Frequently Asked Questions

Stream is an AI-enhanced medical documentation platform that is revolutionizing how clinicians interact with medical information, paving the way for a future that is less dependent on static and siloed notes. River Records is the team behind the magic!

Stream records your conversations and dictations and transcribes them in real time. Stream then organizes information into problem-focused sections, called 'cards'. Each card contains the information about a single medical problem (e.g. hypertension, anxiety disorder, healthcare maintenance) that is discussed during a patient encounter and is linked to similar cards from prior encounters. All of the information in our cards are also editable using additional audio recordings or by typing directly in the card, whichever is easier! Stream can also be integrated with your EMR.

We love an AI scribe, and Stream critically includes a state-of-the-art AI scribe as one of the primary methods of data capture in a patient encounter. You'll save time just by leveraging the scribe to generate your documentation. However, a scribe wraps up its work when the encounter is done. Stream is just getting started when an encounter ends. We know your patients' stories don't end when they walk out of the room, so Stream keeps working for you and your patients even when you're not with them. Stream captures your patients' medical problems and stores them for next time, so they're ready for you when you're ready for your patient.

Cards in Stream are individual problem-focused elements that store patient information relevant to the given problem or medical condition. Imagine these cards like the problem list in your current EHR where each item contains information that is important and related to the given problem. Cards by default follow a SOAP format (Subjective, Objective, Assessment, Plan), but templates are super flexible and allow customized structures and organization. Cards can also contain information about data that doesn't easily fit into a SOAP format - things like patient instructions, referral and work letters, and any kind of documentation you might need to write. Let Stream do it for you instead.

Stream works inside of a web browser so you don't need any specific apps or tools to use our system. It can run on a mobile phone, laptop, desktop, or any other wifi-enabled device that has a microphone. You can also use combinations of these tools if that works for you - record the visit on your smartphone, save the recording, and edit the note on your laptop or desktop. It's up to you!

Absolutely! Stream can be used on mobile as well as the desktop. If your desktop does not have a microphone you can open the application on your phone. We can also recommend a microphone to work with your computer if you would like. Reach out with any questions at support@riverrecords.ai.

Absolutely! We prioritize data security, employing advanced encryption and strict compliance measures to ensure that all patient information is handled with the utmost confidentiality and care. Our security practices are consistent with best in class HIPAA guidelines.

Stream isn't meant to replace your EHR so we do expect that you'll take what you need before you close your account. That being said, things happen. We're hopeful you'll return to Stream so we'll hold onto your data for 6 months in case you forgot something or want to get started again.

Absolutely. If you want us to delete your account just let us know and we'll delete everything on our servers that you created including patients, encounters, recordings, transcripts, and cards. Reach out to us at support@riverrecords.ai.

Clinical notes have traditionally been made up of sections for Subjective, Objective, Assessment and Plan. We write all of the subjective information in the Subjective section, even if that information pertains to multiple medical problems. Similarly we mash together objective data and then only in the plan section do we break things out into individual medical problems.

At River Records, we think that it makes more sense to organize information by problem, whether that's S, O, A, or P. This makes it much easier to review only the information you need at a moment in the future or for another clinician to review just the bits they need. No more scrolling through endless, mashed together SOAP notes. With Stream, you can navigate to the information you want with just a click on the problem list.

So, to answer your question, with Stream your note is made up of granular, problem oriented sections - or cards - that you can configure on export however you like and send to your EMR for storage. We support export as a set of problem oriented cards or a traditional SOAP. You can also opt for APSO output if that's your preference.

Yes, if you want a more traditional SOAP note there are a couple of ways to get there. Our preference, and the way that allows you to still take advantage of the problem based, longitudinal information management, is to simply use our existing export function. You can also write a template that will include all of the medical problems in one card (i.e. a Progress Note). Templates are super powerful and quite flexible. If this is your preference and you're running into any issues, don't hesitate to reach out to discuss.

Templates are super flexible. If you want a shorter note, a longer note, just a bulleted list, prose written in the style of Shakespeare, or anything in between, just write those instructions in a template, apply to a problem, and Stream will take it from there.

We know that everything doesn't happen when the patient is in the room with you. Whether pre-charting, after-hours charting, or anything in between, you can simply click 'record' and add new information to the chart using your voice. Click refresh on a card and Stream will update accordingly. If it's something small, all of the cards are also editable. This is great in the clinic, the emergency department, after a phone call with the patient, or wherever and whenever else you are working.

If Stream misses a detail, you can simply add another audio recording more explicitly stating the information or offering some instructions to the scribe; then simply refresh the relevant card(s). Alternatively, you can manually add or edit the information in the relevant cards simply by typing. Our system is designed to allow for multiple audio recordings, including pre-charting and after hours charting, to adapt to your specific workflow.

Stream aligns with modern billing requirements, focusing on medical decision-making and complexity in all of your visits. As list-based ROS and PE sections are no longer required, we have moved away from those structures to better reflect how we all think about our patients and diagnostic work-up. We encourage you to verbalize the pertinent positive and negative findings during your visit or post-visit wrap up, and we will make sure all of the relevant information is captured. However, if you feel that these sections support your decision making and documentation practices, you can customize the style of the output of our cards with templates.

Yes, Stream is designed for integration to fit into your workflows. We strive to make things smooth for you in clinic and to decrease your cognitive workload. With integration we will automatically build your schedule in Stream and push your completed documentation back to your EMR. Message us at support@riverrecords.ai to learn more.

Stream is extremely flexible. You can build templates to customize output from Stream however you would like it to appear. The most common use case involves customizing the order in which data appears in a section. However, you don’t have to stop there. Templates are extremely powerful and give you a lot of control over what is automatically generated. Templates can be used to generate patient instructions at a 6th grade level, write a referral or work letter, organize information for the future, or write any other kind of documentation you might need. You can also customize output based on keywords you mentioned in a recording. This is extremely powerful and means you can subtly prompt the system to write something for you if there are phrases you regularly use in conversation with patients. We’re excited to see what you build.

Absolutely! We prioritize data security, employing advanced encryption and strict compliance measures to ensure that all patient information is handled with the utmost confidentiality and care. Our security practices are consistent with best in class HIPAA guidelines.

Stream is currently $149 per month per clinician including email support from our team of physician informaticists so we can address any questions or issues that arise. Integrated accounts cost $225 per month per clinician. There is an integration fee depending on the size of your clinic. Message us about yearly discounts. If you are planning to enroll as part of an enterprise, please reach out to hello@riverrecords.ai for a detailed quote based on your team's needs.

All of our clients get a 14 day free trial to evaluate our platform and ensure it fits in their current workflow. If it does (and we are confident it will), you can elect to pay monthly, or yearly to lock in your rate. Contact hello@riverrecords.ai for details.

Yes! Though we strive to make Stream as intuitive as possible, taking full advantage of its capabilities may take some time. We offer 1:1 or 1:many onboarding sessions by Zoom. Message support@riverrecords.ai to schedule a session.

If you have a question that hasn't been answered here, don't hesitate to reach out to support@riverrecords.ai. There's no need to suffer in silence. Our team is here to help.