Chartnote

The ambient scribe is real model work, but it sits on top of a product that predates it and would survive without it. Chartnote's original and still distinguishing asset is a library of thousands of medical snippets and dot phrases plus a custom template system, which is curated content rather than intelligence. Same shape as Conveyor AI by Mobius MD in this category: remove the AI and a useful documentation tool remains, which is not true of the pure plays. Graded on the moat is not the model reasoning applied elsewhere in this index.

Conventional draft and review with the same structural gate as other transfer based products here: the note is generated in Chartnote and the clinician moves it into the record, so nothing files itself and a human is necessarily in the loop at the point of entry. Held at B because no acceptance rate, edit burden figure or confidence threshold is published.

No accuracy figure, model card, named models or evaluation methodology located. Capability is described functionally, generating SOAP notes from patient conversations with high accuracy medical speech to text, without any measurement attached to either claim.

Nothing identifies any party in the chain: no model or model family, no foundation model provider, no hosting arrangement and no sub processor list was located in two passes. Compliance with the health privacy rule is asserted alongside robust security protocols, which describes posture rather than naming anyone who processes an encounter. The self serve distribution makes the gap harder to close through the usual route.

A health system can compel a sub processor list through procurement; an individual clinician adopting the tool has no leverage and no counterparty other than a signup page, so published disclosure is the only source available and there is none. Ask directly whether any third party model provider is invoked, and for a written list of every party that receives encounter audio or derived text.

App store reviews and short clinician quotes only. No study, controlled evaluation, accuracy benchmark, third party rating or named health system deployment located. Note also that much of the comparative material circulating about this vendor is published by competitors selling against it, and by Chartnote's own blog comparing itself to others, so treat the surrounding commentary with the caution this index applies to self interested sources.

A second pass added very little, and that is itself the finding on this record rather than a reason to write more.

No retention schedule, deletion commitment, de identification practice, encryption detail or training use statement was located for this product. The vendor's own material describes health privacy compliance with robust security protocols, which is an assertion about posture rather than an account of what happens to an encounter.

The distribution model is what makes thin documentation consequential here, and it is worth stating plainly. This is a self serve tool that an individual clinician can adopt without any institutional review. Nobody with the expertise to ask about retention, training use or subprocessors sits anywhere in that adoption path. Where a hospital buys a scribe, procurement extracts these answers privately and the vendor's website matters less. Where a clinician signs up alone, published material is the only mechanism, and there is very little of it.

So the practical instruction is unusually simple. Before recording a patient, ask the vendor in writing: is audio retained, and for how long; are transcripts retained; is any of it used to train or improve models; and which third parties process the encounter. Keep the answers, because they are the record of the diligence a clinician is professionally responsible for having done.

None of this suggests the answers are unfavourable. It records that they are not obtainable without asking, from a vendor whose buyers are least equipped to ask.

No business associate agreement posture was located for this product specifically. Health privacy compliance is asserted in the vendor's own material; the agreement is not mentioned.

That distinction is the whole of this axis and it is worth separating carefully, because the two are routinely conflated in this category and the difference matters most for exactly this vendor's buyer.

Compliance is a posture a vendor asserts about its own practices. The agreement is a contract that makes the vendor legally accountable to the covered entity for protecting the information, defines permitted uses, and creates breach notification obligations. A clinician who uses a tool on protected health information without an executed agreement has committed a violation regardless of how well built the product is, and the vendor's compliance claim does not cure it.

For a self serve product this is the single most important thing to establish, and it is the easiest for a vendor to answer. Peers in this category now state it plainly, some including the agreement with every account at signup so no one has to ask. That is the standard, and it is not a demanding one.

The earlier assessment noted that third party comparison pages discuss compliance in this category generally, and declined to attribute a claim to this vendor on that basis. That remains the right treatment.

Ask whether an agreement is offered, whether it is executed at signup or on request, and whether it is available on the lowest paid tier rather than only to larger customers.

No named or dated attestation, no report of either type, no penetration testing statement and no trust centre were located.

The company appears small and this grade records what a counterparty can verify rather than a judgement that controls are absent. The usual proportionality argument applies with one qualification worth keeping.

That argument runs: a small vendor can reasonably defer the cost of an attestation because its buyers are sophisticated and will extract the answers through procurement instead. It does not hold here, for the same reason it did not hold for the other self serve products in this lane. This tool is adopted directly by individual clinicians. There is no procurement, so there is no alternative mechanism, and publishing becomes the only route by which a buyer learns anything.

That does not mean a small vendor must hold a report. It means the substitutes matter more: a plainly written security page describing encryption, access control, retention and subprocessors would do most of the work an attestation does for a buyer at this scale, at a fraction of the cost, and would put this record well ahead of several better funded peers.

The vendor publishes a comparison of scribes on its own blog which includes an accurate limitation about its own integration depth. A company willing to name its own weakness in its own marketing is likely to answer a direct security question straight.

Ask what external testing has been performed, whether a security page exists, and what the roadmap to an attestation is.

No clearance claimed and none required for ambient documentation. No United States device pathway attaches to a note the clinician reviews and signs.

The product is one of the narrower records in this category and that is worth recording as a positive rather than as an absence. It combines ambient capture, dictation and smart templates to produce a note. No coding engine, risk adjustment scoring, decision support layer, order generation, patient facing component or revenue cycle module was located. The scope expansion pattern documented across most of this lane is not present here, and the vendor's own description of itself is confined to documentation.

