AI Scribe for Complex Medicine | Customizing Notes for Oscar EMR
Rose Bilotta
North York, ON, Canada
Doctor
Rose Bilotta
Specialty
Functional Medicine
Empathia can’t replace my judgment — but it needs to do the busy work of organizing my 200 pages of data that slows me down.
The challenge
Before Empathia
- Complex Data Overload: The system was unable to generate comprehensive summaries of 200-page lab and radiology reports from hospital records, leading to manual work.
- Slow Performance: Rose experienced frustration with the slow processing speed of the current system when generating draft summaries compared to other AI tools like Perplexity.
- Granular Template Needs: Required intricate customizations like "year-diagnosis; year-diagnosis" formatting for history and the removal of "not reported" text from empty fields.
- Workflow Gaps: The system could not currently upload additional documents after an encounter was created, forcing linear, rigid charting.
- Technical/UI Friction: Encountered issues with the Oscar extension icon blocking view and the inability to easily split screen on Mac. Rose expressed concerns about the slow performance of the current system compared to other AI tools like Perplexity. Michael acknowledged the feedback and promised to take it back to the engineering team.
Rose Bilotta deals with extremely complex patient data, frequently involving 200-page lab and hospital records from US medical tests. Her primary documentation challenge is the manual, inefficient extraction and summarization of this historical and lab data into her Oscar EMR. She requires a highly customized template structure—down to the semicolon—to maintain the accuracy and detail required for her specialty. Rose shared examples of comprehensive US medical tests and reports, highlighting the gaps in their current Canadian system.
The Transformation
After Empathia
Key Improvements
Template Customization & Macros: Used to define intricate formats and list styles; Michael is implementing requested granular changes.
Lab Summary Table (Commitment): Investigating a specialized template structure to summarize 200-page complex lab documents in a clear, columnar format over time.
Smart Edit (Future): Used to explore the system's current capacity for note modification.
Oscar EMR Extension: Troubleshooting the positioning issue and resolving audio permissions to ensure seamless use.
Performance Improvement (Commitment): Feedback escalated to the engineering team to address slow processing speed.
Michael and Rose used the session as a deep-dive technical troubleshooting and feature request review. Michael acknowledged the system's current limitations with complex data and committed to engineering investigations to solve performance and document handling issues. They agreed to prioritize template customization as the immediate solution.
Implementation & Workflow Adaptation
Michael committed to implementing an extensive list of specialty-specific template modifications to fit Rose's exacting needs:
• Lab Summary Structure: Commitment to working on a new template to properly summarize lab information in columns over time and a dedicated structure for handling 200-page lab documents.
• Detailed Custom Formatting: Modifying the medical history template to the exact "year-diagnosis; year-diagnosis;..." format. • Template Logic: Implementing logic to exclude fields that say "not reported" and ensuring blank spaces are added for manual inputs (Labs ordered, Ultrasound).
• Technical Fixes: Investigating and fixing the slow processing speed and the Oscar extension icon positioning issue.
• Future Feature Planning: Committing to investigating the ability to upload additional documents after an encounter is created and adding color coding to distinguish information sources.
The meeting resulted in a clear, ambitious roadmap to transform Empathia from a general-purpose scribe into a highly specialized documentation tool specifically for Complex Medicine. By committing to solving the problems of slow data processing, lab summarization, and template granularity, Empathia is working to eliminate the massive manual data entry burden Rose faces, freeing up time for analysis and clinical reasoning. They agreed to schedule a follow-up meeting the following week to further address Rose's needs, with Michael committing to investigate solutions for better document handling and template customization.
🚀 Results & Takeaways
Addressing Complex Data: Clear plan established for tackling the 200-page lab report summary challenge with specialized templates.
Granular Control: Commitment to implementing 10+ highly specific template modifications to meet specialty formatting requirements.
System-Wide Improvement: Feedback on slow performance and document upload gaps was escalated to the engineering team.
Continued Support: Follow-up meeting scheduled to ensure all customizations and fixes are successfully implemented.
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Key Features Used
Generate Other Notes
Instantly generate other clinical notes, like referral letters, patient handouts, sick notes, consult letters, etc
Smart Edit
AI-powered editing that understands medical context
Templates
Customizable templates for common visit types
