How an AI Scribe Gets a Note Wrong, and the Checks That Catch It

Fluent is not the same as right

Language models write well. That is the problem: a note with a wrong dose reads exactly as confidently as a correct one. We test Clinic Scribe on hundreds of invented consultations in five languages, and every error below is one we actually found. Each now has a check that stops the doctor before signing.

The errors, and the checks

• A dose ten times too high. Speech recognition hears "Telma 40" as "Telma 400", or "Urimax zero point four" as 4. Both agree with the transcript, so only knowledge of the drug can catch them. A dose outside the usual range blocks signing.
• A changed dose kept at the old strength. "Serlift 50, increase to 75" - and the medicine list still says 50. Two passes over the conversation are compared; a disagreement blocks signing.
• A self-correction missed. "Betnovate - sorry, Mometasone." The corrected drug must win.
• A relative's medicine in the patient's list. A wife mentions her own Thyronorm. It is kept out and flagged by name.
• A "no" that disappears. "Fever?" "Nahi." The denial must reach the note, in any of the five languages.
• Spoons turned into millilitres. "Two spoons" becomes "2 ml", or "2 gm". Household measures stay as said.
• Half a number. "HbA1c seven point..." and the rest not heard, written as 7. The unfinished decimal is flagged.
• A follow-up that contradicts itself. "Six months, on 18 November" - 18 November is six weeks away. One of them was misheard or misspoken.

Why checks, not a smarter prompt

We tried telling the note model more about each specialty. It made the notes worse: given more medical knowledge, the model drifted toward what is typical instead of what was said. So the knowledge goes into checks - dose ranges for Indian brands, the negatives each specialty asks about - which cannot invent anything and can only stop a signature.

The doctor still reads every note

No check catches everything. The note shows the words behind every line, flags must be ticked one by one, signed notes cannot be overwritten, and the doctor reads every note. That is the design, not a disclaimer.