One consequence of the distribution model belongs here for completeness rather than as a criticism. Because the tool is adopted directly by individual clinicians rather than procured by institutions, the ordinary checkpoint at which an organisation would assess a clinical AI product before it touches patients does not occur. Nothing is being circumvented, since no pathway attaches and no rule requires that review. But the professional obligation, the consent obligation and the diligence obligation all rest on the individual who signs the note, without the institutional support a hospital deployment provides.

That is the position for every self serve product in this lane and it is not unique to this vendor. It is worth stating on each of them, because the clinicians most likely to adopt this way are those least likely to have read anything about the obligations they are assuming.

Establish local consent requirements before recording, since those vary by state and are the clinician's responsibility rather than the vendor's.

No fairness statement, subgroup analysis or accent and dialect performance disclosure was located, and no language coverage is claimed.

The fairness point from the earlier assessment stands and is worth preserving because this index applies it consistently. Where a vendor makes no multilingual claim, its silence on cross language performance does not contradict a marketing promise, and that is a materially different position from a vendor advertising dozens of languages with no evidence behind any of them. This record sits in the first group.

What remains is the accent and dialect question, which applies to every English language product regardless of what it claims, because speech recognition performance varies across speakers whether or not a vendor mentions it.

The distribution model shapes how that question can be pursued. Adoption is by individual clinicians rather than institutions, so there is no organisation positioned to run an evaluation, aggregate error patterns across a practice, or notice that documentation quality differs systematically for some patients. Each clinician sees only their own encounters, which is exactly the vantage point from which distributional differences are invisible.

So the realistic ask is narrower than for an enterprise vendor. Not a published subgroup study, which a company this size will not have, but a straight answer to what the underlying speech model is and what its published performance characteristics are. If the vendor licenses a commercial speech service, that provider may have published evaluation data the vendor could simply point to.

Ask which speech model is used, and what evidence exists about its performance across accents.

Two passes located no accuracy or error figure, no published limitations and no warranty, indemnity or remediation commitment. Capability is described functionally, generating structured notes from patient conversations with high accuracy speech to text, with no measurement attached to either claim. The distribution model determines what that absence means in practice, and it is worth stating plainly rather than treating as a footnote.

This is a self serve product an individual clinician can adopt without any institutional review, so nobody with the expertise to ask about accuracy, retention or remediation sits anywhere in the adoption path. Where a hospital buys a scribe, procurement extracts these answers privately and the published material matters less. Where a clinician signs up alone, published material is the only mechanism, and there is very little of it. The practical instruction follows.

Before recording a patient, ask the vendor in writing whether audio and transcripts are retained and for how long, whether either trains models, and what the vendor commits to when a note is wrong. Keep the answers, because they are the record of the diligence a clinician is professionally responsible for having done. None of this suggests the answers would be unfavourable. It records that they are not obtainable without asking, from a vendor whose buyers are least equipped to ask.

Transfer based rather than integrated: finished notes move into any web based EMR, which makes the product usable anywhere and connected to nothing. There is no structured field population, no chart context flowing in and no write back, so the clinician carries the note across the gap. For a solo or small practice that means zero implementation, and for anyone wanting the note to arrive as discrete data it means this is not the right tool. The phrasing is at least honest about what it does.

No hosting region, residency detail or subprocessor information was located. Delivery is cloud with web and mobile access.

One fact the vendor publishes about itself is worth crediting and is unusual enough to note. On its own blog it maintains a comparison of scribes in this category which includes itself, and the entry states plainly that integration with certain record systems may be limited. That is a real limitation named by the vendor in its own marketing, and it is the fourth instance of that kind of candour this index has recorded in this lane.

It is also the practically important disclosure for this axis. Where integration is limited, the note leaves the product by hand, which means the vendor's environment holds the encounter and its output for whatever interval elapses before a clinician moves it, and no institutional system has visibility of what was captured. A buyer should establish which record systems are supported and by what mechanism, because the answer determines whether their workflow is a connected one or a copy and paste one.

The rest of the axis is unanswered. Nothing establishes where processing runs, whether an external model service handles the encounter, or what that service retains. For a product built on generative AI, the model provider question is the one most likely to have a simple answer the vendor could publish today.

Ask for the hosting region, the model provider and its retention terms, the subprocessor list, and which record systems are supported.

The pricing STRUCTURE is public and unusually sensible, tiered by monthly AI note volume rather than per seat: a free Basic tier with 15 AI scribe notes a month plus templates and snippets, a Pro tier capped around 100 notes with unlimited Copilot tools, and an unlimited Max tier, with subscriptions purchasable directly through the app store. Volume based tiering means a part time or low volume clinician pays proportionately, which almost nothing else in this category offers.

Held at B rather than A because only the top tier figure, around 100 US dollars a month, was located and it came from a third party comparison rather than the vendor, so the full ladder could not be confirmed. Publishing all four tier prices on the site would move this to A.

Ambulatory and urgent care focused, with family medicine, emergency medicine, internal medicine and urgent care named, and support for SOAP, DAP and custom note structures. The snippet and template library is the practical mechanism for specialty fit, meaning coverage depends on what a clinician builds rather than on models tuned per specialty. No specialty count, no language coverage and no inpatient capability documented.