An ambient AI scribe drafts your pulmonology note from what you say during the visit, then hands the draft back about two minutes after the patient leaves. It documents the COPD interval history, the PFT read you dictate, the CPAP numbers you state. One boundary matters most: it never reads the spirometry tracing or interprets the study. That reading is yours. You review, confirm codes as suggestions, and sign.
Key takeaways
- The scribe drafts pulmonology notes about two minutes after the visit; you review and sign.
- It captures the PFT and imaging read you dictate. It does not open the tracing or the CT. The interpretation stays yours.
- COPD exacerbation counts, CPAP adherence hours, and inhaler regimens come from what you say, not from any device or portal.
- ICD-10 suggestions like J44.1 or J45.909 are starting points you confirm, not auto-coded charges.
- Audio is discarded the moment the note drafts. Nothing is recorded.
From end of visit to drafted note
Assist tier, per clinician, annual billing
Tracings or scans the scribe reads
Source: Patient Square product specifications, 2026.
Why pulmonology charting runs long
Think about a Monday clinic stacked with COPD follow-ups. Each one carries an interval history, a focused respiratory exam, a PFT summary to document, an inhaler regimen to reconcile, a smoking-status update, and a plan that often references the next spirometry or CT. That’s a dense note, repeated fifteen times before lunch. Then the sleep-apnea slots in the afternoon each need the CPAP report transcribed. None of it is one-liner charting.
The burnout data lines up with that load. The AMA’s 2023 Organizational Biopsy found 20.9% of physicians spend more than eight hours a week on the electronic record outside normal work hours, the after-hours “pajama time” that hasn’t moved in years. If you’ve ever cleared a PFT backlog at 6pm from your kitchen table, you know the shape of that number.
An ambient scribe doesn’t shrink the clinical thinking. It shrinks the gap between saying the finding and having it written down. A 2025 JAMA Network Open study of 263 ambulatory clinicians across six US health systems found burnout dropped from 51.9% to 38.8% after 30 days on an ambient scribe, with measured improvement in after-hours documentation time. That’s a burnout signal, not a stopwatch. It points the same direction the arithmetic does.
How an ambient scribe fits a pulmonology visit
You start the session when the patient sits down, then run the visit the way you always do. As you take the interval history and examine the patient, you speak your findings the way you’d dictate them: “dyspnea on exertion at one flight, no orthopnea, breath sounds diminished at the bases, no wheeze, oxygen sat 94 on room air.” The scribe captures it.
When you pull up the PFT and read it, dictate the read aloud. “FEV1 58 percent predicted, ratio reduced at 0.62, obstructive pattern, positive bronchodilator response.” That’s your interpretation. The scribe writes it into the note as you said it. It isn’t looking at the flow-volume loop or the numbers on the report. You did that. The scribe is a stenographer, not a technician.
AI Scribe by Patient Square is an ambient AI medical scribe that listens during the visit and hands back a structured SOAP note, ICD-10 suggestions, and a prescription draft, ready to review and sign about two minutes after the visit.
After the visit you stop the session. Two minutes later there’s a draft: interval history, exam, your PFT and imaging summaries, assessment, plan. You read it, fix anything wrong, and sign. The note comes back in English, the audio is never stored, and the prescription output is a draft you review, never something sent to a pharmacy. Our HIPAA, BAA, and consent guide covers how the PHI handling works.
The tracing boundary, stated plainly
This is the line that matters most in pulmonology. The scribe does not read the spirometry tracing. It does not interpret the flow-volume loop. It does not open the HRCT or measure a nodule. It has no imaging or waveform capability at all.
What it does is capture your words about the study. When you dictate that the spirometry shows an obstructive pattern with a bronchodilator response, or that the six-minute walk desaturated to 86 percent, the scribe writes down that you said it. The DLCO you read off the report goes in because you spoke it. The interpretation is yours, recorded as your reading.
Why labor this? Because a scribe that appeared to interpret a PFT would be making a clinical call it has no business making, and in pulmonology that call drives the diagnosis. A restrictive pattern versus an obstructive one, a reduced DLCO pointing toward ILD versus emphysema, these are your reads. Same holds for imaging: you state the HRCT pattern, the scribe records it. It does not read the CT and tell you what it means.
What a pulmonology scribe has to capture
The vocabulary is specific, and a generic scribe that flattens it into primary-care language will frustrate you on every note. The draft has to come back in pulmonary terms.
| Note element | What you say out loud | What the scribe drafts |
|---|---|---|
| PFT read | ”FEV1 58% predicted, ratio 0.62, obstructive, positive bronchodilator response” | Spirometry findings as dictated |
| COPD interval | ”Two exacerbations since last visit, one needing prednisone, CAT score 22” | Exacerbation count and severity |
| Asthma control | ”ACT score 17, uncontrolled, nighttime symptoms twice weekly” | Control status with score |
| CPAP adherence | ”Usage 6.2 hours nightly, 88% of nights, residual AHI 3.1” | Adherence numbers as stated |
| Nodule follow-up | ”8mm solid nodule RUL, stable, Fleischner 12-month interval” | Nodule detail and interval |
| ILD assessment | ”HRCT shows UIP pattern per report, declining DLCO at 48%“ | Your read of the pattern |
| Tobacco counseling | ”10 pack-year history, still smoking half a pack, offered varenicline” | Cessation counseling detail |
If the draft reads like “patient has breathing issues,” it wasn’t built for you. Dictate the FEV1 as a number and the exacerbation count as a count, and the note carries them. Say “some shortness of breath” and that’s what you’ll get back, which is why stating the figure out loud is worth the two seconds.
