AI Medical Scribe for High-Volume Urgent Care: 40-50 Patients/Shift

• Abdus Muwwakkil – Chief Executive Officer

AI Medical Scribe for High-Volume Urgent Care

The Volume Challenge: 40-50 Patients Per Shift

Urgent care providers face unique documentation pressure:

Typical Urgent Care Shift:

  • 8-10 hour shift
  • 40-50 patients (sometimes 60+ on busy days)
  • 10-12 minutes per patient (including documentation)
  • 4-5 hours of documentation per shift

The Math:

50 patients × 10 minutes documentation = 500 minutes (8.3 hours)

But you only have 10-12 minutes total per patient.

Something has to give—and it's usually provider time or documentation quality.

The Consequences:

  • After-hours charting (2-3 hours nightly)
  • Incomplete documentation
  • Provider burnout
  • Decreased patient interaction time
  • Revenue leakage (unbilled services)

The Documentation Burden: 10 Clicks Per Patient

Modern EHR systems require extensive clicking for even simple visits:

Typical URI (Upper Respiratory Infection) Documentation:

  1. Click: Open patient chart
  2. Click: Select encounter type
  3. Click: Choose template (or start blank)
  4. Click: Chief complaint dropdown
  5. Type + Click: Enter symptoms
  6. Click: ROS (Review of Systems) checkboxes (14 systems)
  7. Click: Physical exam template
  8. Click + Type: Exam findings
  9. Click: Assessment dropdown
  10. Click: Select ICD-10 codes
  11. Click: Order medications
  12. Click: Enter prescription details
  13. Click: Patient instructions template
  14. Click: Disposition
  15. Click: Billing level

Minimum: 10-15 clicks even for straightforward cases

Multiply by 50 patients = 500-750 clicks per shift

Current Pain Point: Every click takes time away from patient care.

Case Study: Urgent Care

Organization: Multi-Site Urgent Care Network

Challenge: 40-50 patients per provider shift created unsustainable documentation burden. Providers spent 10+ minutes per patient on documentation (10-15 clicks minimum). After-hours charting averaged 2-3 hours nightly. Provider burnout high with 30% annual turnover. Current ‘solutions’ (Dragon, AI scribes) created more work by requiring extensive editing and corrections.

Solution: Mobile-first voice capture with one-tap recording. Template optimization for top 4 conditions (98% of visits). Click reduction from 10-15 to 3-5 per patient through intelligent defaults and voice-driven documentation. Offline mode for continuous capture without connectivity concerns.

Results: Documentation time reduced to 3-4 minutes per patient (vs 10+ minutes). After-hours charting eliminated for 85% of providers. Daily time savings: 90-120 minutes per provider. Provider satisfaction increased significantly. Turnover reduced to 12% annually.

Key Metrics:

  • Time Per Patient: 3-4 min vs 10 min
  • Daily Time Saved: 90 min per provider
  • Clicks Per Patient: 3-5 vs 10-15
  • After-Hours Charting: -85% eliminated

The Mobile-First Solution

Why Mobile Matters in Urgent Care

Provider Movement:

  • Room to room constantly
  • Minimal desk time
  • Standing/walking throughout shift
  • Need to document while moving

Current Desktop Reality:

  • Workstation on wheels (cumbersome)
  • Desk in each room (inefficient)
  • Central station (breaks workflow)
  • Tablet on cart (still clunky)

Mobile-First Advantages:

  • Phone in pocket (always accessible)
  • One-tap recording start
  • Capture while examining patient
  • No workflow interruption
  • Works offline (no WiFi dependence)

The One-Tap Workflow

Traditional EHR Workflow:

1. Wash hands
2. Enter room
3. Greet patient
4. Walk to computer
5. Click through 15 screens
6. Type documentation
7. Patient waits...
8. Finally start exam

Mobile Voice-First Workflow:

1. Tap record (in pocket before entering room)
2. Wash hands
3. Enter room
4. Greet patient
5. Have conversation
6. Examine patient
7. Discuss plan
8. Tap stop
9. Note auto-generated
10. Validate (3 clicks)
11. Done

Time saved: 7 minutes per patient = 6 hours per shift

Use Case Breakdown: The Top 4 Conditions

98% of urgent care visits fall into these categories:

