A pain-management scribe can draft the visit narrative. It cannot turn an unperformed PDMP review, an unseen image, or a planned procedure into completed evidence. The pilot should test that boundary on purpose. Keep source-system checks, prescribing authority, and the final signed decision with the people and tools that own them.
Thursday’s refill visit has two clocks
One clock follows the conversation: pain since the last visit, function, response, adverse effects, and what the patient reports taking. The other follows actions outside the conversation: source records reviewed, examinations performed, decisions made, and orders actually authorized.
An ambient draft can help with the first clock. It must not fake the second.
| Statement in the draft | Evidence owner | Acceptance test |
|---|---|---|
| Patient reports a change in function | Patient conversation | Attribution remains explicit |
| Clinician reviewed PDMP data | Authorized clinician and PDMP | Review occurred and is recorded according to local policy |
| Procedure was performed | Procedure record and clinician | Date, site, laterality, and completion agree |
| Medication was prescribed | Prescriber and prescribing system | Draft discussion is not presented as transmission |
| ICD-10 candidate | Clinician or authorized coding reviewer | Suggestion is accepted, changed, or rejected before use |
This is the core buying test. The note can be concise or long. Source confusion is the failure.
PDMP review is not a sentence-generation task
CDC describes a prescription drug monitoring program as an electronic database that tracks controlled-substance prescriptions. Its clinical guidance points clinicians to Recommendation 9 of the 2022 opioid guideline and says PDMP information should be reviewed at defined prescribing moments to assess risk (CDC PDMP guidance). The full guideline also addresses PDMP review and the benefits and risks of toxicology testing (CDC 2022 guideline).
This article is not prescribing advice. The operational point is narrower: a draft that says “PDMP reviewed” needs evidence from the authorized workflow. Hearing those words in a room is not the same thing as accessing the source database. A clinic’s medical, compliance, and legal owners should define when the check occurs and how it is documented.
Patient Square does not access a PDMP, perform toxicology review, transmit prescriptions, or provide EPCS. It can draft what was discussed. The clinician verifies the record and completes required work in the approved systems.
Use a missing-fact drill
Build three synthetic encounters for the pilot. In one, the patient reports a medication but the dose is not stated. In another, a prior procedure is discussed but today’s laterality is never spoken. In the third, the clinician says a source check will happen after the visit.
Now read the drafts cold. Any filled-in dose, inferred laterality, or completed check is a stop signal. Mark it, correct it, and record how the vendor responds. A useful system should make uncertainty visible to the reviewer instead of smoothing it into confident prose.
Run the same cases twice: once with the clinician narrating relevant findings clearly, and once with normal conversational shorthand. The difference tells you how much workflow change the product demands. The federal Health IT Playbook recommends common demonstration scenarios and structured testing against practice needs (ASTP/ONC Health IT Playbook).
Define the product boundary before price
Patient Square is an AI clinical platform. Its AI Medical Scribe drafts a structured SOAP note, ICD-10 suggestions, and a prescription draft for clinician review. Practice Copilot can sit alongside the clinic’s current EHR or use the bundled Patient Square EHR, named AI Copilot EHR on the pricing page, from the Copilot tier. US annual pricing is $79 per physician per month for Assist and $119 for Copilot (Patient Square pricing).
The boundaries matter more here than the price. Patient Square does not claim PDMP access, EPCS, pharmacy transmission, procedure-device integration, imaging review, or a coding engine. A pain clinic that needs those functions should keep or buy systems that provide them.
We think the right trial question is not “Did the AI write a complete note?” Ask, “Can a reviewer tell which facts came from the room and which controls happened somewhere else?” The ICD-10 suggestions explainer covers the coding boundary, while the prescription-draft safety guide covers the difference between a draft and transmission.