What to Do (and Not Do) When Using AI for Clinical Notes

Introduction

AI can save hours on documentation, but success depends on how you use it. This guide covers the do's and don'ts that separate effective AI use from frustration and risk.

Do

• Speak clearly and at a natural pace, AI performs best with clear audio
• Use the right template, SOAP for routine visits, H&P for new patients
• Review before signing, Always verify medications, dosages, and critical findings
• Spell out unusual terms, Drug names, rare conditions, patient names
• Record in a quiet environment, Background noise hurts accuracy
• Use compliance-ready tools only, platforms with HIPAA and GDPR-aligned safeguards like Docdemic

Don't

• Don't skip the review, AI output is a draft, not a final record
• Don't use consumer AI for PHI, ChatGPT, etc. are not compliant
• Don't rush through dictation, Slurred or fast speech reduces accuracy
• Don't ignore recurring errors, Adjust your workflow or report them
• Don't share accounts, Each clinician should have their own login

Conclusion

AI for clinical notes works best when you combine good habits with the right tool. Docdemic is built for this workflow, try it free.