1. Upper Respiratory Infections (URIs) - 90% of Visits

Typical Presentation:

  • Cough, congestion, sore throat
  • Viral vs bacterial determination
  • Symptomatic treatment
  • Return precautions

Traditional Documentation: 8-10 minutes

  • Detailed ROS entry
  • Symptom duration clicking
  • Exam finding documentation
  • Treatment plan selection
  • Patient education

Voice-First Documentation: 2-3 minutes

Provider says:

“Patient is a 34-year-old with 3 days of nasal congestion, sore throat, and cough. No fever. Symptoms started gradually. No sick contacts. On exam, mild pharyngeal erythema without exudate, clear nasal discharge, lungs clear. Appears viral. We’ll treat symptomatically with decongestants and cough suppressant. Return if fever develops or symptoms worsen after 7 days.”

AI generates:

  • CC: Upper respiratory symptoms × 3 days
  • HPI: Nasal congestion, sore throat, cough, no fever, gradual onset
  • ROS: As per HPI, others negative
  • Exam: Pharyngeal erythema without exudate, clear nasal discharge, lungs CTA
  • Assessment: Viral upper respiratory infection (ICD-10: J06.9)
  • Plan: Symptomatic treatment (decongestant, cough suppressant)
  • Patient education: Return precautions documented
  • Billing: Level 3 (99213) - appropriate based on complexity

Provider validates: 3 clicks

  1. Confirm accuracy
  2. Select specific medications
  3. Sign note

Time: 2-3 minutes total

2. Urinary Tract Infections (UTIs)

Typical Presentation:

  • Dysuria, frequency, urgency
  • Urine dipstick testing
  • Antibiotic treatment
  • Culture considerations

Voice-First Example:

Provider says:

“27-year-old female with 2 days of burning with urination and increased frequency. No fever, no back pain, no vaginal discharge. Last UTI 8 months ago. Urine dip positive for leukocyte esterase and nitrites. Starting empiric treatment with Macrobid, sending culture. Follow up if symptoms don’t improve in 48 hours.”

AI generates complete note with:

  • Appropriate HPI elements
  • Relevant ROS (GU symptoms, fever, back pain addressed)
  • PE findings (urine dip results)
  • Assessment with ICD-10
  • Treatment plan (antibiotic choice, duration, follow-up)
  • Billing level recommendation

Time: 2 minutes documentation, 3 clicks validation

3. Extremity Injuries (Sprains, Strains, Minor Fractures)

Typical Presentation:

  • Injury mechanism
  • Swelling, pain, function assessment
  • X-ray evaluation
  • Splinting/treatment

Voice-First Example:

Provider says:

“18-year-old with twisted ankle playing basketball 2 hours ago. Heard pop, immediate pain and swelling. Able to bear weight but painful. No previous injuries to this ankle. On exam, swelling over lateral malleolus, tender over ATFL, negative drawer test, full ROM with pain. Ottawa ankle rules met, so got X-rays. X-rays negative for fracture. Diagnosis is lateral ankle sprain. Applied stirrup splint, instructed on RICE protocol, gave ibuprofen. Crutches provided. Follow up in 3-5 days if not improving.”

AI handles:

  • Mechanism of injury
  • Relevant exam findings
  • Clinical decision rules (Ottawa)
  • X-ray results
  • Diagnosis and treatment plan
  • DME documentation (splint, crutches)
  • Return precautions
  • Billing (likely 99214 due to X-ray review and splinting)

Time: 3-4 minutes including X-ray review

4. Minor Lacerations

Typical Presentation:

  • Wound assessment
  • Irrigation and repair
  • Tetanus status
  • Wound care instructions

Voice-First Example:

Provider says:

“35-year-old with 2cm laceration on right forearm from broken glass 1 hour ago. Bleeding controlled with pressure. Sensation intact, motor function intact, no tendon involvement. Tetanus up to date. Irrigated wound with normal saline, anesthetized with 1% lidocaine, closed with 6 interrupted 4-0 nylon sutures. Dressed with antibiotic ointment and gauze. Discussed wound care, signs of infection. Suture removal in 10-12 days. Prescribed Keflex prophylaxis given mechanism.”

