Table of contents
What is an after visit summary?
An after visit summary (AVS) is the patient-facing document generated at the end of an outpatient encounter. It is now part of CMS Promoting Interoperability (formerly Meaningful Use) — measure PI_HIE_3 rewards clinicians who provide patients electronic access to their visit summary within 1 business day.
Unlike a discharge summary (which is for the next clinician), the AVS is for the patient. It should be brief, readable, and actionable: what we discussed today, what changed, what to do next, when to come back.
Required vs optional fields
Required
- •Patient demographics (name, DOB, MRN)
- •Date of visit and provider name
- •Reason for visit / chief complaint
- •Updated problem list
- •Reconciled medication list (with any changes from this visit)
- •Allergy list
- •Vital signs from this visit
- •Smoking status (last documented)
- •Results reviewed during the visit (if any)
- •Patient instructions (plain language)
- •Follow-up appointment date and provider
Optional but valuable
- •Immunizations updated
- •Referrals made (specialty, reason)
- •Patient-friendly explanations of any test results
- •Self-management goals (e.g., target A1c)
- •Educational handouts attached
- •Care team contacts
Reading level — the unsung quality measure
Joint Commission and most state Medicaid programs expect AVS content at a 6th–8th grade reading level. Average US adult reads at 8th grade. Medical jargon collapses comprehension by 30–60% across health-literacy studies.
| What clinicians type | What patients understand |
|---|---|
| Your TSH was elevated | Your thyroid blood test showed your level was a little high. |
| Continue your antihypertensive | Keep taking your blood pressure medicine. |
| Increase metformin to 1000 mg BID | Take metformin 1000 mg twice a day, morning and evening. |
| F/U with cardiology in 4 weeks | See the heart doctor (cardiologist) in about a month. |
| Pending lipid panel | Your cholesterol test results are not back yet — we will call you when they arrive. |
Free printable template
--- AFTER VISIT SUMMARY ---
Hello, [First name].
Thank you for visiting [Practice name] today.
Date of visit:
Provider:
Reason for your visit:
WHAT WE TALKED ABOUT TODAY
[1-2 plain-language sentences about the visit]
YOUR PROBLEM LIST (current health concerns)
•
•
•
YOUR MEDICATIONS
Continue taking:
• [name, dose, how often]
Changed today:
• [name, dose, how often, what changed]
New today:
• [name, dose, how often]
Stopped today:
•
ALLERGIES:
YOUR VITALS TODAY
Blood pressure: Heart rate:
Weight: Height:
Temperature: Oxygen level:
RESULTS REVIEWED
[Plain-language summary, or "Pending — we will call you"]
WHAT TO DO NEXT
•
•
WHEN TO CALL OUR OFFICE:
WHEN TO GO TO THE EMERGENCY ROOM:
YOUR NEXT APPOINTMENT
Date: Provider:
Reason:
QUESTIONS? Call us at [phone] or message us in the patient portal.Sample 1 — Routine annual physical
Patient: A. Wilson · Date: 2026-04-28 · Provider: Dr. Maria Santos, MD
What we talked about today
We did your yearly check-up. Overall you're doing well. Your blood pressure has crept up a little since last year, so we're going to start a small change to your routine and check again in 3 months.
Your problem list
- High blood pressure (new today)
- Seasonal allergies
Your medications
New today: lisinopril 10 mg — take one tablet by mouth every morning. Continue: cetirizine 10 mg as needed for allergies. Multivitamin: as before.
Vitals today
BP 142/88. HR 76. Weight 188 lb (down 2 lb since last year — nice work). Height 5'9". Temp 98.4°F.
Results reviewed
Your cholesterol panel and basic labs were all in good range. Your A1c (blood sugar) was 5.6 — normal. We are not running any new tests today.
What to do next
- Start your new blood pressure medicine tomorrow morning.
- Aim for 30 minutes of walking 5 days a week.
- Cut back on salty foods (processed meats, canned soups, restaurant meals).
Call our office
If you feel dizzy when you stand up, swelling in your ankles, or a dry cough that doesn't go away.
