Using Note Taker with telehealth

During a telehealth session, you can use Note Taker to generate a draft note. In this guide, we'll cover:

• Navigating Note Taker during a telehealth appointment
• Editing draft notes
• Refining a draft note using instructions
• FAQs

Navigating Note Taker during a telehealth appointment

During all telehealth sessions, you’ll see the option to Record audio in the bottom tool bar to begin live transcription. Once you click this, Note Taker will begin using your audio to generate a transcript.

You can click Pause in the bottom tool bar to pause live transcription at any time.

Click Resume to continue recording the audio of the appointment for live transcription.

Note: The Note Taker tool can be used for all types of telehealth appointments: one-on-one, couples, and group appointments. If you’re using the Telehealth by SimplePractice mobile app, see What does Note Taker look like when using the Telehealth by SimplePractice mobile app?

Editing draft notes

Once the telehealth session is complete, Note Taker finalizes the live transcript and creates a draft note for the appointment.

Note: The Note Taker workflow was recently updated to separate session content from viewing and refining a draft note. The core functionality, including transcription and AI-powered draft generation, remains the same. Previously, you could click the Note Taker button to view an automatically generated draft and the session content in one flyout. Now, viewing session content and viewing a draft are separate steps.

To access Note Taker's AI-generated draft note, navigate to the appointment page and select the Note tab. At the top of the Progress Note box, click Note Taker.

The draft note is displayed in the Note Taker flyout. At the top you’ll see the option to enter instructions to refine your draft note. At the bottom, you can click Load into note to load this content into your Progress Note, where you can manually edit it.

Important: You'll have access to the draft note for 7 days after its generation or until you sign and lock the note, whichever comes first. 

If you already starting typing a progress note for the appointment when the draft note became available, a modal will appear that says Replace the existing progress note? 

Click Don't replace to keep your typed progress note if you prefer to access the draft note later.

Alternatively, you can click Replace note to override your typed progress note.

Review and edit the draft note to make sure it's accurate and aligned with your clinical expertise. 

To view the full appointment transcript, click Session Content.

Important: Both the draft note and appointment transcript are only viewable 7 days after the appointment has ended or until the note has been signed and locked, whichever happens first. For more information, see Will the recording and transcription of the appointment be deleted?

To give our team feedback on the draft note:

1. Click How is this draft note?

2. Give your satisfaction rate from 1-5 and why you chose the rating
3. Click Submit

Important: It’s your practice’s responsibility to know the legal requirements of your state when recording the audio from a telehealth appointment for live transcription. If you have any questions, we recommend consulting the relevant licensing and/or governing body.

Refining a draft note using instructions

After Note Taker generates a draft note, you can enter instructions to refine the note and better match your documentation style. This can help you adjust tone, formatting, structure, or level of detail without manually editing the entire draft.

Important: Editing a draft note using instructions is only available on a web browser. If you’ve completed a session in-person on a mobile device, you can switch to a web browser to make these edits for that session.

In the Note Taker flyout, you’ll see the option to enter instructions to refine your draft note:

Note: You can refine a note up to 5 times per appointment. A counter will appear in the Note Taker flyout so you can track how many refinements remain. You can still make manual adjustments once the limit is reached. 

To refine your draft note:

1. Open the Note Taker flyout for the appointment
2. In the Instructions field, enter what you’d like updated
   • Example instructions:
     • “Make the note more concise and reduce repetition.”
     • “Use SOAP format and expand the Assessment and Plan.”
     • “Use neutral, clinical language.”
     • “Add more detail about interventions and client response.”
3. Click Refine 

4. While the note is updating, you’ll see Refining your draft note

5. Once a revised version of the generated draft note based on your instructions becomes available, click Load into note to populate the updated progress note

Once the draft note has been loaded as a progress note, click Save to avoid losing any changes you’ve made. 

Note: You can continue to refine your draft in the Note Taker flyout even after saving the progress note.

FAQs

• How does Note Taker select a note template type?
• I deleted an appointment within the 7-day window. What happened to the draft note?

How does Note Taker select a note template type?

Note Taker will mimic the previous note template type that you use for that particular client. For more information, see Does Note Taker use the previous progress note to help create a new draft note?

When you use Note Taker for a client’s first appointment, it automatically generates an intake progress note in the format of a biopsychosocial assessment combined with a SOAP note. For the second appointment, it defaults to a SOAP note, based on the previous intake note. After that, Note Taker continues using the most recent note type by default.

If you want to change the note format, we recommend manually editing the last generated draft to match your preferred style. This may include adjusting the formatting, note sections, writing style, level of detail, or overall structure.

I deleted an appointment within the 7-day window. What happened to the draft note?

If you used any of the Note Taker features for an appointment and you deleted the appointment within the 7-day window, the draft note also gets deleted. There isn’t a way to retrieve the draft note associated with a deleted appointment.