ScribeMDPro

Pulmonology

Pulmonary notes that respect PFT and imaging detail

Asthma, COPD, ILD, sleep — ScribeMDPro produces structured pulmonary notes with PFT and imaging review.

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Pulmonary medicine sits at the intersection of history, physical exam, pulmonary function tests and chest imaging. A COPD follow-up should reflect GOLD stage, exacerbation history and current inhaler regimen. An asthma visit needs symptom control assessment against a defined framework. Interstitial lung disease visits pivot on imaging comparison and PFT trending. ScribeMDPro's clinical model was configured for these visit types — the note surfaces the PFT and imaging review in a consistent format and captures inhaler regimen changes as structured plan items rather than paragraph text.

Documentation challenges we solve

  • Inhaler regimens are often described conversationally but need to appear as clean plan items
  • PFT trends across visits deserve consistent, easy-to-review formatting
  • ILD imaging comparison is core to the assessment and often documented poorly
  • Sleep disorder visits require careful symptom review and adherence assessment

What clinicians gain

  • Structured inhaler regimen output separating maintenance from rescue
  • PFT review formatted for cross-visit trending
  • ILD template with imaging comparison as a first-class section
  • Sleep visit template with symptom severity and adherence capture

How it works

  1. Step 1
    Start ambient capture

    Open ScribeMDPro before the pulmonology encounter and start recording — the patient never has to talk to a device.

  2. Step 2
    Focus on the patient

    Conduct your normal history and exam. Review symptoms, PFTs and imaging as usual — each becomes a structured section.

  3. Step 3
    Auto-drafted note

    A structured SOAP note appears seconds after the visit ends, formatted for your specialty.

  4. Step 4
    Review, sign, export

    Edit inline, copy to your EMR, download as PDF, or push through supported integrations.

Example SOAP output

S: 61yo M with COPD (GOLD 3, group E) on umeclidinium/vilanterol and albuterol PRN. Reports one exacerbation in past year requiring prednisone. Current dyspnea mMRC 2. No fever, hemoptysis.
O: SpO2 94% RA, RR 16. Lungs: prolonged expiration, scattered wheezes bilateral. Recent PFTs: FEV1 45% predicted, FEV1/FVC 60%.
A: COPD GOLD 3, group E, stable.
P: 1) Step up to triple therapy — fluticasone/umeclidinium/vilanterol. 2) Pulmonary rehabilitation referral. 3) Pneumococcal vaccination today. 4) Recheck 3 months.

Illustrative only. Clinicians retain final responsibility for the record.

Frequently asked questions

Does it capture inhaler regimens clearly?

Yes — maintenance and rescue inhalers are output as separate structured items.

How does it handle PFT review?

PFT values are captured for cross-visit trending in a consistent format.

Can it document ILD workup?

ILD templates include imaging comparison, PFT trend, and multidisciplinary discussion when applicable.

What about sleep medicine visits?

Sleep visits are supported with symptom severity scoring and CPAP adherence capture.

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