The scribe for patients whose
chart arrives before they do.
Mast cell disease, dysautonomia, Ehlers-Danlos, tick-borne illness, autoimmunity, long COVID, PANS/PANDAS. Adults and children reach you after years and many clinicians, carrying records to match. Stream files all of it by medical problem, so the thread you are following stays visible across a workup that runs for months — or a relationship that runs for a decade.
Most AI scribes are built for
a patient with one problem.
Record the visit, generate the note, move on. That assumes the visit is the unit of work. In this medicine it is not — the unit is a multi-system picture assembled over months, from your own visits and from everything the patient brought with them.
So this is not a pitch about shorter visits. You built an independent practice to spend more time with patients, not less. The time worth protecting is the other kind — re-reading, re-deriving, hunting through a chart for a decision you already made.
The intake is a records project
Hundreds of pages before the first visit — a dozen subspecialists who each saw one system, or years of neuropsych evaluations, school reports and therapy notes. The synthesis exists nowhere but in your head, and you rebuild it every time they come back.
The workup outlives your memory of it
A differential narrowed over eight months. Treatments tried, escalated, abandoned. The one result that moved things. In a stack of dated notes the reasoning is gone, and re-deriving it becomes the visit.
Multi-system means the note fights you
Mast cell disease, dysautonomia and a tick-borne history are not one problem with one plan. A scribe that writes a single note per encounter flattens exactly the structure you need to keep.
"The note isn't the problem. The note as the only organizational unit for clinical knowledge — that's the problem. Every patient is a longitudinal project. Stream is built to manage it."
Designed around the records, not the encounter.
Because in this work, the reading is most of the job.
Turn the box of records into a problem list.
Upload the consult PDFs, the neuropsych evaluation, the school report; paste the free text; take in the fax. Stream summarizes what arrived and files the relevant pieces under the problem each one belongs to. The stack from a dozen prior clinicians, or from a decade of speech, occupational and psychological therapy, becomes something you can read before the patient sits down — two lines instead of twenty pages, per problem.
The intake is the work. This is the step the other specialty pages treat as a footnote.
See one problem across the whole workup.
Open any problem and view every Assessment & Plan you have written for it, in order, plus an on-demand recap of how it evolved. What you tried, what you ruled out, and why you moved on — recoverable in seconds rather than reconstructed from memory at the start of every visit.
Also how a new partner inherits a patient you have carried for a decade. Pastes into MDHQ, Cerbo, Charm, Elation — or works on its own.
Nothing falls through a long interval.
Pending labs, timed and specially-handled collections, records you requested from an outside clinician and follow-ups you set months out are extracted from each visit and tied to the problem they belong to. When a patient travels to reach you and is seen a few times a year, the interval is where things get lost.
Coding when you want it: ICD and CPT capture suggestions at the point of care, ignorable if you do not bill insurance.
Ordered by what this work actually demands.
External Record Ingestion
Upload a consult PDF, paste free text, or take in a fax. Stream summarizes it and files the relevant pieces under the right problem. For a patient arriving with years of outside workup, this is the feature that matters most.
Problem-Oriented Chart
Every visit's Assessment & Plan is filed under the medical problem it belongs to. A multi-system patient keeps a multi-system structure instead of being flattened into one document per visit.
Timeline + Recap
Open any problem and see every A&P you've written for it over time, plus an on-demand recap. The reasoning behind a months-long workup stays recoverable — and a clinician joining the practice can pick up a patient carried for years without reading the whole chart.
Pre-Visit Huddle
Five minutes before a visit, Huddle surfaces what's active, what's been falling off your radar, and what's still pending — drawn from the whole history, not just the last note.
Automatic Task Tracking
Pending labs, timed collections, outside records you requested and long-dated follow-ups are pulled from each visit and tied to their problem — so an eight-week interval doesn't swallow them.
Coding When You Want It
ICD and CPT capture suggestions at the point of care. Useful for the visits you do bill, and entirely ignorable in a cash-pay practice.
What it changes, in one clinician's words.
"I can review and reuse information from previous visits inside Stream — creating a more comprehensive note every time."
What Stream does not do.
You will find this out in the trial anyway, so here it is first.
It does not write back into your EHR.
Stream produces the note and you paste it. Worth knowing what that costs you here specifically: practices in this field typically run MDHQ, Cerbo, Charm or Elation, and no AI scribe writes back into those either. It is a real limitation and a smaller one than it would be in a hospital-owned primary care clinic.
It does not interpret results or suggest diagnoses.
Stream organizes what you wrote and what you received. It will not read a mediator panel and tell you what it means. It is not clinical decision support and has no opinion on your differential — a deliberate line in a field where a great deal of software claims otherwise.
It is not SOC 2 certified.
Stream is HIPAA compliant, signs a BAA with every subscriber, encrypts data in transit and at rest, and never trains models on your patient data. It does not hold SOC 2, and we will not imply a date for it. More detail on security.
It does not know your field's frameworks.
Stream has no built-in consensus criteria for mast cell activation, no scoring for dysautonomia, no protocol library. It structures your reasoning; the reasoning is yours.
$149/month. Start free.
Unlimited visits. Works alongside any EHR. 30-day free trial, no credit card required.
Start free for 30 daysMulti-provider practices can ask about per-seat Clinic pricing with volume discounts.
Frequently asked questions
Is Stream a good fit for a complex chronic or integrative practice?
What happens to the records a new patient brings with them?
Does this work for a paediatric developmental or integrative practice?
Does Stream work with MDHQ, Cerbo, Charm or Elation?
Does Stream interpret labs or suggest diagnoses?
Is my patient data used to train AI models?
Built by practicing physicians. Published in JAMA Network Open. Read the research →
Built for the patients
nobody else could organize.
Start your 30-day free trial. No credit card. $149/month after trial. Works alongside any EHR.
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