$7 a month AI scribe

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GreenGreen

GreenGreen

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I've been searching for a viable and cheap AI scribe for a while... some of the costs are OUTRAGEOUS for AI scribing.

Current system is a clipboard and a Plaud note pin.

Clipboard to write orders so staff can put them in, and the AI scribe for end of day charting.

The device costs $180 one time. For $7 month it let's me have my own templates that I make to streamline the process.

I spent a few hours yesterday setting it up.... then today it was time to try it out.

Complete home run. New patients today took about 1 minute to chart with very high fidelity of the conversations.

If you want a really cheap AI scribe, something to help you remember those 30 or 40 visits in the day... this could be your answer.

Not for everyone, but I'm so happy that I finally have a final piece of the puzzle to streamline clinic and decrease the brain burden. I couldn't bring myself to be price gouged by the scribe services... so I'm over the moon.

Just thought I'd share my new discovery. Apologies if this is old news or something well know to the community.
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My templets are pretty good and stream line stuff. Cost has prevented me from wanting AI scribe. But $7 a month to never have to write an HPI again sounds tempting.
 
Do you (we) have to get patient permission to use AI in healthcare setting? I assume no since its private property?

Do you verbalize the physical exam, speak out diagnosis, etc while seeing the patient or are you just typing that in later?
 
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DYK343 said:
Do you (we) have to get patient permission to use AI in healthcare setting? I assume no since its private property?

Do you verbalize the physical exam, speak out diagnosis, etc while seeing the patient or are you just typing that in later?
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I have a clause in the patient consent form that allows for computer and/or electronic devices to be utilized to help generate visit notes... my lawyer helped with some of the wording.

Also, I don't record any names while using the device. I usually greet the patient, then begin recording immediately after verifying the patient.

Like you, my templates usually let me fly through the visit, but the HPI and A/P are so, so much improved and now it actually feels like an individual note, instead of something copied and pasted across tons of visits.
 
I’m not confident in AI yet tbh. 90% of the stuff I search w google ai is false
 
I’ve been using DAX which is the Epic AI tool my hospital provides. I can’t believe how good it is. I don’t use it for the Physical Exam part because it’s just kinda weird to be shouting out your exam while the patient is in the room. Notes take me less than a minute most times at this point. I do have to ask the patients if they are ok with me using it, never had one say no so far.

Most annoying thing for me by far now is filling out FMLA or similar type paperwork. Like the questions they ask are intentionally annoying.
 
Is a detailed hpi even that important? We're not differentially diagnosing chest pain.

If I have a pt with heel pain, I'll write "pt c/o L/R/Bil heel pain, post static, x months duration" and everything beyond that is fluff

If I have a pt with an ulcer, their subjective is less reliable "it started as a blister 2 days ago," no that's only when you noticed it...
 
I wrote a guide for my MAs on how to fill them out. Every single pt gets 2 months out. Under medical facts I just write "foot surgery." As long as they don't ask annoying questions like "what % of the shift can the pt spend sitting/standing/kneeling/crawling" it's pretty easy
 
Adam Smasher said:
I wrote a guide for my MAs on how to fill them out. Every single pt gets 2 months out. Under medical facts I just write "foot surgery." As long as they don't ask annoying questions like "what % of the shift can the pt spend sitting/standing/kneeling/crawling" it's pretty easy
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There is a large international company that basically supports the entire area I live in. A significant percentage of people in my area work for this company. Their disability forms are the exact same question worded differently about 15x over. I feel like they are trying to make me change my answer so they can deny.
 
Adam Smasher said:
Is a detailed hpi even that important? We're not differentially diagnosing chest pain.

