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AI documentation for telehealth vs in-person - same tool or different? hero image

AI documentation for telehealth vs in-person - same tool or different?

Dr. Danni Steimberg's profile picture
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Question by a member of our Twofold community

“I am a primary care doc doing a mix of in person and telehealth visits. Some days I am in the office with a full schedule, other days I am on video all day. I am testing an AI scribe and trying to decide if I should treat telehealth and in person as two separate workflows or just use the same setup for everything.

My concerns are audio quality, patient consent, privacy on the video platform, and the time it takes to start or stop the scribe between visits. For people already doing this, do you use one AI documentation tool for both telehealth and in person, or different tools and settings. What actually works in daily practice without making things more complicated?”

Brief Answer

Most clinicians can use the same AI documentation platform for both telehealth and in person visits, but with different settings and habits. Telehealth often has cleaner audio from the call itself but needs clear consent and attention to what the video platform records. In person visits depend more on room microphones, background noise, and starting and stopping capture at the right time.

You usually do not need two different vendors. What you do need is one tool that supports both workflows, lets you control when recording happens, and can also work from a short post visit summary when live capture is not ideal.

The Longer Answer

A useful way to think about this is to compare the environments, then decide if you need one platform with two configurations or entirely separate tools.

Comparison at a glance

Dimension

Telehealth visits

In person visits

Same tool considerations

Audio source

Direct from video platform or headset

Room mic, laptop, phone, or external mic

Tool must handle both direct feed and open room audio

Noise profile

Compression, internet lag, talk over each other

Background office noise, distance from mic, paper, keyboards

Noise robust models and good mic placement matter

Consent conversation

Usually at start of video, can be scripted

Often at check in or in room, more informal

One simple script adapted for both settings

Privacy risks

Household members near patient, screen recording by others

People passing by exam room, thin walls

Ability to pause or mute during sensitive moments

Start and stop workflow

Tied to video session start or a button inside the platform

Manual start and stop per encounter

Tool should make capture controls obvious and fast

Use of summaries

Easy to dictate summary directly into browser after call

Easy to dictate between room changes or at workstation

Same summary based workflow works in both contexts

Telehealth specific considerations

  • Audio is often closer to the speaker which can improve transcription, but internet lag and talk over each other can confuse models. A headset or clear mic input helps a lot.
  • You should be explicit about consent. Many clinicians use a one sentence script near the start of the call and document acceptance in the note.
  • Make sure the AI tool and the telehealth platform both meet your privacy and security standards and that no recording is being stored outside of what you expect.
  • For group visits or family members joining, clarify who is speaking and when. Saying brief labels such as “patient” or “parent” out loud can improve attribution in the note.

In person specific considerations

  • Mic placement is critical. If the device is too far away or near a noisy workstation, the transcript quality drops and you end up editing more.
  • You need a reliable habit for starting capture when you enter the room and stopping when you leave, so you are not recording hallway conversations or other patients.
  • For physical exams, rustling, paper, and movement can interfere with clarity. Some clinicians switch to a short spoken summary at the end of the visit instead of full ambient capture.
  • If you do team based visits, identify speakers briefly so the AI can separate your reasoning from nursing or other staff comments.

When a single platform is usually enough

Most clinicians can stay with one AI scribe platform if all of these are true:

  • It can capture from both browser based telehealth and a physical device in the room.
  • It supports quick manual start, pause, and stop so you can control capture in both contexts.
  • It can work either from full conversation audio or from a short dictated summary.
  • You can adjust templates and prompts once, then reuse them for both settings.

In practice, the platform stays the same while you change the input source and small workflow details.

When separate configurations help

You rarely need two different vendors, but you may want two different configurations inside the same tool.

Scenario

Helpful configuration choice

Video heavy days

Use a telehealth profile with default headset input and shorter prompts that focus on history, assessment, and plan

Clinic heavy days

Use an in person profile with more emphasis on exam findings and room noise handling

Sensitive or high risk visits

Turn off full capture and use a “summary only” profile where you dictate a recap after the visit

Mixed schedule with tight turnaround

Keep both profiles available and decide per visit which one fits the encounter and the patient preference

Treat these as presets rather than separate products. This keeps your review and note style consistent.

Operational checklist

A quick checklist you can apply to both telehealth and in person use:

  • Decide how you obtain and document consent in each setting.
  • Pick your default mode for each context: full capture or summary only.
  • Standardize where you review drafts and how long you spend per note.
  • Test audio in both environments and adjust mic placement or devices once.
  • Make sure you can reliably pause or stop capture when needed.

Once these pieces are stable, it becomes much easier to use one AI documentation stack across both telehealth and in person days.

What Clinicians Are Saying on Reddit and Forums About Note Backlogs

Healthcare Forum
Healthcare Forum - Journal of Orthopaedic Experience & Innovation
"Telehealth vs. In-Person Documentation - the Same, only Different"

How Twofold can help: Twofold runs the same way whether your visit is on video or in the exam room. You can capture the live conversation or simply speak a short summary at the end of the encounter, and Twofold will generate a structured note that fits primary care or mental health patterns without forcing you into two separate systems.

Comments

2 comments
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All comments are reviewed by our moderators. Only comments that contribute meaningfully to the conversation will be approved and published.

You
RK

Rachel Kim

Behavioral Health Clinician

1 weeks ago

Once I set up separate telehealth and clinic presets inside the same AI tool, I stopped thinking about it and just focused on patients.

CJ

Caroline James

LCSW

1 weeks ago

I use ambient capture only on video visits and switch to a quick end of session summary in the office. Same platform, two workflows, no more Sunday charting.

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