COPD and asthma follow-ups: narrate the trend
Chronic airway disease is about the delta between visits. A COPD note that just says “stable” is nearly worthless three months later. The scribe has no memory of the last visit. None. It only knows what you say in this room, so the trend has to be spoken. Say “two exacerbations since last visit, one requiring a prednisone burst, we added a LAMA and the CAT dropped from 26 to 22,” and the note captures that arc. Say “doing about the same,” and future-you gets nothing.
Asthma runs the same way. State the ACT score, the control category, the trigger pattern, and the step you’re making. The scribe drafts it cleanly. What it can’t do is pull the prior ACT forward or flag that control slipped since the last visit. That judgment is yours, at the review step.
We think this is a quiet upside. Dictating the interval trend out loud, while the patient is in front of you, tends to produce a sharper history than reconstructing it from a template at night. If you’ve read our primary-care time-back model, the pulmonology math is similar with heavier note types stacked on top.
Sleep visits, CPAP data, and the numbers you dictate
Sleep-apnea follow-ups are their own documentation pattern, and they’re data-heavy in a specific way. The value of the visit lives in the adherence report: nightly usage, percent of nights used, residual AHI, mask-fit and pressure issues.
The scribe records those numbers when you read them aloud. Dictate “usage averaging 6.2 hours a night, used 88 percent of nights, residual AHI 3.1, morning headaches resolved,” and the note reflects it. What it does not do is reach into the CPAP machine, the SD card, or the compliance portal and pull the data itself. There’s no device connection. You read the report, you say the figures, the note captures your account of them. If your real bottleneck is getting adherence data to flow automatically from the DME portal into your chart, a scribe doesn’t solve that. It’s an interoperability problem, and a scribe doesn’t touch it.
Nodules, ILD, and tobacco cessation
Pulmonary nodule surveillance is where the imaging boundary and the longitudinal problem meet. The scribe has no prior scan on file, so the comparison you want in the note is the one you speak. State the current size, the prior size, the Fleischner or Lung-RADS interval, and your read of stability, and the note reflects it as your assessment. It never opens the CT. ILD visits work the same: dictate the HRCT pattern as reported and as you read it, the DLCO trend, the symptom trajectory, and the note carries your words rather than any interpretation of the scan.
Tobacco cessation counseling is the part that gets clipped in a rushed note, and it matters for the patient and the coding both. Dictate the pack-year history, current use, readiness to quit, and the intervention you offered, and the scribe drafts the counseling detail. Say it out loud and it lands; skip it and the note skips it too.
ICD-10 for pulmonology: suggestions to start from
Pulmonology coding rewards specificity. COPD alone splits across J44.0, J44.1, and J44.9 depending on whether there’s an acute exacerbation or a lower-respiratory infection. The scribe reads your dictated assessment and suggests codes to match: J44.1 for COPD with acute exacerbation, J45.909 for unspecified asthma, G47.33 for obstructive sleep apnea, J84.9 for unspecified interstitial lung disease.
Those are suggestions. They show up next to the draft. You confirm the ones that fit, change the ones that don’t, and drop the rest. The scribe has no line into your billing system and posts no charges. And the specificity that drives correct coding also drives denials when it’s missing: say “COPD” without the exacerbation detail and the suggestion comes back vague too, because the scribe only has what you gave it. Our ICD-10 suggestions explainer walks through why review matters here.
Inhaler teaching and the prescription draft
Pulmonology visits generate prescriptions constantly: inhalers, oral steroids, exacerbation antibiotics, cessation aids. When your plan includes one, the scribe drafts it from what you said, writing out the drug and dose so you don’t retype the order.
It does not screen the draft for interactions or check technique. Inhaler teaching stays a hands-on task: you demonstrate, the patient teaches back, you correct. The scribe can document that you did it if you narrate it, but it can’t do the coaching. The draft never goes to a pharmacy and there’s no e-prescribing link. You review it, adjust what needs adjusting, and act on it in your own workflow. See our post on prescription draft safety for why the clinician is the safety check.
Security and ownership
Respiratory and sleep records are sensitive health data. Audio is processed in memory and discarded the moment the note drafts, so no recording of the visit exists afterward. Notes are encrypted in transit with TLS 1.2 or higher and at rest with AES-256, they belong to your practice, and you can export or delete them anytime. We maintain HIPAA compliant safeguards, offer a signed BAA to every customer, and have a SOC 2 Type II audit underway. If compliance gates your decision, start with the security page.
When it earns a place, and when it doesn’t
Pulmonology notes are long and the visits are cognitively heavy. If charting is stealing time you’d rather spend on treatment planning or with patients, the trade is worth weighing: narrate your PFT and imaging reads as you already do, and the note drafts for your review, with the reading always kept as yours.
One concession worth stating up front. If what you actually need is structured data flowing between your PFT lab, your sleep-lab database, and your EHR, a scribe isn’t that purchase. It captures spoken clinical work and hands you an export. If you never want to say the read out loud, or if your bottleneck is device-to-chart automation rather than typing, this isn’t the right buy for you yet.
Pricing starts from $79 per clinician per month on the annual Assist plan, then steps up to the Copilot and Autopilot tiers, which add a bundled AI EHR, messaging, and receptionist and follow-up automation. On the scribe-only plan it runs alongside your pulmonology EHR and hands you an export; it does not write back into your system. See our comparison of AI medical scribes, the cardiology scribe overview if you co-manage cardiopulmonary patients, and how to evaluate an AI scribe before committing to any vendor.
Want to see the draft quality against your own PFT reads and CPAP notes?