If I have a pt with heel pain, I'll write "pt c/o L/R/Bil heel pain, post static, x months duration" and everything beyond that is fluff

If I have a pt with an ulcer, their subjective is less reliable "it started as a blister 2 days ago," no that's only when you noticed it...
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I don’t even bother adding the fluff to hpi anymore
 
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Adam Smasher said:
I wrote a guide for my MAs on how to fill them out. Every single pt gets 2 months out. Under medical facts I just write "foot surgery." As long as they don't ask annoying questions like "what % of the shift can the pt spend sitting/standing/kneeling/crawling" it's pretty easy
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They always ask that..lol.
 
Hybrocure said:
I don’t even bother adding the fluff to hpi anymore
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My physical exam for plantar fasciitis is....

pain on palpation plantar medial tubercle left calcaneus no pain side to side compression of the calcaneus negative teinelnl sign with palpation over lying the tarsal tunnel. Palpable DPPT pulse intact protective sensation.


That's it


HPI... 45-year-old female presents to clinic today with 4 month history of left heel pain. No significant back injury, surgery or pain. Denies any specific injury associated with the heel hurrs after periods of prolonged rest and first step out of bed in the morning. Takes occasional Ibuprofen has not made any attempts at treating it has not seen any other specialists.

Then insert with dragon a standard plan....this isn't that hard people.
 
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We charge $15 per stack of forms. The idea isn't necessarily to profit from doing this, it's to "make you whole." You lose some time on the patient's behalf, you recoup the some of the value of that time from the patient.

I've seen in articles that pregnant women get REALLY annoyed with their OBGYNs when they charge for FMLA forms, but everyone else seems to understand
 
So - I will put in a word for "fluff" and I use that lightly because I mostly historically agree with everyone else that history doesn't matter, until it does. As of late - my patients are so pathetically sick, that my favorite component of AI is capturing all of their ridiculous, burdensome past medical history to ensure that I don't operate on some of these people accidentally.

I received in the mail an audit for avulsions from 2-3 years ago. Its from essentially Medicare. There's nothing that appears scary or nefarious in it, though obviously these sort of events are not fun. In a 2 person practice where I do most of the work, somehow most of the patients aren't mine. I don't trust my office manager so I spent a morning and just did the whole thing. Shouldn't be my job, but such is life. It sucked - a continuous indictment of being in private practice.

Reading the notes selected for an audit is jokingly like having to do ABFAS. You question every little word and in this case I sometimes question, beg, and hope for more words to be included. I'm mostly of the opinion that your physical exam should contain your most relevant facts, but I found myself cringing at how little detail my partner sometimes included while thanking the stars for a history discussing the amount of pus that was leaking or the nature of the patient's injury that brought them in for surgery.

Everyone should occasionally question exactly how much documentation they need. I have historically short changed the history section.

Document what you want to document, but if you should find yourself in a routine audit - you may wish you'd dropped a little more text in.
 
heybrother said:
So - I will put in a word for "fluff" and I use that lightly because I mostly historically agree with everyone else that history doesn't matter, until it does. As of late - my patients are so pathetically sick, that my favorite component of AI is capturing all of their ridiculous, burdensome past medical history to ensure that I don't operate on some of these people accidentally.

I received in the mail an audit for avulsions from 2-3 years ago. Its from essentially Medicare. There's nothing that appears scary or nefarious in it, though obviously these sort of events are not fun. In a 2 person practice where I do most of the work, somehow most of the patients aren't mine. I don't trust my office manager so I spent a morning and just did the whole thing. Shouldn't be my job, but such is life. It sucked - a continuous indictment of being in private practice.

Reading the notes selected for an audit is jokingly like having to do ABFAS. You question every little word and in this case I sometimes question, beg, and hope for more words to be included. I'm mostly of the opinion that your physical exam should contain your most relevant facts, but I found myself cringing at how little detail my partner sometimes included while thanking the stars for a history discussing the amount of pus that was leaking or the nature of the patient's injury that brought them in for surgery.

Everyone should occasionally question exactly how much documentation they need. I have historically short changed the history section.