AI documents:

  • Wound details (location, size, mechanism)
  • Neurovascular assessment
  • Procedure details (irrigation, anesthesia, closure technique)
  • CPT codes (12002 - intermediate repair, 2.1-2.5cm)
  • Materials used
  • Wound care instructions
  • Follow-up plan
  • Prescription
  • Billing (99213 visit + procedure)

Time: 5 minutes including procedure time

The Click Reduction Breakdown

Traditional EHR: 10-15 Clicks Minimum

  1. Open chart → 1 click
  2. Select encounter → 1 click
  3. Chief complaint → 1 click + typing
  4. Template selection → 1-2 clicks
  5. ROS checkboxes → 5-10 clicks (all organ systems)
  6. PE template → 2-3 clicks
  7. PE findings → 3-5 clicks + typing
  8. Assessment → 2 clicks (dropdown + code)
  9. Plan → 3-5 clicks (meds, instructions, orders)
  10. Billing level → 1 click
  11. Sign note → 1 click

Total: 22-35 clicks + significant typing

Voice-First: 3-5 Clicks Total

  1. Before entering room: Tap record button → 1 tap
  2. After patient conversation: Tap stop → 1 tap
  3. Validate generated note: Review → 1 click to confirm
  4. Select specific medications (if needed): 1-2 clicks
  5. Sign note: 1 click

Total: 3-5 clicks, minimal typing

Time per patient:

  • Traditional: 8-10 minutes documentation
  • Voice-first: 2-4 minutes documentation

Daily impact (45 patients):

  • Traditional: 6 hours documentation
  • Voice-first: 1.5 hours documentation
  • Saved: 4.5 hours = $675/day = $169K/year per provider

Template Standardization for Efficiency

Since 98% of urgent care visits are common conditions, optimized templates create massive efficiency:

URI Template (Voice-Triggered)

Provider phrases that trigger URI template:

  • “Upper respiratory infection”
  • “Cold symptoms”
  • “Viral URI”
  • “Cough and congestion”

AI auto-populates:

  • Standard ROS relevant to URI
  • Standard PE components for respiratory
  • Common treatment options (decongestant, cough suppressant)
  • Return precautions template
  • Patient education (when to return, home care)

Provider customizes:

  • Specific symptoms mentioned
  • Specific exam findings
  • Specific medications chosen
  • Any red flags or deviations

Result: 90% of note is auto-generated correctly, 10% provider customization

UTI Template (Voice-Triggered)

AI recognizes patterns:

  • Dysuria + frequency → likely UTI
  • GU symptoms + female patient → UTI template
  • “Burning with urination” → UTI workflow

Auto-populates:

  • Relevant GU ROS
  • Standard pelvic exam components (if applicable)
  • Urine dipstick documentation fields
  • Common antibiotic choices
  • Culture ordering
  • Return precautions

Time saved: 5-6 minutes per UTI patient

Extremity Injury Template

AI detects:

  • Mechanism of injury mentioned
  • Body part affected
  • Request for imaging

Auto-generates:

  • Injury-specific exam (ROM, neurovascular, stability)
  • Clinical decision rules (Ottawa, Pittsburgh)
  • X-ray documentation structure
  • Splinting/DME documentation
  • Ortho referral criteria

Time saved: 4-5 minutes per injury patient

Sound of Silence Integration

The Interruption Problem:

Average urgent care provider interrupted 15-20 times per shift:

  • “Do you need supplies in Room 3?”
  • “Patient in Room 5 is asking about wait time”
  • “Can you clarify this order?”
  • “Patient’s family has a question”

Each interruption costs:

  • 3 minutes to regain focus
  • 15 interruptions × 3 minutes = 45 minutes lost daily

Sound of Silence Protocol:

Visual indicator when provider is actively documenting:

  • Light outside door
  • Status in team app
  • Do Not Disturb signal

With voice-first documentation:

  • Provider documents DURING patient encounter
  • Less time in “documentation mode”
  • Fewer opportunities for interruption
  • More time available for urgent questions

Result: 30 minutes saved daily from reduced interruptions

ROI Calculator for Urgent Care

Costs (Per Provider Annually)

Technology:

  • OrbDoc subscription: $299/month × 12 = $3,588
  • Implementation: $500 one-time
  • Training: Included

Total Annual Cost: $4,088

Benefits (Per Provider Annually)

