AI Scribe

February 2026 · 6 min

Overview

AI Scribe is Bio Ecko's ambient clinical documentation feature powered by ElevenLabs real-time speech-to-text and OpenAI GPT-5.2 Pro. During a doctor-patient consultation, the AI Scribe listens to the natural conversation and automatically generates structured SOAP clinical notes, extracts prescriptions, suggests ICD-10 diagnosis codes, and calculates follow-up dates -- all without the doctor needing to type.

The feature is available in the OPD Consultation screen under the Clinical Notes tab.

How It Works

The AI Scribe follows a three-phase workflow:

Phase 1: Consent & Recording

1. Doctor opens the OPD Consultation for a patient
2. Clicks Start AI Scribe (microphone button)
3. A consent dialog appears -- the doctor confirms the patient has been informed and agrees to recording
4. Audio capture begins with echo cancellation and noise suppression enabled
5. Real-time partial transcripts stream on-screen as the doctor and patient speak

Phase 2: Real-time Transcription

• Audio is streamed to ElevenLabs Scribe v2 via WebSocket at 250ms intervals
• Voice Activity Detection (VAD) segments speech turns automatically
• Finalized transcript segments appear in the transcript panel in real-time
• A red 'REC' badge with duration timer is visible while recording
• The doctor can speak naturally -- no special commands needed

Phase 3: AI Processing

• Doctor clicks Stop & Process when the consultation is complete
• The raw transcript is saved to the database
• GPT-5.2 Pro processes the full transcript and extracts structured clinical data
• Fields are auto-populated in the consultation form (only empty fields are filled -- existing data is never overwritten)

What Gets Extracted

The AI processes the transcript and extracts the following into the consultation form:

• Chief Complaint -- The primary reason for the visit as stated by the patient
• History of Present Illness -- Detailed narrative of the current illness, onset, duration, severity
• Past History -- Any past medical/surgical history mentioned during the conversation
• Examination Findings -- Physical examination findings documented by the doctor
• Assessment -- Clinical impression and working diagnosis
• Treatment Plan -- Planned treatment, procedures, investigations
• Advice -- Patient instructions, lifestyle modifications, precautions
• Follow-up Date -- Auto-calculated from mentions like 'come back in 2 weeks' (14 days)
• Diagnoses with ICD-10 Codes -- Suggested diagnosis codes based on discussed conditions
• Prescriptions -- Medicine name, dosage, frequency, duration, route extracted from dictated prescriptions

Voice-to-Prescription

When the doctor dictates prescriptions during the consultation (e.g., 'Let us put you on Amoxicillin 500mg three times a day for 5 days'), the AI extracts:

• Medicine Name -- Exact drug name as spoken
• Dosage -- Strength (e.g., 500mg)
• Frequency -- How often (e.g., three times a day / TID)
• Duration -- How long (e.g., 5 days)
• Route -- Oral, topical, injectable, etc.
• Instructions -- Before/after food, special timing, etc.

Extracted prescriptions are added to the Prescription tab. If prescriptions already exist, new items are appended (never replaced). The doctor should always review AI-extracted prescriptions for accuracy before saving.

Voice-to-Follow-Up

When the doctor mentions a follow-up during the consultation, the AI detects time-based phrases and auto-calculates the follow-up date:

• 'Come back in 2 weeks' = 14 days from today
• 'See me after 10 days' = 10 days from today
• 'Follow up next month' = 30 days from today
• 'Review after 3 months' = 90 days from today

The calculated date is pre-filled in the Follow-up Date field. The doctor can adjust it manually if needed.

Patient Consent

Before the AI Scribe can start recording, the doctor must confirm patient consent:

1. A consent dialog appears explaining what will happen
2. The patient must be verbally informed that:
   • The conversation will be recorded and transcribed by AI
   • The transcript will be used to generate clinical notes
   • Data is stored securely and linked to the patient record
   • The patient may request to stop recording at any time
3. The doctor checks a confirmation box and clicks Start Recording
4. Consent status (given/timestamp) is logged in the visit transcript record

Consent only needs to be given once per recording session. If the doctor starts a new recording for the same visit, consent must be re-confirmed.

Transcript History

All transcripts are stored in the visit_transcripts table and linked to the visit and patient:

• Raw Transcript -- Verbatim text from the recording
• Processed Notes -- Structured SOAP output from AI processing
• Duration -- Recording length in seconds
• Consent Status -- Whether consent was given, with timestamp
• Status -- Recording / Processing / Completed / Failed

Transcripts can be reviewed alongside the final clinical notes for audit trail purposes.

Technical Requirements

For AI Scribe to work:

• Microphone Access -- Browser must have microphone permission granted
• Stable Internet -- WebSocket connection to ElevenLabs requires stable connectivity
• Supported Browsers -- Chrome, Edge, Firefox (latest versions) with WebRTC support
• ElevenLabs API Key -- Must be configured as ELEVENLABS_API_KEY environment variable
• OpenAI API Key -- Must be configured as OPENAI_API_KEY for GPT-5.2 Pro processing

The scribe uses the browser's built-in MediaRecorder API with opus codec for efficient audio streaming.

Notes

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