Accurate, Effortless Documentation
Subjective
HPI:The patient presents with back pain ongoing for 3 months and associated numbness in the right leg. She sustained a fall 2 days ago and denies loss of consciousness at the time. She did have some dizziness prior to the fall. No falls since then. The patient has tried Tylenol with no benefit and has a follow-up with neurology in 2 weeks.
ROS
Musculoskeletal: +back painNeurological: +numbness, +dizziness
Objective
Throat: Pharyngeal exudate. Moist oral mucosa. Normal tonsils. Normal oropharynx. No oral ulcers or bleeding gums.
Cardiovascular: No carotid bruits. No peripheral edema, cyanosis, or pallor. No murmurs, rubs, or gallops. Peripheral pulses 2+ and symmetric. Capillary refill is less than 2 seconds. Regular rate and rhythm. No S3, S4. Normal S1 and S2.Lungs: Normal breath sounds and good air movement. Clear to auscultation bilaterally. No wheezing, rales, crackles, or rhonchi. Normal respiratory effort.
Assessment
M75.102 Unspecified rotator cuff tear or rupture of left shoulder, not specified as traumatic
Plan
Recommended to start physical therapy x6 treatments. Prescribed Ibuprofen 800 mg TID PRN. Consider MRI and arthroscopic surgery if needed. Follow up after a couple of sessions of therapy or sooner if symptoms persist or worsen.
Focus on providing care, not documenting it.
DeepScribe helps every clinician leverage the power of artificial intelligence to:
Save time
DeepScribe automatically generates clinical notes after each patient encounter – reducing documentation time by up to 75%.
Reduce burnout
Improve billing cycles and mitigate burnout by reducing average chart closure time to as fast as 1.6 minutes.
Maximize revenue
See 2 extra patients each day, while earning more from each visit through improved accurate risk adjustment factor (RAF) scores.
How it works
Activate DeepScribe from your iOS device at the start of a patient visit – no prompts required.
As you talk to the patient, our ambient AI platform seamlessly records, transcribes, and analyzes the conversation in real time.
Review the AI-generated note, make any edits (if necessary), and sign off. It’s that easy.
When the visit is complete, review DeepScribe’s automated patient chart notes right from your EHR.
AI Documentation built for Enterprise
Learn more about the features that make DeepScribe the best partner to help you unlock the power of AI – and modernize your enterprise patient data strategy.
Customization Studio
Fine-tune DeepScribe’s AI-generated notes to match provider workflows and improve adoption.
Trust and Safety Suite
Audit DeepScribe’s accuracy with features that promote AI transparency.
Features
Discover ambient AI that’s built for Enterprise
Drive adoption by offering control over note content and formatting – matching DeepScribe’s AI notes to physician preferences and specialty workflows.
DeepScribe notes are entered directly into the appropriate fields of your EHR system – no uploads or attachments required.
Our ambient AI model was refined using more than 3 million labeled patient conversations, resulting in documentation that’s more accurate than human scribes – and 32% more accurate than GPT-4 alone.
Automatically generate a list of applicable ICD-10 codes after every patient conversation to simplify billing and coding.
Clinicians can use DeepScribe across any care setting – whether you’re seeing a patient face-to-face or using telemedicine.
Realize the full potential of Healthcare AI with DeepScribe
Explore how DeepScribe’s customizable ambient AI platform can help you save time, improve patient care, and maximize revenue.