{
  "version": 1,
  "caseId": "dora",
  "caseTitle": "Oxford NHS Dora (Ufonia)",
  "sourceNote": "Case context assembled from two peer-reviewed evaluations (eClinicalMedicine 2024; Clinical Ophthalmology 2026), the Oxford University Hospitals newsroom, and NHS trust reporting; public citations appear on the case page.",
  "northStar": "Return scarce ophthalmology capacity to the patients who need it by safely discharging routine cataract patients after surgery.",
  "freeText": "Role: clinical-operations lead at an NHS trust preparing a governance review of Dora, the autonomous voice agent that follows up cataract patients by telephone. Treat this as the working design. Focus the review on whether the clinical boundary, the 48-hour callback rule, and clinician sign-off still hold as the pathway extends to pre-operative assessment.",
  "canvas": {
    "01": "Workflow: follow-up about three weeks after uncomplicated cataract surgery. Metrics: sensitivity in catching patients needing review, calls completed autonomously, unplanned care after a clear call.",
    "02": "Direct users: post-operative patients on the telephone, and the ophthalmology team receiving flags and summaries. Affected: waiting-list patients who gain the freed capacity, and the accountable trusts.",
    "03": "Role: autonomous clinical caller. Autonomy: execute, inside a tight loop. It conducts the call end to end and recommends discharge or callback; a clinician reviews the summary before discharge is confirmed.",
    "04": "Regulator-grade bars, published before routine use: 93.75% sensitivity for patients needing review, strong symptom-level agreement with ophthalmologists, and 96.5% of calls completed unaided.",
    "05": "The cataract pathway and the five symptom domains that matter after surgery: redness, pain, vision, new floaters, and flashing lights. Restricted to uncomplicated surgeries by design.",
    "06": "Telephony: it places real calls and converses in natural language, then writes a structured summary into the clinical record. It cannot prescribe, book theatre time, or act beyond routing a callback.",
    "07": "Only uncomplicated cataract cases. Any flagged symptom routes to a clinician callback within 48 hours. Emotionally complex situations and non-verbal cues are excluded; those belong to humans.",
    "08": "Each call becomes a structured record in the patient's pathway. Improvement is audited in public: a supervised validation study first, then a published evaluation of routine deployment.",
    "09": "Clinicians review every summary before discharge and call back every flagged patient; the trusts own the pathway; named investigators published the results that license the autonomy."
  }
}