Should I use the AI scribe built into my EHR, or a separate one?

Short answer: if you are employed and the choice was made for you, use the scribe built into your EHR. If you own the practice, a separate AI scribe is usually the better long-term choice, because it writes in your template and goes with you when you change records systems. The built-in one is easier on day one. The separate one is yours.

Clinicians have been arguing about this all year, mostly among themselves, and the argument is worth listening to.

Built-in vs. separate AI scribe at a glance

Why do clinicians like the scribe built into their EHR?

Because there is nothing to set up and nothing to paste. A clinician at a physical therapy practice, on the scribe built into their clinic's records system:

“It works great, as long as you don't forget to record.”

A clinician whose employer offers only the scribe inside its records system likes theirs too:

“It sometimes tends to spit out juvenile sounding language, but it is pretty accurate and saves me boatloads of time.”

Convenience is not a small thing at six in the evening. That is the whole case for built-in, and it is a good one.

What goes wrong with a built-in AI scribe?

The note is written in the records system's style, not yours. A clinician using a health system's built-in scribe:

“I've found it to be quite thorough, almost TOO thorough at times. And it cannot format to whatever you may use at your site for templates.”

A clinician at the VA has found a workaround, and the workaround tells you everything. They copy the scribe's note into a second AI tool, one they have trained “to turn the note into the sections that go into my psychotherapy template.” Two tools to get one note.

Why does a built-in scribe make it hard to switch EHRs?

Because the scribe is the part of the records system you touch at every visit, so it becomes the part you cannot leave. One clinician running a psychiatric practice was comparing two records systems. The one they use today comes with what they call an “amazing psych-intuitive AI scribe.” They want more flexible templates and a patient portal. The scribe, they say, is their “sticking point.”

A psychiatric nurse practitioner in the same conversation is doing the arithmetic from the other side: a biller at 5 percent, an extra charge for faxing, a work phone for texting patients, and a separate scribe. An all-in-one system might save them money, but:

“If it's not a good eHR or if the e prescribing is terrible or something, then it's not worth it.”

What does a separate AI scribe do better?

It is yours, so you can change it. A clinician who pays more for theirs because it “picks up the nuances of psych very well and is very customizable” has found a cheaper tool they like:

“If I can get the templates customized the exact way I like it, I may jump ship.”

Nobody jumps ship on their records system to save on the scribe. With a separate one, you can. Another clinician puts the buying test in one line:

“The best AI scribe IMO is the one that copy/pastes the generated note with the touch of a button into your EHR and the one that allows you to customize the template.”

A third says the copying is the point: it makes them review the note properly before they sign.

What is the downside of a separate AI scribe?

The seam between the scribe and the records system. If the paste is slow or the format fights you, a separate scribe loses its point.

“The AI is poorly integrated with the EMR we use, so it takes longer to edit them as opposed to just writing a regular note.”

How should a practice owner choose?

1. Ask the portability question first: when I change records systems, do my scribe, my template and my habits come with me?

2. Run one recorded visit through each tool and count the lines you rewrite.

3. Time the paste on a real note. More than a few seconds, every visit, adds up.

4. Price each option in patient visits per month, including what you would pay to leave.

5. Read the contract questions before the trial ends.

Frequently asked questions

Is the AI scribe built into my EHR free?

Sometimes it is included and sometimes it is an add-on. Either way you pay, in the subscription or in the cost of leaving later. Ask what the scribe costs on its own, and what happens to your templates if you change records systems.

Can I use a separate AI scribe with any EHR?

Usually, yes. Most separate scribes produce a note you paste into any records system, and some export directly. Test the paste on a real note before you buy. If it is slow or breaks your formatting, it will cost you at every visit.

Do my notes stay in my EHR if I change scribes?

Yes. Signed notes live in your records system either way. What you lose when you change scribes is the setup: your template, your prompts and your habits. With a built-in scribe, you lose them when you change records systems instead.

The short version

The built-in scribe is convenient until you want to leave. A separate scribe is yours, in your template, and it goes with you when the records system changes. Solanto will be the separate one: it will write in your template, put the note where you sign it, and leave the judgment to you, in Cloud mode or in Private Mode, where the note never leaves your device.

The price is on the page, not behind a call. Early access is open: solanto.ai/pricing

Ask the colleague who calls their scribe the reason they cannot switch what it would take to leave. Then send them this.