AI Scribe for the Emergency Department
Document chest pain workups, sepsis bundles, trauma activations, and behavioral holds at ED tempo. PatientNotes captures the chief complaint, HPI, ROS, exam, MDM, and disposition while you keep moving. Notes ready before the patient leaves the department.
Documentation for Every ED Presentation
From chest pain to trauma activations to peds fevers, PatientNotes captures the structured detail your MDM and billing actually need.
Chest Pain Workup
HEART score, troponin trending, EKG interpretation, ACS risk stratification, and admit-vs-discharge MDM.
Trauma Activation
Primary and secondary survey, FAST exam, ATLS milestones with timestamps, mechanism, and disposition to OR or trauma surgery.
Sepsis Bundle
CMS SEP-1 1-hour and 3-hour elements: lactate, cultures, antibiotic timing, fluid resuscitation, and reassessment.
Behavioral Hold
Suicide risk assessment (Columbia, SAD PERSONS), capacity, medical clearance, sitter orders, and 5150/EMTALA documentation.
Pediatric Emergency
Weight-based dosing, fever workup, PECARN head injury rules, croup scoring, and family-centered MDM.
Toxicology Consult
Toxidrome identification, ingestion timing, antidote selection (NAC, naloxone, fomepizole), and Poison Control coordination.
Built Around ED Workflow
The features below come from working with full-time ED attendings and APPs. Nothing is generic.
ESI Triage Capture
Documents the Emergency Severity Index level (1-5), vital sign triggers, and resource estimate that justifies the assigned level for nursing and billing review.
MDM Mapped to 2023 E/M Guidelines
Captures number and complexity of problems addressed, data reviewed, and risk of complications. Suggests CPT 99281-99285 and flags critical care time for 99291/99292.
Sepsis SEP-1 Timing
Tracks lactate draw, blood culture order, broad-spectrum antibiotic administration, and 30 mL/kg crystalloid milestones against the 1-hour and 3-hour CMS bundle clocks.
Trauma Time Stamps
Auto-stamps primary survey, intubation, blood product activation, FAST result, and disposition for trauma registry abstraction.
Disposition and Follow-up
Generates clear discharge instructions, return precautions, prescription summary, and PCP follow-up window. Builds the admit H&P or transfer EMTALA note when needed.
Re-evaluation Notes
Captures repeat exams, response to therapy, and decision points throughout a long ED stay so the chart reflects active reassessment, not a single point-in-time note.
A shift with PatientNotes
The 7 AM shift starts with eight patients already in the rack. The night doc is signing out a sepsis admit waiting on a bed, a 4-year-old with intussusception going to the OR, and a chest pain on a heparin drip with a pending repeat troponin. You walk into room 12 to see the new chest pain and tap Record on your phone.
You take the history, do a focused cardiopulmonary exam, order an EKG, troponin, BMP, CBC, lactate, BNP, and a chest X-ray. By the time you walk back to the workstation, the HPI is structured, the ROS is populated from the conversation, the exam is laid out, and the MDM scaffolding is open with the differential you actually said out loud (NSTEMI, dissection, PE, GERD). The patient leaves the department upgraded to cardiology before you would have written your first paragraph the old way.
At 14:30, EMS calls a Level 1 trauma. You hit Record again. PatientNotes timestamps your primary survey, the FAST result, the airway decision, the blood product activation, and the disposition to the OR. Your trauma registrar gets a complete narrative without you spending 30 minutes reconstructing it after the code. Last updated April 2026 by the PatientNotes Clinical Team.
Sample AI-Generated ED Note
A 58-year-old male with NSTEMI: full HPI, ROS, exam, ED course with timestamps, MDM with HEART score, and CPT mapping. This is the actual output structure.
EMERGENCY DEPARTMENT NOTE
Date: 2026-04-28 Provider: J. Patel, MD ESI: 2 Arrival: 14:32
CHIEF COMPLAINT:
58yo M with substernal chest pain x 2 hours, radiating to left arm.
HPI:
Patient is a 58-year-old male with HTN, HLD, T2DM, and 30 pack-year smoking
history who presents with substernal chest pressure that began at rest about
2 hours prior to arrival. Pain is 8/10, pressure-like, radiates to the left
arm and jaw, associated with diaphoresis and nausea. Took 2 SL nitro at home
with partial relief. No recent illness, trauma, or prolonged immobility.
Last meal 4 hours ago.
ROS: Positive for chest pain, diaphoresis, nausea. Negative for fever,
cough, hemoptysis, leg swelling, calf pain, syncope, headache.
PMH: HTN, HLD, T2DM (A1c 8.2 last month). PSH: None. SH: 30 pack-years,
quit yesterday. No alcohol, no drugs. FH: Father MI age 55.
MEDS: Lisinopril 20 mg daily, atorvastatin 40 mg nightly, metformin
1000 mg BID, ASA 81 mg daily.
ALLERGIES: NKDA.
OBJECTIVE:
Vitals on arrival: BP 162/94, HR 102, RR 20, SpO2 96% RA, T 37.0, Pain 8/10
General: Diaphoretic, mild distress, alert and oriented x3.
