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AI Scribe for Emergency Medicine

Transcribe Health drafts your ED notes while you work the board, so the history, exam, and decision-making are on the page by the time you disposition the patient.

Photo: engin akyurt / Unsplash

Emergency documentation, at the pace of the shift

Emergency medicine documentation is unlike any other specialty because you are never charting one patient. You are holding four or five in your head at once, each at a different point in a workup, and the note for the chest pain in bed 3 gets interrupted by an EMS call, a positive troponin, and a septic patient rolling through the doors. By the time you sit down to write, the details have blurred together.

The chart also has to carry weight it does not in clinic. Your medical decision-making is what supports the E/M level and what an auditor reads first. For a high-acuity patient that means the differential you ran, the data points you reviewed, and the risk you were managing all have to be on the page, not just the final diagnosis. A syncope workup that ends in discharge still needs to show why you ruled out the dangerous causes.

Transcribe Health listens through the encounter and drafts the note as you work: the HPI from the patient, the exam as you call it out, the MDM from your reasoning, and the disposition from your plan. You read it, correct anything, and sign. It does not order tests or make the call. It records the thinking you already did so you are not rebuilding it from memory at the end of a ten-hour shift.

Documentation Challenges in Emergency Medicine

  • 1

    Charting a full board at once, with constant interruptions from nurses, EMS handoffs, and new arrivals breaking up every note you try to finish

  • 2

    Capturing medical decision-making in enough detail to support a level 4 or 5 chart: the differential you considered, the data you reviewed, and the risk that justified the workup

  • 3

    Documenting undifferentiated complaints, chest pain, abdominal pain, syncope, where the note has to show your reasoning through a workup that may or may not land on a diagnosis

How Transcribe Health Helps Emergency Medicine

MDM Capture for High-Acuity Charts

Records the differential you talked through, the labs and imaging you reviewed, and the risk that drove your plan, so the note supports the level you actually worked at.

Workup and Disposition Documentation

Follows an undifferentiated complaint through orders, results, and reassessment, and writes up the disposition with the reasoning behind admit, discharge, or transfer.

Notes That Survive Interruptions

You can step away mid-encounter and come back. The draft holds what was said and picks up where you left off, so a broken-up shift does not mean a broken-up note.

An ED note, captured during the workup

An abridged chest pain encounter with a HEART score workup and disposition, drafted the way you would see it before signing.

ED visit · Chest pain, HEART score workup, observation disposition
HPI

54-year-old man presents with 2 hours of substernal chest pressure that started at rest, non-radiating, associated with mild diaphoresis, no nausea. Pain was 6 out of 10, now 2 out of 10 after aspirin given by EMS. History of hypertension and a 30 pack-year smoking history. No prior cardiac history, no known CAD. Denies dyspnea, syncope, or leg swelling.

Exam

BP 148/88, HR 78, RR 16, SpO2 98% on room air, afebrile. Alert, no acute distress. Heart regular rate and rhythm, no murmur. Lungs clear. No JVD, no peripheral edema. Chest wall non-tender to palpation. Skin warm and dry.

MDM

Undifferentiated chest pain in a patient with cardiac risk factors. Differential includes ACS, aortic dissection, PE, and musculoskeletal pain. ECG shows normal sinus rhythm with no ST-segment changes or T-wave inversions. Initial high-sensitivity troponin negative. Chest x-ray with no acute process, no mediastinal widening. HEART score 4 (history 1, ECG 0, age 1, risk factors 1, troponin 1), intermediate risk. Given intermediate risk and a single negative troponin, will place in observation for serial troponins and monitoring rather than discharge.

Disposition

Admit to observation. Serial high-sensitivity troponin at 3 hours. Continuous cardiac monitoring. Aspirin 324 mg given. Cardiology consulted for stress testing versus CT coronary angiography per their protocol. Patient and family updated on the plan and reason for observation. Reassess after second troponin resulted.

Illustrative example. Not a real patient encounter.

Built for emergency medicine coding and your EMR

The note captures the data you reviewed, the number and severity of problems, and the risk that back up your ED E/M level. That is the detail auditors look for on a level 4 or 5 chart, and the first thing to slip when you are charting between patients.

CPT
  • 99283ED visit, moderate complexity
  • 99284ED visit, high complexity, moderate severity
  • 99285ED visit, high complexity, high severity
  • 99291Critical care, first 30 to 74 minutes
  • 12001 / 12002Simple repair of superficial wound, scalp, trunk, or extremities
  • 9301012-lead ECG interpretation and report only
ICD-10
  • R07.9Chest pain, unspecified
  • R10.9Unspecified abdominal pain
  • R51.9Headache, unspecified
  • R55Syncope and collapse
  • I20.9Angina pectoris, unspecified

Fits the workflow you already have

Drafts drop into the EMRs emergency departments run on: Epic (including the ASAP module), Oracle Health (Cerner), and MEDITECH. You get the note type you are working in, whether that is a standard ED visit, a critical care note, or a procedure note for a laceration repair. It writes up the ECG and imaging interpretations you dictate. It does not read the tracing or the film and it does not replace your ordering system; you make the call and it records it.

What's Happening in Emergency Medicine

JAMA Network Open

ED Physicians Spend 43% of Time on Data Entry, Only 28% on Patient Care

A study of 79 emergency physicians found they average nearly 4,000 mouse clicks during a 10-hour shift and spend 43% of their time on data entry vs. only 28% on direct patient care.

The ED documentation burden is acute. Ambient transcription during fast-paced encounters can shift the data entry vs. patient care ratio back toward clinical work.

Read more
Vizient

139.8 Million ED Visits Annually with 5% Projected Increase

Americans made 139.8 million ED visits in 2024. Projections show a 5% increase in inpatient utilization and 10% rise in inpatient days over the next decade, with behavioral health patients averaging 9-10 hour ED stays.

Rising volumes with constrained throughput demand faster documentation. AI transcription reduces per-encounter documentation time in a high-volume, time-critical setting.

Read more
Cureus

ED Crowding Consistently Causes Delays and Increases Complication Risk

A systematic review confirms ED crowding consistently delays essential assessments and treatments, prolongs length of stay, increases complication risk, and disrupts workflow efficiency.

Documentation delays contribute to the bottleneck. Faster, automated documentation during encounters improves throughput and reduces boarding-related workflow disruption.

Read more

Emergency medicine AI scribe questions

Can it keep up when I'm charting several patients and getting interrupted?
Yes. Each encounter is a separate draft, so you can move between patients and come back without losing what was said. When a note gets cut off by an EMS call or a new arrival, it holds the thread and picks up where you left off.
Does it document medical decision-making well enough to support my coding?
It captures the differential you talked through, the labs and imaging you reviewed, and the risk that drove your plan. That is the MDM detail that supports an ED level 4 or 5 chart and holds up on audit, which cuts down on both under-coding and clawback exposure.
Does it handle undifferentiated complaints and negative workups?
Yes. For chest pain, abdominal pain, or syncope that ends in discharge, the note still shows the dangerous causes you ruled out and why. Your reasoning through the workup ends up on the page, not just the final diagnosis.
How is patient information protected?
All data is encrypted in transit and at rest, handled under a Business Associate Agreement available on every plan, and covered by HIPAA for US practices and PHIPA and PIPEDA for Canadian practices.
Does it connect to our EMR?
Structured notes drop into major ED EMRs including Epic with the ASAP module, Oracle Health, and MEDITECH. It documents the ECG and imaging interpretations you give; it does not read tracings or films or replace your ordering system.
HIPAA Compliant

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