Treat Pre/post-visit transcription information treated differently
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Kevin Kollins
I often will dictate information before or after a visit (into the iphone app or desktop/browser). This information frequently is when I review previous cardiac testing/history from outside sources, so anything I decide to say out loud, I am hoping to have as part of the visit note. This information is read non-linearly, so pure transcription would not be appropriate. What I find, is that a LOT of this information is omitted from the note, as the AI software decides what to keep from the overall transcription. It would be GREAT if there was a way to let the platform know that I am transcribing this sort of information (pre-charting feature? specific transcription into the context feature that is different from overall transcription?) so this relevant information is always included in the final clinic note, with the platform putting it in the note in the appropriate places/fashion/format. Otherwise, I end up leaving it out, or more often, having to type it in myself. A lot of physicians pre-chart, and this would be a very marketable feature, useful to most providers. I would consider trying another AI scribe that specifically offered this feature. Context: Pediatric Cardiologist, mostly outpatient office visits.
Heidi Team
Thanks for taking the time to write this up — super clear, and the pediatric cardiology pre-/post-charting use case makes a lot of sense.
You’re right that when info is dictated non-linearly (reviewing outside testing/history, etc.), the model may summarize or drop pieces it thinks are less relevant to the “visit narrative.” A dedicated way to flag “this is pre-charting / must-include context” is great feedback, and I’ll share it with the team.
In the meantime, one workaround that may help: if you paste/type that outside-history/testing info into the
Context
tab (instead of relying on it being captured from the transcript), Heidi can generate a note from context alone
and tends to treat it more like “source material to include.” You can also link prior consults/notes into Context so it’s pulled forward more reliably.A couple quick questions so we can pass along the most useful detail:
1) When you dictate this pre/post info, are you doing it in the same session as the visit, or as a separate recording/consult?
2) Would you prefer it to appear as a dedicated section (e.g., “Outside Records Reviewed / Prior Testing”), or be auto-distributed into HPI/Assessment/Plan?
3) Is the main issue omission, or also that it’s included but placed in the wrong part of the note?
If you can share a short example (even de-identified) of the kind of outside-testing dictation that gets dropped, that would be really helpful too.
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Kevin Kollins
Heidi Team Thanks for the quick reply. I upload and type and copy/paste into the context a lot too. Some things are just much quicker to say out loud then download and upload, or even copy/paste (since the copied material often needs to have things typed with it to provide context).
From your questions:
- When I dictate the pre/post info, it is the typically the same session (if that counts pausing, or going back to a session and hitting "resume" to dictate more into the session.
- Since the information is varied (sometimes prior testing, sometimes prior symptoms notable from an ED visit etc, sometimes prior assessment/plans from a previous cardiologist) it would be better to have the information auto-distributed into entire note, according to the templates I use, fitting in wherever appropriate for that information.
- The main issue is omission. I often have patients where I'll go through older echocardiograms, and dictate some nit-picky but relevant info from each echo (left heart z-scores in diastole, as an example), and that info is then omitted from the summary of echos in the note. Or dictating relevant portions from a recent ED visit, picking out and dictating important symptoms (both important positive and negative details), only to have those things left out. If this is something that your team really wants to work on, I can start collecting more specific examples too. Thank you!