Twofold Health best AI medical scribe?

[docdanny]

We are looking into getting an AI scribe for our medical practice. We are a heavy Microsoft shop but don't like DAX. We've trialed a few and found Twofold Health to be best. Has anyone here implemented a scribe in a Microsoft env and willing to share feedback?

 

[ChatGPT]

Quick questions​

• Which EHR are you on (Epic, athenaOne, eCW, NextGen, etc.)?
• How do you plan to capture audio: Windows desktop app, mobile device, or through Teams/telehealth?

What’s worked well in Microsoft-heavy rollouts​

• Identity/SSO: Require Entra ID (Azure AD) SSO with MFA; use least-privilege service accounts. Map user groups to specialties/templates.
• Data protection: Get a BAA and confirm data flow/retention. Enforce M365 Purview DLP (especially Clipboard/Endpoint DLP) to keep PHI inside approved apps and block risky copy/paste. Log access in Purview Audit.
• Endpoints: Use Intune to deploy the scribe app, lock mic/camera permissions, and allowlist vendor domains. Standardize Windows audio settings (disable “exclusive mode” if you see device contention; enable noise suppression only if it doesn’t clip).
• Network: Prioritize QoS on clinic Wi‑Fi/VLANs for real‑time audio. If using VDI, verify mic redirection and latency budgets.
• EHR integration: Prefer SMART on FHIR/HL7 or native EHR add‑ins over pure copy/paste. If copy/paste, create role‑based templates and text expanders to cut clicks.
• Telehealth/Teams: If notes are derived from Teams visits, decide whether you’ll rely on a sidecar recorder vs. a vendor’s official integration; align with your call‑recording/compliance policy.
• Governance: Pilot with 5–10 clinicians per specialty, track time-to‑sign, late notes, and burnout metrics. Review sample notes weekly for quality/SOAP completeness and hallucination checks.

Notes on vendors you mentioned​

• Twofold Health: Markets HIPAA/HITECH compliance, says “recordings are never stored,” offers org‑wide BAA on Group plans, and transparent pricing (individual tier listed at $49/mo). Good fit if you want simple desktop/phone capture and paste into any EHR. (trytwofold.com)
• Nuance DAX (Microsoft): Deep Epic alignment—DAX Copilot is embedded in Epic and broadly deployed at large systems, which can be attractive if you live in the Microsoft/Epic stack and want tight EHR integration. If you’ve tried it and don’t like it, that’s still useful context for others here. (news.nuance.com)
• Market pulse: Abridge has significant U.S. health‑system adoption and fresh funding, which some orgs cite for vendor stability. AWS HealthScribe is another route if you prefer to build/integrate on your own stack and keep data under your AWS controls (HIPAA‑eligible). (reuters.com)
• Evidence: Early studies/pilots show reduced burnout, but financial/throughput gains aren’t guaranteed—set expectations and measure locally. (axios.com)

If you share your EHR and capture workflow, I can map this to a concrete setup (Intune policies, Purview DLP rules, and a pilot/runbook) tailored for Windows and M365.