(This was written in early May 2023 – may have improved since then?)

This is for a new product called AutoNotes.ai that will create progress notes for you for about $14+ per month.

I am tentatively interested in this and signed up for a free trial.

I have concerns (below) but am hopeful this continues to improve.

The system has no BAA agreement for HIPAA because they claim not to collect any PHI.  This may be true. 

Their terms of service and privacy policy may be amended at any time and the only notification provided will be on their website.  I am wary of this now that I have been burned by such stealth changes by one of my own BAA subcontractors.

Information for each client will have to be entered from scratch each time as they do not store data about clients.  For the free demo, it takes about 60 seconds to generate each note.  You then cut and paste it into your EHR.

While they claim to collect no PHI, they do send SOME data of SOME sort to several tracking systems and data aggregators.  At best, they are tracking YOU -- the clinician.  At worst -- they may be sending some of the data you enter to data aggregators which -- hopefully -- do not have data from other sources to be able to pin down the individual clients you are describing.

DATA IS SEND TO THE FOLLOWING OUTSIDE TRACKING COMPANIES ON BOTH THEIR DATA INPUT PAGE & THE GENERATED NOTE PAGE:

**PRIVACY BADGER BLOCKED:**
connect.facebook.net
www.googletagmanager.com
s.gravatar.com
snap.licdn.com
i0.wp.com

**GHOSTERY BLOCKED:**
Google Tag Manager
LinkedIn Analytics
Facebook Connect
Gravatar

The following is an example of the note generated for a fake client with Acute Stress Disorder:

%GREEN = IN WHAT I REPORTED%
&RED = INVENTED BY AI, NOT REPORTED BY CLINICIAN&
BLACK = I HAVE NO STRONG OPINION

Subjective:
Client &reported increased levels of stress, particularly in the& %workplace. Described experiencing anxious mood and labile mood, but was able to demonstrate appropriate behavior and normal speech throughout the session. Client was self-reflective% and &engaged& %during the 45-minute video session%, %which allowed for a comprehensive exploration of the current challenges they face&. The client recognized the need to address these issues in order to improve their overall well-being.

Objective:
During the session, several areas were discussed. &Client was open and honest& about %feeling overwhelmed and stressed at work, further precipitating their anxiety. They were able to identify specific work situations that were particularly difficult for them to navigate. It was noted that the client was able to maintain self-reflective behavior during discussions,% which will be beneficial for making progress in therapy.

Assessment:
%The client is showing signs of progress in therapy, taking active steps to address and work through their challenges with stress and anxiety.% Their willingness to participate and self-reflect in session indicates a strong commitment to achieving their therapeutic goals. %Current therapeutic interventions, which are directed at helping the client build skills and coping strategies, are having a positive impact on the client's progress.%

Plan:
%In order to lower workplace stress and continue advancing in therapy, the client agreed to set specific objectives for themselves. They plan on talking to their manager about ways to manage their workload or address any outstanding concerns. Additionally, they will begin practicing meditation four times a week during their lunch breaks, as a means of managing stress and promoting relaxation.% &Continued exploration of these& and other stress reduction &strategies will be a focus in future sessions.&

Hmmm...  My take-away is that this needs more work (that's fine); I want to know why they have to report to LinkedIn, Facebook, Gravatar, and Word Press while I'm logged in and what they report; and the system IS inventing minor elements that I did not tell it to add.  For example, while I reported the client was overwhelmed and stressed, I did not say the client was open and honest about it.  I told the system the client was "progressing", but never said that increased levels of stress were reported in this session.

It occurred to me this morning that by the time I fill out the form and write two or three sentences, I've already done all the work that is needed for an official note (after adding start and end times, diagnosis, name, client age, and a few other elements to the form).  There is no need to convert it all to narrative -- it can stay in form factor mostly.

So -- while I want an AI I can trust to help with notes (and this one may grow into such) -- right now the effort of getting it to create a note is about exactly equal to the effort of just writing it myself anyway.

-- Michael