inbox rather than the clinical triage queue.

What to do:

Check whether the incident predates 13 March 2026
If occurring after that date, review the call recording to assess why the routing occurred
Check the form configuration for that surgery to confirm clinical and admin routing is correctly mapped
Escalate to engineering if routing appears incorrect and the form configuration is confirmed correct

5. A practice is concerned EMMA suggested a different medication to the patient

This is a clinical safety concern and must be treated as such regardless of when it occurred.

What to do:

Pull the call recording immediately
Confirm whether EMMA suggested a medication name the patient did not mention
If EMMA did suggest an alternative medication name, this is a clinical safety incident if it occurred after 13 March 2026, as this behaviour was specifically fixed on that date
Escalate immediately to the clinical safety lead and engineering with the call ID, the medication names involved, and a description of what occurred
Do not dismiss or minimise this complaint pending investigation

Clinical Safety Incident Protocol

If a practice reports that EMMA suggested or introduced a medication name that the patient did not explicitly mention, and this occurred after 13 March 2026, this must be treated as a clinical safety incident.

Immediate steps:

Pull the call recording and listen to the full call
Document exactly what EMMA said versus what the patient said
Escalate to the clinical safety lead immediately
Escalate to engineering immediately with the call ID and full details
Do not close the ticket or advise the practice that the issue is resolved until a full investigation has been completed and confirmed
Follow the internal incident response process

Step-by-Step Triage Process

Ask the practice to describe the issue precisely. What medication name appeared on the form? What should it have been? Did EMMA suggest a name the patient did not mention?
Pull the call recording and listen to the relevant section.
Confirm what the patient said and what EMMA transcribed.
Check whether the incident predates or postdates 13 March 2026.
If EMMA introduced a medication name the patient did not mention after 13 March 2026, escalate immediately as a clinical safety incident.
If the medication name was simply transcribed slightly differently from what the patient said, confirm whether the clinical team would be able to identify the correct medication from the patient's record.
If the issue is routing-related (medication call going to admin inbox), check the form configuration and the March 2026 routing fix timeline.

What to Tell the Practice

Example wording for a standard medication transcription complaint:

"EMMA captures what the patient tells her and submits it as a written request to your team. If a medication name is recorded slightly differently from how the patient said it, your clinical team reviewing the submission will cross-reference the patient's actual record and can identify the correct medication. EMMA cannot access your prescribing system and cannot change or add to any patient's medication record. The clinical decision always sits with your team."

Example wording for a clinical safety concern about EMMA suggesting a medication:

"We take any concern about medication safety very seriously. We are pulling the call recording now to review exactly what happened. As of March 2026 we have a fix in place that prevents EMMA from suggesting or introducing any medication name the patient did not explicitly mention. If this occurred after that date we will treat this as a priority investigation. We will come back to you with our findings as soon as the review is complete."

Common Mistakes

Telling a practice that EMMA can access or change a patient's prescription. She cannot. This must never be stated or implied.
Dismissing a medication safety concern without pulling the call recording first.
Not treating a post-March 2026 medication substitution incident as a clinical safety incident.
Telling a practice that medication name mishearing is fully resolved. Accuracy is significantly improved but no speech recognition system achieves perfection on complex clinical vocabulary. Be honest about this.
Not mentioning that a human clinician always reviews medication submissions using the patient's full medical record.

Escalation Guidance

Escalate to engineering immediately if:

EMMA introduced a medication name the patient did not mention after 13 March 2026
Controlled medication names are appearing on forms that patients did not state
Medication name mishearing is causing consistent routing failures after the March 2026 stability fix

Escalate to the clinical safety lead immediately if:

A patient may have confirmed an incorrect medication name during a call
A practice reports a potential clinical harm event related to medication information captured by EMMA

When escalating, always include:

Surgery name and ODS code
Call ID and timestamp
Exact medication name that appeared on the form
What the patient actually said during the call (from the recording)
Whether EMMA introduced the name or transcribed what the patient said
Whether the incident predates or postdates 13 March 2026

Last Reviewed: May 2026 Owner: Support and Customer Success