Read a short visit aloud with a colleague and record it with each scribe you are considering. Then check each note against the answer key below. Because you wrote the visit, you know exactly what was said, so you can see what a note added, dropped or turned around. Three tools take about twenty minutes.

Why use a script?

Because checking a note against memory is guesswork. A note you barely changed can be right, or it can be wrong in ways you did not catch. A script gives you the truth before you start.

Use a role-play, never a real patient’s audio. A colleague reads the patient and you read the clinician. For something shorter, the ten-minute check has five quick tests.

The test visit

About six minutes at a normal pace. Read it as written, small talk and correction included. When you reach the ankle check, do it without saying anything.

Clinician: Hi, come on in. Before we start, is it all right if I use my scribe today? It listens and writes the note.

Patient: Sure, that’s fine. Oh, and just so you know, I use they and them.

Clinician: Thank you. So, what brings you in?

Patient: My blood pressure check. And I’ve been getting winded on the stairs at work. We moved to the fourth floor in June.

Clinician: How long have you noticed that?

Patient: About two months. It’s worse by the end of the day.

Clinician: Any fevers?

Patient: No, none.

Clinician: Any swelling in your legs?

Patient: Maybe a little in the evenings. My socks leave a mark.

Clinician: Okay. Let’s go through your medicines. You’re on lisinopril 10 milligrams. No, sorry, 20 milligrams, once a day.

Patient: Twenty, yes. In the morning.

Clinician: And metformin, 500 twice a day?

Patient: Right. My last doctor said my kidneys were fine, so we kept it the same.

Clinician: Good to know. Anything else going on?

Patient: My sister was just diagnosed with diabetes. She’s on insulin now. It scared me a bit.

Clinician: That’s understandable. And your knee, after the surgery?

Patient: That was years ago. It’s fine now.

Clinician: Glad to hear it. How was your weekend?

Patient: Busy. We took the dog to the lake. He refused to get out of the water.

Clinician: Sounds like a good dog. Let me have a listen. Deep breath in, and out. Lungs are clear.

The clinician presses on both ankles for a few seconds and says nothing.

Clinician: Heart sounds regular. Your blood pressure today is 148 over 92.

Patient: That’s higher than usual.

Clinician: It is. Here’s the plan. We’ll keep the lisinopril at 20 for now. I’ll send an order for a basic metabolic panel today, so we can check your kidneys and potassium. I’d like to see you back in four weeks to recheck your blood pressure. If the breathlessness gets worse, or you get chest pain, call us the same day.

Patient: Okay. Four weeks.

The answer key

Check every note against these twelve lines. Checks 1 to 8 are about truth, 9 and 10 about what is missing, 11 and 12 about noise.

1. The correction and the numbers. Lisinopril 20 mg once daily, not 10. Metformin 500 mg twice daily. Blood pressure 148/92.

2. Pronouns. They and them, all the way through.

3. Claims stay claims. Kidney function is what the last doctor reportedly said, not a finding.

4. Nothing made up. No “denies chest pain.” Nobody asked.

5. Negatives the right way round. Denies fever. Reports mild leg swelling in the evenings, not “denies swelling.”

6. No diagnosis you did not make. Breathlessness on stairs for two months, described, not named.

7. Someone else’s history stays theirs. The sister’s diabetes and insulin go under family history. The patient is not on insulin.

8. Only the exam you said. Lungs clear, heart regular. Nothing about the ankles.

9. The promise. Basic metabolic panel ordered today.

10. The plan as said. Keep lisinopril at 20 mg. Recheck blood pressure in four weeks. Call the same day if breathlessness worsens or chest pain starts.

11. Old problems stay old. The knee surgery is history, not an active problem.

12. No small talk. No dog, no lake.

Any miss in checks 1 to 8 means you would be signing something that did not happen. That tool fails, however fast it was. Misses in 9 to 12 cost you edits.

Did it say more than you did?

Some rewording is the point of a scribe. Some of it is a problem. Here is where the line sits, using the visit above:

1. Tidied. “Getting winded on the stairs at work” becomes “shortness of breath on exertion.” Fine.

2. Filled in. It adds “for two months, worse at the end of the day.” Fine, because the patient said it.

3. Jumped ahead. It writes “exertional dyspnea, likely heart failure.” Fail. You never said it.

4. Made up. It writes “denies chest pain.” Fail. Nobody asked.

Is it yours?

If two tools pass the key, compare four things:

• Minutes from the end of the visit to a note you would sign.

• Lines you changed. A line you had to add because it was missing counts twice.

• Whether the note landed where you sign it, in your own template.

• Whether it left the assessment and plan to you, or wrote its own.

Before you sign anything

Ask the vendor these five questions, and ask for the answers in writing:

1. Where does the audio go, and how long is it kept?

2. Which other companies handle it?

3. Is anything from my visits used to train models, and is opting out the default?

4. Can I cancel in any month?

5. What happens to my notes if I leave?

Frequently asked questions

How long does the test take?

About six minutes to read the visit aloud, then a few minutes per note to check it against the key. Three tools take about twenty minutes.

Can I use a real patient visit instead?

No. A role-play gives you a visit you can check line by line, and no patient information leaves the room.

What if two tools pass every check?

Then compare the second part: minutes to a note you would sign, lines you changed, and whether the note lands in your template.

The short version

Read the visit, record it with each tool, and check the note against the key. If a note says something that did not happen, you are the one who signs it.

Run it on us too. If we fail one, tell us at aj@solanto.ai.

Send this to the colleague who is about to sign up for a scribe.