Document what you want to document, but if you should find yourself in a routine audit - you may wish you'd dropped a little more text in.
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That’s what I like about the AI summary for the HPI specifically. It catches details that there’s no way I would remember but has proven to be helpful when referring back to past visits, especially in patients with a bunch of issues.

It summarizes the plan pretty good too but I have to edit it or add to it pretty often.
 
heybrother said:
The real question is do you charge for FMLA paperwork.
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Not a chance.

That is asking for bad reviews or (literal 1-star... or just bad-talking) from people who are already not the happiest of campers.

... that's right up there with charging/threatening no-show fees imo. It does not make you any friends. 🙂
 
I'm seeing some good comments.

Frustrated with the thing today - the syncing stopped working... so I'm a little sad. Still has it's flaws but it's locally stored. Not happy but it should iron out soon. Was just thinking yesterday about how happy I was with it.

In response to most comments:

Yes, it's true that HPI may not be important.... until someone sues you and all your notes are almost identical and clearly there's a template being used against you in court. For some it may not be an issue, but if you're in a deep blue state, Brooklyn, etc. I think it's helpful.

Mostly I like using this because it allows me to remember a lot of what was discussed with a plan for patients who are more complex.

For standard "bread and butter" things, yes. There's little benefit. So a lot of the time It's not needed. But yesterday I had a very complex patient who had seen three neurologists and was looking into tarsal tunnel... which as all of you know is very high on the possible future lawsuit list. So happy I had this.

Before this device, charting/orders/coding per visit averages around 2-3 minutes if it's not bread and butter. It's down to less than 1 minutes for these now. Which will save me around a few hours/week. I'm no slouch with technology implementation or charting speed...

Just wanted to share my perspective as there are many newer podiatrists looking for help and resources such as this.

🙂
 
GreenGreen said:
I'm no slouch with technology implementation or charting speed...

Just wanted to share my perspective as there are many newer podiatrists looking for help and resources such as this.
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You are our very own AI Trailblazer. I for one am living vicariously through you, along for all the high's and lows' of your journey as you navigate this vast and wild AI jungle.

To me it sounds like the only changes that you have to make during patient encounters is to verbally dictate your objective findings. Or else it obviously doesn't know what PE test you're doing. But I'm guessing it does listen to the subjective HPI organically without needing input from your end as the patient speaks?

Have you had to change anything else during patient encounters?
 
MindfullyPresent said:
You are our very own AI Trailblazer. I for one am living vicariously through you, along for all the high's and lows' of your journey as you navigate this vast and wild AI jungle.

To me it sounds like the only changes that you have to make during patient encounters is to verbally dictate your objective findings. Or else it obviously doesn't know what PE test you're doing. But I'm guessing it does listen to the subjective HPI organically without needing input from your end as the patient speaks?

Have you had to change anything else during patient encounters?
Click to expand...
1. Dictating the objective findings is the main thing. You definitely want to be specific about the description ie. so on your left medial hallux border etc.
2. There's value in starting the note off by describing in the encounter - so you are here for a follow-up of left foot X problem etc.
3. If you don't name the side - it won't know the side.
4. It will faithfully attribute as true things the patient claims. So if the patient says I think my foot hurts because aliens flattened my penis as a baby - it might actually write that. I'm obviously being absurd, but I've definitely had somewhat silly things written in the note based on things patients believe. ie. they'll attribute a historic injury or event as the cause and the program will include it.
5. Don't talk about your own health or it may think its the patient's health.
6. If the patient's family starts talking about their health it may get included as part of the patient.
7. There is definitely value in walking out of the room after and adding your own clarifications and concerns.
8. The program will sometimes "make things up" ie. I'm prescribing meloxicam 7.5 mg - I say I'm prescribing meloxicam but I never describe the dosing. The program will claim I wrote 15 mg - I never said the dose so this is clearly created.
9. If you offer the patient a diversity of surgeries and clarify why you picked one of the other - sometimes it will write out your described thought process. Sometimes it won't. The program is often good/helpful, but its sometimes inconsistent in quality.
10. The programs will sometimes start out "OPQRS" lines in the note and if they weren't touched it will leave them back. I find this fairly annoying ie. write about what we did say, not about what we didn't say.
11. The programs at times will write very long direct quotes of things the patient said. For post-ops they often include too many details. I had some tingling. I had some aching etc. Did you do great - yeah, I'm very happy. It will still include the small complaints and that can sort of be annoying if the patient really is 99% pretty good.
12. Perhaps I could get this in a better program / paid template etc but I personally want the program to write all of the patients conditions we touched on ie. diabetes shouldn't just be listed in the history section - it should always be its own line in the plan. Sometimes it isn't. Sometimes they again make up something claiming you told the patient to continue care with the PCP. That's fine and probably non-problematic, but if you didn't say it then its made up.
 
