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Included Health clinical team's AI use case

Clinical team using an internal ambient scribe workflow at Included Health

Telehealth ambient scribe workflow where visit audio is transcribed with Whisper and processed with GPT-4o into SOAP notes and patient instructions for clinician review.

The problem

What was broken before AI

Telehealth clinicians had to listen, reason, document, and keep the patient conversation moving at the same time. SOAP notes and patient instructions are important, but producing them after every visit adds cognitive load, creates after-visit paperwork, and makes the EHR feel like part of the visit rather than a support system.

What changed

What the use case made possible

AI made it possible to capture the visit audio, transcribe it, generate structured draft documentation in parallel sections, and return a SOAP note plus patient instructions quickly enough to fit into the clinician’s existing telehealth workflow.

Why this matters

Why this use case is worth studying

The most useful detail is the modular design. Instead of asking one model call to produce an entire medical note, the team broke the job into narrower documentation tasks: chief complaint and HPI, recent encounters and vitals, assessment and plan, patient instructions, and verification. That gives the system clearer boundaries, makes hallucination controls more explicit, and creates a better review surface for the clinician.

Use this when

When this pattern applies

Use this when a team spends significant time turning conversations into structured, reviewable records and the output must follow a strict format with human approval.

Exponential Builder analysis

01

Break the artifact before you automate it

The team decomposed SOAP documentation into smaller sections, which makes each model call easier to constrain and easier for a reviewer to inspect.

02

Put verification in the product path

A second pass that checks support from the transcript turns quality control into part of the workflow rather than a separate QA project.

03

Measure the edits humans actually make

Comparing generated notes with clinician-submitted versions gave the team a practical signal for where the system needed improvement, especially around conciseness.

Who this is for

Best fit

Healthcare operators evaluating AI documentation workflows

Product teams building AI into regulated internal tools

Clinical operations leaders trying to reduce documentation friction

Engineers designing human-in-the-loop AI systems

Founders building workflow AI for compliance-heavy industries

What to avoid

Mistakes and warnings

Where this pattern can go wrong if you copy it too literally.

Do not let generated clinical notes bypass clinician review.

Do not use consumer AI tools with protected health information unless privacy, security, and contractual requirements are satisfied.

Do not rely on one model call for complex regulated documentation.

Watch for unsupported plan items, inferred diagnoses, and missing pertinent negatives.

Shorter notes are not automatically better; the paper notes that post-processing removed some pertinent negatives, which could affect completeness.

Survey results are useful but self-reported, and the paper is an arXiv preprint with proprietary production data that cannot be independently inspected from the public source.

Public workflow preview

The shape of the workflow

A high-level look at how the use case works, with the reusable pattern made clear.

01

Capture visit audio

With patient consent, the telehealth visit is recorded through the clinical workflow.

02

Transcribe the encounter

Whisper converts the audio into a transcript, with domain-specific prompting used to improve medical transcription fidelity.

03

Generate note sections

GPT-4o produces discrete SOAP-note components instead of one large note all at once.

04

Verify and assemble

Each generated section is passed through a verification step, then stitched into a draft note.

05

Create patient instructions

A separate GPT-4o prompt turns the visit into patient-facing instructions using simpler language.

06

Clinician review

The clinician reviews, edits, and approves the SOAP note and patient instructions before they enter the record.

Copy the pattern

The reusable idea

Pattern in one sentence

Turn a high-stakes conversation into a structured draft by transcribing it, generating narrow sections separately, verifying each section, and requiring expert review before final use.

Reusable idea

For any regulated or high-stakes workflow, copy the shape rather than the medical implementation. Start with the artifact people already have to produce, break it into sections with different rules, generate each section separately, run a verification pass, and require a qualified human to approve the final version. The key is designing AI around the review workflow, not around a magical one-shot answer.

Steal this workflow

Mini-template for structured draft generation:

Input: conversation transcript

Output: reviewed structured record

1

Create section list: [Section A], [Section B], [Section C], [User-facing summary].

2

For each section, write allowed evidence: “Only include facts directly stated in the transcript.”

3

Generate sections independently.

4

Run each section through a verifier: unsupported facts, missing negatives, repetition, formatting.

5

Assemble the draft.

6

Present the draft beside the source transcript for review.

7

Capture reviewer edits and tag them by type: omission, unsupported claim, tone, formatting, conciseness.

8

Update prompts or post-processing based on the top recurring edit types.

Suggested prompt

Suggested pattern for a draft-only documentation assistant: You are helping prepare a structured draft for expert review. Use only the transcript below. Do not infer facts, diagnoses, commitments, recommendations, or next steps that are not directly supported by the transcript. Generate only the requested section: [SECTION NAME]. First identify the transcript details relevant to this section. Then synthesize them into a concise, professional draft in the required format. If a detail was not discussed, omit it rather than saying it was not discussed. If multiple concerns are present, separate them clearly. Do not include commentary before or after the draft. After drafting, check your answer for unsupported claims, inferred action items, repetition, and formatting errors. Return the corrected section only. Transcript: [PASTE TRANSCRIPT]

Field notes

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