Need Help with Efficiency and SOAP Notes? Use Freed AIScribe

About 6 months ago, I started doing a lot more teaching in addition to my clinical work. This meant going from 14 patients per day to up to 36 patients per day. I knew I was going to need a new way to balance out my work life balance. I decided to give an AI Scribe a try. I certainly have plenty of concerns about AI, particularly the fear of "training my replacement." That said, I think that using an AI Scribe actually calmed my fears down (for the time being).

Freed reached out to me about a partnership recently and offered me discounted rates. Little did they know, I've already been using their service for about 6 months. Again, that AI was not aware of this, was quite reassuring to me. I honestly cannot even figure out how to access my discount code with them without canceling my old subscription, so I'm just going to rough it and stick with my subscription.

If you don't need to read anymore about Freed and want to try an AI Scribe, here's a link: getfreed.sjv.io/EE0QRW

Code: TallyRepro50

I do not use Freed AI everyday. I do use it most days of the week. I have found that at my peak performance time, from about 9:30am -11:30 am that I am faster than Freed for follow up appointments (not new intakes). I typically have my follow up appointment notes done 2-5 minutes before Freed AI has finished processing the information. This goes back to the reassurance factor that I will not be replaced (yet) by AI. Plus, I very much enjoy bragging being faster than AI (at this time).

If I am faster than the AI Scribe, why do I continue with my own subscription and use it throughout my work week? Well, I am not always faster than Freed AI Scribe. I am sure you have experienced the effect of the long day, maybe too many patients, a heavy lunch or no lunch at all as the lull of 3 pm approaches. This is the time which I use Freed AI Scribe the most. During this time of day, having the back up is simply invaluable to me. I must admit that during this lull in the day, I tend to "space out" a little and forget details that I would normally like to document. Freed AI picks up on these lost details and summarizes them for me.

How does it work? Well, I have an app on my phone or access on my computer. I can turn either on to listen to my encounter with myself and the patient (it works well for in person or telemedicine). I do always obtain verbal consent before starting the use of the Freed AI and then document it in the chart. I had considered using a one time document consent form for each patient, then documenting their consent in the chart, and using Freed AI whenever it was my preference. I do the verbal consent with each encounter to inform the patient I am using the service regardless of whether or not they have previously consented to using AI. I imagine that there are some conversations that a patient who previously consented to use of an AI Scribe may decide they don't want listened to.

I am quite surprised at my patients' level of comfort with Freed AI Scribe . I do not think that I a single patient has declined consent of an AI Scribe. I find this very surprising, but also I would definitely consent to use of this service for my own medical appointments. I think my patients actually prefer when I use the app as I am able to maintain a much more conversational style encounter without having to obsess over my parallel processing of documentation. I certainly feel more relaxed myself when using the AI Scribe. I do not think use of Freed AI Scribe changes the encounter drastically whereas when I have a student present, I can certainly notice a different in my patient's behavior and comfort level. I think the invisibility of Freed AI Scribe is really important to its utility and prefer it to an in person scribe. I do prefer documenting some information during the appointment instead of just letting AI do all the work because I like to visually look at the data I've collected and use it in my treatment plans. I suppose I could terminate the encounter early, and have Freed AI summarize the data for me, but I think they timing would not work out well.

This service is definitely more targeted for a primary care provider as a opposed to a psychiatrist. The mental status exam is not adequate, but I have my own template I use on a daily basis anyway. The service does a really nice job with subjective, summary, and plan. The plans are problem based. The service is surprisingly accurate and I usually have very little changes that I need to make to the notes. The app does get confused if you talk about someone else's medical problem, for example, if I am gathering a reproductive history on a patient's mother, it has interpreted this information as referring to the patient instead of her mother. This does not happen often and really only happens if I am asking multiple in depth questions about the health problems of a family member.

I have also found that Freed AI Scribe is really helpful for intakes. I certainly can get quite bogged down in all the details I want to obtain, especially in older women with a history of PMDD, postpartum depression who are now in perimenopause. In reproductive psychiatry, this sort of intake can really be like two in one because you have to ask so many in depth questions over the course of someone's life experiences. Freed AI is definitely better at writing follow up notes, but it helps me keep track of details I would have otherwise lost in these longer intakes.

Do I recommend Freed? Yes. Is it perfect? No, but nothing is (or should be?)

Freed AI Scribe is certainly very useful and helps me get home to my family earlier which is time that is worth way more than the cost of the subscription.

Sign up for Freed AI Scribe here: getfreed.sjv.io/EE0QRW

Code: TallyRepro50

I wanted to show you an example of the note, so I spoke to Freed myself with some pretty standard complaints around depression. This is not from a patient encounter or self disclosure. I made zero edits to the note.