Time Savings:

  • 90 minutes saved per shift
  • 5 shifts/week = 450 min/week saved
  • 50 weeks/year = 22,500 min/year = 375 hours
  • 375 hours × $150/hour = $56,250 value

After-Hours Charting Elimination:

  • 2 hours/night × 5 nights = 10 hours/week
  • Reduced by 85% = 8.5 hours/week saved
  • 50 weeks = 425 hours/year
  • 425 hours × $150/hour = $63,750 value

Provider Retention:

  • Turnover cost: $250K per provider
  • Baseline turnover: 30% = $75K annual cost
  • Improved to: 12% = $30K annual cost
  • Savings: $45K per provider

Revenue Capture:

  • Better documentation = appropriate coding
  • Average $15K/year per provider in unbilled services captured
  • Revenue increase: $15K

Total Annual Benefit: $180K per provider

Net ROI

Benefit: $180,000 Cost: $4,088 Net: $175,912 ROI: 4,303% Payback Period: 8 days

For a 10-provider urgent care:

  • Annual net benefit: $1.76M
  • Monthly benefit: $146K

Implementation for Urgent Care

Week 1: Setup

  • Configure mobile apps (iOS/Android)
  • Customize templates (URI, UTI, injury, laceration)
  • Test offline mode
  • EHR integration testing
  • Provider device setup

Week 2: Training

Provider Training (2 hours):

  • Mobile app workflow
  • Voice documentation techniques
  • Template customization
  • Validation process
  • Troubleshooting

MA Training (1 hour):

  • Patient check-in updates
  • Provider availability signaling
  • Supply management coordination

Week 3-4: Pilot

  • Start with 2-3 providers
  • Test during typical shifts
  • Daily feedback collection
  • Rapid iteration on templates
  • Address any connectivity issues

Week 5-6: Rollout

  • Expand to all providers
  • Monitor metrics continuously
  • Celebrate quick wins
  • Share provider testimonials
  • Optimize workflows based on data

Week 7+: Optimization

  • Refine templates based on patterns
  • Add new templates as needed
  • Track ROI metrics
  • Share results with team
  • Scale to additional sites if multi-site

Provider Testimonial Pattern (Generic)

“In high-volume urgent care, every minute counts. Mobile voice documentation has been transformative—I capture everything during the patient encounter, validate the note in under a minute, and I’m done. No more late-night charting. My work-life balance has completely changed.”

Urgent Care Provider Multi-Site Urgent Care Network

“We were skeptical about another ‘AI solution’ after previous tools created more work than they saved. But this actually delivers. Our providers are saving 90+ minutes per shift, and for the first time in years, we’re not losing providers to burnout.”

Medical Director Regional Urgent Care Group

“The click reduction alone would be worth it—from 15 clicks to 3 per patient is huge. But the real game-changer is documenting while examining the patient instead of after. I’m spending more time with patients and less time staring at screens.”

Physician Assistant Community Urgent Care Center

Common Urgent Care Specific Features

1. Work Queue Management

Visual dashboard showing:

  • Patients waiting
  • Rooms occupied
  • Documentation status per room
  • Average wait time
  • Provider capacity

Voice notes integrate with queue:

  • “In progress” when recording
  • “Ready for review” when generated
  • “Complete” when signed
  • Real-time status for front desk

2. Rapid Medication Ordering

Common urgent care meds pre-loaded:

  • Antibiotics (Amoxicillin, Azithromycin, Macrobid)
  • Pain management (Ibuprofen, Acetaminophen)
  • Cough/cold (Decongestants, Cough suppressants)
  • Steroids (Prednisone tapers)

Voice ordering:

“Start amoxicillin 500mg three times daily for 10 days”

AI adds:

  • Standard dosing
  • Duration
  • Instructions
  • Quantity
  • Refills (if appropriate)

Provider validates with 1 click

3. X-Ray Integration

Voice documentation includes imaging:

“X-rays show no acute fracture or dislocation. Soft tissue swelling present.”