HEENT: NCAT, mucous membranes moist.
Neck: No JVD, no carotid bruits.
Cardiac: Tachycardic, regular rhythm, no murmur, rub, or gallop.
Lungs: CTAB, no rales, no wheeze.
Abdomen: Soft, nontender, no pulsatile mass.
Extremities: Symmetric pulses, no edema, no calf tenderness.
Skin: Diaphoretic, no rash.
Neuro: GCS 15, no focal deficit.
ED COURSE:
14:38 - EKG: ST depression 1 mm in V4-V6, T-wave inversion in lead III.
No STEMI criteria. Compared to prior 2024 EKG: new changes.
14:40 - ASA 324 mg PO chewed.
14:42 - Heparin drip initiated, 80 U/kg bolus (5,800 U) then 18 U/kg/hr
(1,300 U/hr). aPTT goal 60-80.
14:45 - Nitro drip started at 10 mcg/min, titrated to pain and BP.
14:50 - Labs drawn: troponin-I, BMP, CBC, lactate, BNP, lipid, coags.
15:10 - Initial troponin-I: 0.18 ng/mL (ULN 0.04). BNP 320. Lactate 1.4.
Cr 1.2, K 4.1, Hgb 14.2, Plt 240.
15:18 - Cardiology paged for NSTEMI. Plan for cath lab today.
15:30 - Repeat pain 3/10. BP 138/82, HR 88. Repeat EKG: unchanged.
MDM:
Differential: NSTEMI (most likely given EKG changes, troponin elevation,
classic risk factors), unstable angina, aortic dissection (no tearing
quality, equal pulses, normal CXR mediastinum), PE (no DVT risk factors,
SpO2 normal), GERD/musculoskeletal (less likely given EKG and troponin).
HEART score: 7 (high risk) - History 2, EKG 2, Age 1, Risk 1, Troponin 1.
6-week MACE risk ~50-65%. Disposition: admit to cardiology for cath.
ASSESSMENT:
1. NSTEMI (I21.4) - high HEART score, dynamic EKG, positive troponin.
2. Hypertensive urgency (I16.0) - improving with nitro.
3. Uncontrolled T2DM (E11.65) - A1c 8.2.
4. Tobacco use (Z72.0) - cessation counseling provided.
PLAN:
- Admit to cardiology, cath lab activated.
- Continue heparin drip, ASA, nitro drip.
- Hold metformin, monitor for contrast nephropathy.
- Statin continued.
- Repeat troponin q3h until trend established.
- NPO for cath.
- Family updated. Patient agrees with plan.
Critical care time: not billed (patient stable on therapy, total
critical decision-making time under 30 min).
CPT: 99285 (Level 5 ED, high complexity MDM, 3+ acute problems with
threat to function, extensive data reviewed, high risk).
Time of disposition: 15:42. Total ED time: 70 min.Common ED ICD-10 Codes, Suggested Inline
PatientNotes proposes the codes most-used in emergency medicine based on the documented HPI, exam, and MDM. You confirm with one click.
R07.9Chest pain, unspecifiedA41.9Sepsis, unspecified organismR55Syncope and collapseR10.9Abdominal pain, unspecifiedS00.93XAUnspecified superficial injury of head, initial encounterI63.9Cerebral infarction, unspecified (acute stroke)F19.20Other psychoactive substance dependence, uncomplicatedT39.1X1APoisoning by 4-aminophenol derivatives, accidental, initial encounterCPT-side: PatientNotes maps documented MDM to 99281-99285 and flags 99291/99292 critical care when duration is captured.
Who is using PatientNotes in the ED?
Three real-world settings where the math works.
Dr. Maria Alvarez
Solo locums, rural critical access ED in West Texas
Maria covers 24-hour shifts where she sees 18-25 patients with no scribe and no resident. Before PatientNotes she finished charts at home from 2-4 AM. With ambient capture, her notes are signed before the next patient is roomed. Her group reports a measurable bump in 99284 and 99285 levels because the MDM detail is finally there.
Pinewood Emergency Physicians (mid-size group, 14 docs)
Suburban community ED, 55,000 visits/year
The group switched from a hybrid scribe model (in-person scribes day shift, self-charting nights) to PatientNotes for everyone. They cut scribe spend by about $180,000 a year and improved chart completeness on overnight shifts where scribes were never available. SEP-1 bundle compliance moved from 71% to 88% in two quarters because the timing is captured live.
Dr. Marcus Lee
Hospital-employed ED attending, academic level 1 trauma center
Marcus uses PatientNotes for his moonlighting community shifts where his hospitals enterprise Abridge contract does not extend. He keeps the same template at both sites. Charts done before he leaves the department, no take-home work, no surprises in coder feedback at the end of the month.
Coming from Microsoft Dragon Medical One?
Dictation versus ambient: how the switch actually works for ED docs.
Many ED physicians have used Microsoft Dragon Medical One (Nuance) for years. Dragon is a mature, EHR-integrated dictation product with strong medical vocabulary support. The honest distinction is dictation versus ambient: Dragon requires you to speak the note out loud, in order, after the encounter. PatientNotes listens to the encounter as it happens and writes the note for you.