heybrother said:
1. Dictating the objective findings is the main thing. You definitely want to be specific about the description ie. so on your left medial hallux border etc.
2. There's value in starting the note off by describing in the encounter - so you are here for a follow-up of left foot X problem etc.
3. If you don't name the side - it won't know the side.
4. It will faithfully attribute as true things the patient claims. So if the patient says I think my foot hurts because aliens flattened my penis as a baby - it might actually write that. I'm obviously being absurd, but I've definitely had somewhat silly things written in the note based on things patients believe. ie. they'll attribute a historic injury or event as the cause and the program will include it.
5. Don't talk about your own health or it may think its the patient's health.
6. If the patient's family starts talking about their health it may get included as part of the patient.
7. There is definitely value in walking out of the room after and adding your own clarifications and concerns.
8. The program will sometimes "make things up" ie. I'm prescribing meloxicam 7.5 mg - I say I'm prescribing meloxicam but I never describe the dosing. The program will claim I wrote 15 mg - I never said the dose so this is clearly created.
9. If you offer the patient a diversity of surgeries and clarify why you picked one of the other - sometimes it will write out your described thought process. Sometimes it won't. The program is often good/helpful, but its sometimes inconsistent in quality.
10. The programs will sometimes start out "OPQRS" lines in the note and if they weren't touched it will leave them back. I find this fairly annoying ie. write about what we did say, not about what we didn't say.
11. The programs at times will write very long direct quotes of things the patient said. For post-ops they often include too many details. I had some tingling. I had some aching etc. Did you do great - yeah, I'm very happy. It will still include the small complaints and that can sort of be annoying if the patient really is 99% pretty good.
12. Perhaps I could get this in a better program / paid template etc but I personally want the program to write all of the patients conditions we touched on ie. diabetes shouldn't just be listed in the history section - it should always be its own line in the plan. Sometimes it isn't. Sometimes they again make up something claiming you told the patient to continue care with the PCP. That's fine and probably non-problematic, but if you didn't say it then its made up.
Click to expand...
This sounds disastrous
 
Hybrocure said:
This sounds disastrous
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Its not. You just have to work with it and master it. You still need strong templates. I type so much less.

I've had oodles of chronic VA disasters, CRPS, botched elsewhere surgeries, and the notes still mostly write themselves. Even when they aren't perfect the notes have enough detail that I can easily fix it.

The simple truth is more often then not I think - oh, I'll add something, and then I realize a few lines down that its already there.

And it makes billing BS complaints and nail fungus add ons so much easier.
 
heybrother said:
4. It will faithfully attribute as true things the patient claims. So if the patient says I think my foot hurts because aliens flattened my penis as a baby - it might actually write that. I'm obviously being absurd, but I've definitely had somewhat silly things written in the note based on things patients believe. ie. they'll attribute a historic injury or event as the cause and the program will include it.
Click to expand...
Classic case of extraterrestrial erectile Pes Penisvalgus. Will likely headline PM News right after the peanut butter bunion cure.
 
Speaking of AI...it looks like you can now get free CME from Open Evidence.
Snip20250402_8.png
 
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