AI:

  • Documents radiographic findings
  • Adds appropriate CPT codes (73630 - foot X-ray)
  • Includes images in note
  • Generates radiographic report structure

Billing automatically includes imaging

4. Procedure Documentation

Common procedures auto-documented:

  • Laceration repair
  • I&D (incision & drainage)
  • Splinting
  • Foreign body removal
  • Ear lavage

Voice capture includes:

  • Procedure details
  • Anesthesia used
  • Technique
  • Complications (if any)
  • Wound closure method

CPT codes auto-suggested based on procedure described

5. Work Clearance Notes

Automatic generation of:

  • Return to work notes
  • School excuse notes
  • Activity restriction documentation
  • Disability forms

Based on visit documentation, system generates appropriate clearance with:

  • Diagnosis
  • Treatment provided
  • Restrictions
  • Expected return date
  • Provider signature

Saves 5 minutes per work note

Mobile Offline Mode: Critical for Urgent Care

Why Offline Matters:

Urgent care facilities often have:

  • Spotty WiFi in some rooms
  • Overwhelmed network (many devices)
  • Connectivity drops during busy times
  • Rural locations with limited bandwidth

How Offline Mode Works:

  1. Recording: Happens locally on device (no connection needed)
  2. Storage: Encrypted local storage until sync
  3. Processing: When connection restored, uploads and processes
  4. Queue Management: Multiple encounters can queue
  5. Status Indicator: Clear visual showing sync status

Provider Experience:

  • No difference in workflow (record → stop → validate)
  • Background sync when connected
  • No waiting for network
  • No lost recordings

Critical Feature: Prevents “I can’t document because the WiFi is down”

Scaling Across Multi-Site Urgent Care Networks

Site 1: Pilot & Refine

Month 1-2:

  • Single site implementation
  • Template optimization
  • Workflow refinement
  • Metrics collection

Key Learnings:

  • What templates work best
  • Provider adoption factors
  • Common support needs
  • ROI demonstration

Sites 2-5: Rapid Rollout

Month 3-4:

  • Replicate proven model
  • Use Site 1 providers as champions
  • Accelerated training (lessons learned)
  • Shared template library

Efficiency Gains:

  • Implementation time: 2 weeks (vs 4 weeks for Site 1)
  • Training time: 1 hour (vs 2 hours)
  • Time to productivity: 3 days (vs 1 week)

Sites 6+: Systematic Scaling

Month 5+:

  • Standardized implementation playbook
  • Regional training teams
  • Template exchange between sites
  • Cross-site analytics

Network Benefits:

  • Consistent documentation across sites
  • Provider mobility between locations
  • Centralized quality monitoring
  • Aggregate ROI measurement

10-Site Network Results:

  • Total annual benefit: $17.6M
  • Provider retention improvement: 50% reduction in turnover
  • Patient satisfaction: Higher due to less rushed encounters

The Future: High-Volume Provider AI Assistance

Beyond documentation, AI can help manage volume:

Real-Time Triage Support:

  • “Patient in Room 3 may need CT based on symptoms”
  • “Room 5’s symptoms suggest strep—consider rapid test”
  • “Room 7 meets admission criteria—consider ED transfer”

Capacity Management:

  • Predict patient volume based on time/day/season
  • Optimize provider scheduling
  • Anticipate supply needs
  • Adjust staffing recommendations

Quality Monitoring:

  • Real-time missed billing opportunities
  • Compliance gap alerts
  • Clinical guideline adherence
  • Patient safety flags

Learning System:

  • Adapts to individual provider style
  • Improves template suggestions over time
  • Recognizes pattern variations
  • Predicts documentation needs

Conclusion: Sustainable High-Volume Practice

Urgent care doesn’t have to mean unsustainable burnout. With mobile-first voice documentation:

✅ 3 minutes per patient (vs 10 minutes) ✅ 90 minutes saved per shift (375 hours annually) ✅ After-hours charting eliminated (2-3 hours nightly → none) ✅ Click reduction: 10-15 → 3-5 per patient ✅ Provider satisfaction increased ✅ Turnover reduced by 50% ✅ $180K net benefit per provider annually

The question isn’t whether AI documentation works for urgent care.

The question is: How much longer can providers sustain the current burden?

Get Started with High-Volume Documentation

See mobile-first voice documentation in action for your urgent care.

  • Schedule Demo: Watch 40-50 patient workflow
  • ROI Calculator: Calculate your time savings
  • Free Pilot: Test with 2-3 providers for 30 days

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