AI Medical Scribe for
Allergy and immunology consults pair long exposure histories with precise test data — wheal sizes, specific IgE titers, tryptase. AI drafts the consult note and keeps the numbers where you said them.
A real example of the documentation Medical Scribe generates for immunopathologists — ready as soon as you finish dictating.
24F referred following two episodes of anaphylaxis in the past 4 months, both within 30 minutes of restaurant meals: generalized urticaria, throat tightness, and wheeze; the second treated with IM adrenaline in ED. Suspects nuts; has avoided peanut since childhood 'itchy mouth' episodes. PMH: allergic rhinitis, mild eczema in childhood. Current medications: cetirizine 10mg PRN. Family history: mother with asthma. No new cosmetics, medications, or insect stings preceding either episode.
IgE-mediated tree nut allergy (cashew/pistachio predominant) with two episodes of food-triggered anaphylaxis; baseline tryptase normal, mastocytosis not suspected. Plan: strict tree nut avoidance including cross-contact precautions; adrenaline auto-injector 300mcg prescribed, two devices; cetirizine 10mg daily during pollen season for rhinitis; dietitian referral for avoidance and label-reading education; review in 6 months with repeat specific IgE.
Anaphylaxis action plan completed and provided. Auto-injector technique demonstrated and return-demonstrated by patient. Advised to wear medical alert identification and to inform restaurants of tree nut allergy. Patient's questions regarding coconut answered (not restricted).
Illustrative example. Every note is fully editable, and you control the format — SOAP, DAP, or your own custom template.
Food, drug, environmental, and occupational exposures; family atopy; every prior reaction with timing and severity. A thorough immunology history takes 40 minutes to elicit and nearly as long to type.
Skin prick wheal diameters, serum specific IgE in kUA/L, tryptase levels, patch test reads at 48 and 96 hours — one transposed number changes the clinical picture.
When the plan includes strict avoidance and an adrenaline auto-injector, the documentation of triggers, education given, and action plan provided must be complete and unambiguous.
Real-time transcription that understands medical terminology and clinical context.
Recognizes terms, conditions, and procedures specific to your practice area.
Generate comprehensive clinical notes in minutes instead of hours.
Enterprise-grade encryption and security to protect sensitive data.
These aren't generic formats — they ship in the product today, structured around how you actually document.
Plus 280+ templates across every specialty — or build your own in minutes.
An immunopathology consult lives or dies on the story: what was eaten, when the reaction started, how it was treated, what runs in the family. Medical Scribe records the consult, in clinic or via telehealth, and drafts the note while you focus on eliciting the history rather than transcribing it.
The built-in Immunopathologist’s Note follows your assessment: a Subjective section spanning presenting reactions, dietary, environmental, and family history; an Objective section for examination findings and investigations — skin prick results, specific IgE, tryptase; and Assessment & Plan covering diagnosis, testing planned, avoidance strategies, immunotherapy options, and emergency management education.
Immunology decisions hinge on values — an 8mm wheal versus a 3mm one, a rising titer versus a stable one. Medical Scribe documents only the results and findings you actually stated in the consult, never inferring or inventing data, so the note you sign reflects your workup and nothing else.
The Objective section of the Immunopathologist's Note records the values you dictate during the consult — wheal diameters with controls, specific IgE in kUA/L, tryptase — exactly as spoken. You verify every number when you review and sign, and it never fills in results you didn't state.
Yes. Education on auto-injector use, avoidance strategies, and the action plan you provided are captured in the note's plan and additional notes — but only if that discussion actually happened in the visit, which is exactly what medicolegal review of an anaphylaxis consult looks for.
Yes. The built-in Immunopathologist's Note (Subjective, Objective, Assessment & Plan) scales from a full first consult with complete exposure and family history to a brief immunotherapy or urticaria review. Custom templates for your clinic letters take minutes.
Medical Scribe is HIPAA compliant with encryption in transit and at rest. Notes are drafted from the recorded consult, and nothing enters the record until you have reviewed and signed it.
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