Visit Summary: Jamie reports worsening depression with insomnia, poor concentration, decreased appetite, and passive suicidal ideation without a plan. She is currently taking Lexapro 20 mg daily and experienced palpitations after an accidental double dose, with a negative EKG result. Jamie also reports weekly panic attacks, anxiety, and sexual side effects from Lexapro. The plan includes continuing Lexapro, starting BuSpar for anxiety and sexual side effects, and addressing insomnia and family stressors. Follow-up is scheduled in 4-6 weeks.

Subjective:

Patient reports worsening depression with associated symptoms including insomnia, poor concentration, decreased appetite, and passive suicidal ideation without plan. She feels safe at home and has support from partner. Currently taking Lexapro 20 mg daily. She experienced palpitations after accidental double dosing of Lexapro, which resolved. ER visit for palpitations resulted in negative EKG.

Patient reports experiencing anxiety and panic attacks occurring approximately once weekly. She is concerned about mother's unspecified problems.

Patient notes sexual side effects from Lexapro and inquires about treatment options for both sexual dysfunction and panic attacks.

Medical History

- Depression

- Anxiety

- Panic attacks

Current and Past Medications and Supplements

- Lexapro 20 mg once daily

Social History

- Living situation: lives with partner

- Social support: partner is aware of patient's condition and providing care

Review of Systems

- Psychiatric: Depression worsening, trouble sleeping, poor concentration, decreased appetite, suicidal thoughts without plan, anxiety, panic attacks occurring once a week

- Cardiovascular: Heart palpitations (resolved)

- Sexual: Sexual side effects from medication

Objective:

- Mental Status Examination:

- Reports worsening depression

- Difficulty sleeping

- Poor concentration

- Reduced appetite

- Experiencing suicidal ideation without a plan but feels safe at home

- Experiencing anxiety and panic attacks approximately once a week

- Vital Signs:

- N/A

- Physical Examination:

- N/A

- Diagnostic Test Results and Labs:

- EKG: Negative, performed during an ER visit for heart palpitations after accidental double dosing of Lexapro (date of EKG not specified)

Assessment and Plan:

1. Major Depressive Disorder:

- Continue Lexapro 20 mg once daily

- Monitor for worsening of symptoms and suicidal thoughts

- Encourage the patient to maintain open communication with their partner and healthcare provider

2. Insomnia:

- Address underlying depression and anxiety

- Encourage good sleep hygiene practices

- Reassess sleep quality at follow-up visit

3. Anxiety and Panic Attacks:

- Start BuSpar for anxiety management; discuss scheduled or as-needed dosing with the patient

- Encourage the patient to engage in relaxation techniques and consider therapy for anxiety management

- Monitor frequency and severity of panic attacks at follow-up visit

4. Sexual Side Effects:

- Initiate BuSpar to help alleviate sexual side effects from Lexapro

- Monitor for improvement in sexual function at follow-up visit

5. Palpitations:

- Reassure the patient that EKG was negative and palpitations resolved after accidental double dose of Lexapro

- Instruct the patient to avoid taking double doses and to contact healthcare provider if palpitations recur

6. Family Stressors:

- Encourage the patient to seek support from friends, family, or a therapist to help manage stress related to their mother's health issues

- Monitor the patient's emotional well-being at follow-up visit

Follow-up:

- Schedule a follow-up appointment in 4-6 weeks to assess the patient's response to BuSpar and overall mental health status.

Patient Letter:

Dear Jamie,

Thank you for visiting today and discussing your health concerns. I appreciate your commitment to improving your mental health and am here to support you in every step of your journey.

Here are the key instructions and recommendations from our consultation:

- Continue taking Lexapro 20 mg once daily. Be cautious not to double the dose as previously experienced.

- Start taking BuSpar to help manage your anxiety and address the sexual side effects from Lexapro. You can take it either scheduled or as needed. We will start with a dose of 5 mg twice daily.

- Monitor your symptoms closely, especially your sleep patterns, eating habits, and any suicidal thoughts.

- Follow up appointment: Please schedule a follow-up in 4 weeks to assess how you are doing with BuSpar and discuss any adjustments needed.

- Support: Continue to communicate openly with your partner about your feelings and symptoms.

Please feel free to reach out if you have any questions or if there is anything else we can do to assist you.

Best regards,

[Your Healthcare Provider’s Name]

Sign up for Freed AI Scribe here: getfreed.sjv.io/EE0QRW

Code: TallyRepro50