Go to the ER
For chest pain, severe headache, sudden vision changes, or trouble speaking.
Next appointment
Blood pressure recheck in 3 months — July 28, 2026 with Dr. Santos.
Sample 2 — T2DM follow-up
Patient: R. Patel · Date: 2026-04-28 · Provider: Dr. Khalid Hassan, MD
What we talked about today
We checked in on your diabetes. Your A1c (3-month average blood sugar) came down from 8.4 to 7.6 — great progress. We're going to keep your medications the same and add walking goals.
Your problem list
- Type 2 diabetes (improving)
- High blood pressure (well controlled)
- High cholesterol (well controlled)
Your medications
Continue: metformin 1000 mg twice a day; lisinopril 20 mg once a day; atorvastatin 20 mg at bedtime. No changes today.
Vitals today
BP 124/78. HR 72. Weight 192 lb (down 5 lb since January — well done). A1c 7.6 (was 8.4).
Results reviewed
A1c 7.6 — better. Kidney function (creatinine, urine albumin) — normal. Lipid panel — at goal.
Your goals before next visit
- Walk 30 minutes most days. Aim for A1c under 7.0.
- Keep checking blood sugar 1-2 times per day, especially before breakfast.
- Avoid sugary drinks (regular soda, juice, sweet tea).
Call our office
If your fasting blood sugar is over 200 for several days in a row, or below 70 (low). Or if you have new numbness or pain in your feet.
Go to the ER
For chest pain, severe stomach pain with vomiting, or fast deep breathing.
Next appointment
3 months — July 28, 2026 with Dr. Hassan. Lab work 1 week before that visit.
Common pitfalls
Medical jargon
“Continue antihypertensive” is invisible to most patients. Use the medicine's purpose: “keep taking your blood pressure medicine.”
No reading-level adjustment
EHR auto-generated AVS often reuses your note language verbatim. Run it through a readability check (Flesch-Kincaid) — aim for grade 6-8.
Missing follow-up date
“Follow up as needed” is not actionable. Specify date or interval and provider.
Generic instructions
Tailored beats templated. “Walk 30 minutes 5 days a week” lands; “exercise regularly” doesn't.
How AI scribes generate the AVS
AI scribes built into the visit can generate two outputs in parallel: the clinician note (technical) and the AVS (patient-facing). PatientNotes does this automatically — extracts what changed, rewrites at a 7th-grade reading level, attaches the next-visit date, and pushes the AVS to your EHR or patient portal in one step.
Frequently asked questions
Does Medicare require an after visit summary?
Functionally yes. CMS Promoting Interoperability (formerly Meaningful Use) requires eligible clinicians to provide an AVS for at least one office visit per measurement period to count toward MIPS PI scoring. Most EHRs auto-generate one for every visit because the cost of generating it is zero once the visit is documented.
Can the AVS be in the patient's preferred language?
Yes — and it should be when the patient's primary language is not English. The Title VI Civil Rights Act and Section 1557 of the ACA require meaningful access for limited-English-proficient patients. Most modern EHRs support AVS generation in 15+ languages.
Is AVS the same as discharge instructions?
No. Discharge instructions specifically apply to inpatient or ED discharges and live in the discharge summary. The after visit summary covers any outpatient encounter — primary care, specialty visit, urgent care — and is shorter and more routine.
When does the AVS need to be available?
CMS expects the AVS to be available to the patient within 1 business day of the visit. In practice most EHRs make it available the same day, often before the patient leaves the clinic. Patients can also access prior AVS through the patient portal indefinitely.
Does it count for Promoting Interoperability scoring?
Yes — measure PI_HIE_3 (Provide Patients Electronic Access to Their Health Information) is partially fulfilled by AVS provision. To get the full measure score, ensure the AVS is electronically accessible (portal, secure email, or download) within 1 business day of the visit.
Should I include test results before they're complete?
No. Including pending or partial results creates more confusion than value. State that results are pending and will be communicated separately. Some EHRs auto-update the AVS once results return; clinicians should still call patients with abnormal or critical results rather than rely on the document.
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