PatientScribe

The door closes behind you.

Twenty steps down the corridor it has already started coming apart: the dose that changed, the scan someone said to book, the name of the drug that replaces the other one, the question you thought of on the way out.

An ink and coloured-pencil drawing of a woman just outside an exam room, reading a printed after-visit summary. Above her, four handwritten instructions are repeated in fainter writing that loses its letters and breaks apart into loose marks.

So we write it all down.

What was actually said in the room, in words you can still read at the kitchen table on Thursday.

The app's recording screen: Recording for Sandy, a consent reminder, and a Tap to record button.

You say you are recording, and then you stop taking notes.

One tap. The phone goes face-up on the desk, or stays in the bag while the Watch listens.

An ink and colored-pencil drawing of a woman asking her doctor's permission to record, holding her phone up slightly while the doctor, still standing, nods; handwritten words above her read: Okay if I record?
Five seconds, and everyone in the room heard it.

By the time you reach the car, it is being written up.

Two or three minutes for most visits. The walk to the car is usually long enough.

An ink and colored-pencil drawing of a woman walking out of the clinic toward her car, reading a notification on her phone that says her summary is ready.

A recording on the way out, a written visit on the way back.

The same four things that came apart in the corridor, written down where you can get back to them.

An ink and colored-pencil drawing of a woman at home on her sofa, reading her visit summary on her phone while the doctor's words re-form into legible handwritten lines above it.

The next one starts before you leave the house.

Tomorrow's prep card is already written, from what your earlier visits saved.

An ink and colored-pencil drawing of a woman at her kitchen table with coffee, reading a prep card on her phone; a handwritten notification above it reads: Appointment tomorrow.
Tomorrow's visit, over this morning's coffee.
Sandy's Health: nine category tiles with counts for allergies, medications, conditions, follow-ups, symptoms, vitals, labs, procedures, and providers.

Nine kinds of thing worth keeping

What gets lifted out of a visit is filed by category, and these are the nine that build up over time: the same nine on your phone, and in a profile you share with the rest of the family.

Before the next visit

A dated follow-up from the last visit eventually becomes tomorrow. When it does, the app's home screen carries a prep card: the provider, the date, and a short list of things worth raising, put together from what is already saved for that person. Open follow-ups. What has changed since last time. It rechecks itself while the screen is open, so the card you read in the parking lot is not the one from three weeks ago.

The appointment itself does not depend on your memory either. A visit the app finds on your calendar gets a reminder before it starts, so the card and the question you meant to ask both make it into the room.

The phone can stay in the bag.

An ink and colored-pencil close-up drawing of a woman's wrist in a coral sleeve, her watch showing the app's record button, the exam room only faintly suggested behind.

The Watch, described exactly

Some appointments are not the kind where you put a phone on the desk. Your hands are full, the phone is in a bag under somebody's coat, and you are the one holding the paperwork. The Watch records on its own.

It holds up to three hours, and at two hours forty-five it tells you fifteen minutes are left; you can stop there or let it stop itself at the limit. To keep listening with the screen down it uses the watch's background audio mode, which is what watchOS gives an app that is recording. Nothing else is holding the microphone open. The user guide puts it in one line we have never wanted to soften:

The recording itself is what keeps the Watch awake.

The recording is saved on the Watch. Your iPhone does not have to be beside you while you record, but it has to become available afterward for the recording to come across. And the watch face complication is a shortcut, not a trigger: tapping it opens the app, and nothing records until you tap Record, which leaves room to ask the question first.

The summary in Spanish

The person who most needs the visit written down is not always the person who was in the room, and not always reading in English. Choose Spanish before the visit is processed, and the summary is written in Spanish, with the transcript and clinical items translated alongside it.

We built it for one particular reader. A mother takes her daughter to an appointment where the visit happens in English, and she follows her own child's care more exactly in Spanish. She is not being handed the gist of what was said. She is reading what was said.

An ink and colored-pencil drawing of a mother and her young daughter talking with their doctor in an exam room, the mother's phone recording from the exam table.
The visit she will read back in Spanish.

This website is not in Spanish. The app is, and that seemed like the more important one to do first.

A few dozen phones, so far

PatientScribe is not in the App Store yet. It is on a few dozen phones, and every one of those builds was handed over by us, one message at a time, to somebody who told us who they were keeping track of. That is the entire distribution system at the moment, and we would rather grow it slowly and answer every reply than put up a download counter and stop reading.

So there is an invitation at the end of this page instead of a badge.