Dragon Medical One
$99-$200/provider/month plus enterprise implementation fees
PatientNotes
$50/provider/month flat, no implementation fee
How to switch in under a week
- 11. Sign up and pick the Emergency Medicine template at patientnotes.ai/onboarding.
- 22. For your next 2-3 patients, record with PatientNotes in parallel with your normal Dragon workflow. Compare both notes side-by-side.
- 33. When you trust the output, drop Dragon. Most ED physicians need under a week. Cancel Dragon at the end of your billing cycle.
See the full side-by-side at /compare/dragon-medical-one.
PatientNotes vs Abridge for the ED
Abridge has marketed heavily to large hospital systems and many academic EDs already use it. It is a strong product. The decision is mostly about who controls the contract and how much you want to pay.
| Dimension | PatientNotes | Abridge |
|---|---|---|
| Pricing model | Flat $50/provider/month | Enterprise contracts, typically $200-$400/provider/month |
| Time to go live | Same day, no IT build | 6-12 weeks integration with hospital IT |
| Best fit | Independent EDs, locums, rural critical access, mid-size groups | Large academic/IDN systems already standardized on Epic + Abridge |
| EHR fit | Paste-friendly into Epic ASAP, Cerner FirstNet, Athena, Meditech | Deep Epic integration, weaker outside Epic |
| ED templates | Chest pain, sepsis, trauma, behavioral, peds, tox out of the box | Generalized ED template, customization via professional services |
| Trial | 7-day free, no card | Sales cycle, demo required |
Full side-by-side: /compare/abridge. Related specialties: internal medicine, cardiology, urgent care.
Emergency Medicine AI Scribe FAQ
Honest answers, with numbers where they matter.
Does PatientNotes work for emergency medicine?
Yes. PatientNotes is built for the high-acuity, interrupt-driven ED workflow. It captures the chief complaint, HPI, ROS, exam, ESI triage level, MDM, re-evaluations, and disposition while you move between rooms. Notes are ready for sign-off before the patient leaves the department, so you are not charting at the end of a shift.
How much does an AI scribe cost for emergency medicine?
PatientNotes is $50 per provider per month, flat. Abridge and Nuance DAX Copilot are typically priced through enterprise contracts that land between $200 and $400 per provider per month after implementation fees. For a 10-physician group, that is roughly $36,000 per year of difference for comparable ambient documentation.
Is Abridge better than PatientNotes for the ED?
Abridge has deep Epic integration and is the standard at many large hospital systems that already standardized on it. If your hospital has a system-wide Abridge contract, that is the path of least resistance. PatientNotes is the better fit for independent EDs, freestanding ER groups, locums physicians, and rural critical access hospitals where you control your own tooling and want a $50/month flat rate instead of an enterprise contract.
Can ED-specific notes like trauma activations and sepsis bundles be auto-generated?
Yes. PatientNotes includes templates for trauma activations (primary and secondary survey, FAST, ATLS milestones with timestamps), sepsis bundles (lactate, blood cultures, broad-spectrum antibiotic timing for the 1-hour and 3-hour CMS SEP-1 elements), STEMI activation, stroke alert, and behavioral holds. You can also build custom templates for your departments protocols.
Does it integrate with Epic and Cerner for ED workflows?
PatientNotes generates notes you can paste into Epic ASAP, Cerner FirstNet, Meditech, Athena, or Practice Fusion. We do not require an HL7 or FHIR build, which is why most independent ED groups can be live in under 48 hours instead of waiting on a hospital IT roadmap. For systems that want a deeper integration, we have an API.
Will it help me bill ED CPT codes 99281-99285 correctly?
PatientNotes maps the documented MDM elements (number and complexity of problems addressed, data reviewed, risk of complications) to the 2023 ED E/M guidelines and suggests the supportable level from 99281 (level 1) to 99285 (level 5). It also flags critical care time for 99291/99292 when documented duration exceeds 30 minutes. Your coders still review, but undercoding from missing MDM detail drops noticeably.
How do I switch from Dragon Medical One to PatientNotes in the ED?
Dragon is dictation-driven and requires you to speak the note. PatientNotes is ambient and writes the note from the patient encounter itself. To switch: (1) sign up at patientnotes.ai/onboarding and pick the Emergency Medicine template, (2) record your next 2-3 patients in parallel with your usual Dragon workflow, (3) compare and switch fully when you are confident. Most ED physicians complete the switch within a week.
Is PatientNotes HIPAA compliant for the ED?
Yes. PatientNotes is HIPAA compliant, signs a Business Associate Agreement (BAA) with every practice, encrypts audio and notes in transit and at rest, and stores PHI in SOC 2 Type II infrastructure. Audio is purged after transcription unless you choose to retain it for QA.
Finish your charts before the patient leaves the department.
Join ED physicians using PatientNotes for chest pain, sepsis, trauma, peds, and behavioral. $50/month. 7-day free trial, no credit card required.
$50/month after trial. No credit card to start. Cancel anytime.