AI scribe and clinic software for osteopaths

The osteopathic record, as the standards set it out

The UK standard is unusually specific. Under standard C2 of the Osteopathic Practice Standards, records should be comprehensive, accurate, legible and completed promptly, and should include the problems, symptoms, concerns and priorities discussed, relevant medical, family and social history, clinical findings, the information and advice given and how it was communicated, a working diagnosis and treatment plan, records of consent, the treatment given, the clinical response and outcomes, and whether anyone else was present. Notes should be contemporaneous or completed promptly, generally on the same day.¹

Most osteopaths write that as a structured case history followed by a SOAP-style treatment entry. wai reads the same captured note in SOAP, problem-oriented or narrative view, so the osteopath keeps the shape the clinic already uses, and the clinic's own template and phrase library are shared across every practitioner. A validated outcome measure, such as a numeric pain rating, the Neck Disability Index or the Oswestry Disability Index, gives the plan a baseline to review against.

Guidance shapes the plan. For low back pain with or without sciatica, NICE advises considering the STarT Back tool or another risk stratification at the first contact, and considering manual therapy, meaning spinal manipulation, mobilisation or soft tissue techniques, only as part of a package that includes exercise.³ A plan field for the exercise programme keeps that visible in every draft.

Codes come from the note. wai suggests ICD-10 and SNOMED CT codes, each shown beside the line of the consultation it rests on, for the osteopath to confirm. Typical ones in the WHO ICD-10 used in the UK are M54.5 for low back pain, M54.2 for cervicalgia, M54.6 for pain in the thoracic spine and G44.2 for tension-type headache. In the US, osteopathic physicians are licensed doctors, and their notes carry ICD-10-CM codes such as M54.50 for low back pain and the segmental and somatic dysfunction codes by region, M99.01 cervical, M99.02 thoracic and M99.03 lumbar. Procedure codes, CPT in the US, stay with the clinic's biller.

Treatment is felt, not said. An ambient scribe captures speech, so the region, the side and the technique enter the record when the osteopath says them aloud. Narrating the examination as it happens also gives the patient the explanation the standards expect.

Letters to the patient, the GP and the insurer

Most letters should go to the patient. The Academy of Medical Royal Colleges recommends writing most outpatient letters directly to the patient with a copy to the GP, and says writing to patients should be the default setting for an AI scribe.⁷ For an osteopath, that letter explains the working diagnosis in plain words, sets out the treatment plan and the exercises, and lists the symptoms that need urgent medical care.

Referral letters go to the GP when the history or examination needs a medical opinion, such as progressive neurological symptoms, a headache that has changed, or pain that has not responded as expected. wai drafts each with the findings and the question for the GP, as the referral letter sets out. Osteopaths are not among the professions that can certify a fit note, which are doctors, nurses, occupational therapists, pharmacists and physiotherapists, so advice about work goes in the patient letter or to the GP.⁴

Insurers and solicitors want reports. Where a private medical insurer funds treatment, it often asks for the diagnosis, the sessions so far and the response before it authorises more, and a personal injury case may need a medico-legal report. wai drafts medico-legal and expert reports from the record, and an insurer progress report runs as a clinic template, each held for the osteopath to sign and downloaded as a PDF.

Consultations in the patient's own language

The standards are direct about language. Standard A3 says that if a patient communicates in a different language, the osteopath should take reasonable steps to help, for example with an appropriate interpreter, and that an osteopath who cannot communicate sufficiently with the patient should not treat them.² Consent depends on the same understanding, and standard A4 asks for the key elements of the consent discussion to be recorded.²

wai works in 60 languages, among them English, Arabic, Spanish, French, Portuguese, Italian, Russian, Polish, Turkish, Urdu and Mandarin. English can be mixed in one consultation with Spanish, French, Portuguese, Russian, Italian, Dutch, German, Hindi or Japanese, and the other languages are captured in that language. The signed record is written in English, and the patient's summary, exercises and warning symptoms can be translated into their language beside it, with emergency numbers kept exactly as written. wai records the conversation in the language it happened in. It does not replace an interpreter where the osteopath and the patient share no language. The multilingual consultations guide covers how that works.

Clinic software for osteopathy clinics, from first visit to review

Osteopathy clinics run on repeat appointments. Patients request appointments through booking links that read each osteopath's calendar, reminders go out before each visit, and cancellations are offered to the waitlist. Calls, email, web forms and WhatsApp land in one thread per patient, and the front desk approves each drafted reply before it is sent.

Payments go through the clinic's own Stripe account, with deposits for new patient appointments, payment links, memberships and insurer invoices. wai sends recalls for the review appointment in the treatment plan, each approved by a person, and the after-visit companion tracks the GP referral and the follow-up until each is done.

Before each visit the osteopath sees a sourced brief of the patient, the last findings, the plan and any GP reply, each traced to the record it came from. The clinic management software page shows the front desk in full.

One new patient consultation, start to finish

Take a 34-year-old software developer with two months of neck pain and headaches at the end of the working day. She is Italian and switches between Italian and English as she explains. The osteopath asks about arm symptoms, numbness, visual disturbance, difficulty swallowing or speaking, and any sudden severe headache, and records her Neck Disability Index score at the start.

The osteopath narrates the examination, reduced rotation to the right, tenderness over the right upper trapezius and suboccipital muscles, restricted movement at the upper cervical segments, and a normal neurological examination of the arms. They discuss the options, the expected soreness after treatment and the rare risks of neck manipulation, and she chooses soft tissue work and mobilisation without manipulation, with a desk set-up change and daily exercises, and a review in three weeks.

The draft record lists her concerns, each screening question with its answer, the findings by region, a working diagnosis of mechanical neck pain with tension-type headache, the consent discussion including her choice to avoid manipulation, and the plan. wai suggested M54.2 for cervicalgia and G44.2 for tension-type headache, and the osteopath confirmed both. She had mentioned feeling light-headed when she skips lunch, and the draft had listed that under the screening questions, so the osteopath moved it to the history with its context and signed.

What went out was a letter to the patient, copied to her GP, with the plan, the exercises and the headache symptoms that need same-day medical care, and an Italian summary beside the English. The front desk sent a booking link for two follow-ups and the three-week review, and set the review recall.

The evidence behind wai's method

The note is one part of the day the evidence measures. In a randomised trial of 238 outpatient physicians across 14 specialties at UCLA Health, the ambient scribe with a significant effect cut the time spent writing each note by about 41 seconds, against 18 seconds in usual care.⁵ At The Permanente Medical Group, 3,442 physicians used an ambient scribe across 303,266 encounters in its first ten weeks.⁶ Neither study measured osteopaths, so wai takes on the letters, recalls and bookings as well as the record.

The standards ask for the conversation, not only the treatment. Standard C2 lists the advice given and how it was communicated, and standard A4 asks for the information discussed, the patient's concerns and the decisions made to be recorded.¹² An ambient draft captures that dialogue in the words used, and wai holds every draft until the osteopath signs it.

The patient's own language. In a systematic review of 33 studies, 76% found at least one outcome better when patient and physician shared a language other than English.⁸

Measured in a working clinic. At The Wellness in London, which runs on wai every day, every clinician has 15 hours a week back, as published in the customer story.⁹

Where to start

Start with new patient consultations for one osteopath. In week one, build the case history template against the content standard C2 lists, with fixed fields for red flag answers, regions and side, consent and the outcome measure, and measure the time from the end of each consultation to a signed record. In week two, add the patient letter in the patient's language and the review recall, and count corrections to screening answers and regions.

Then audit twenty records against standard C2 after a month. Compare the workflow with the chiropractic guide and the physiotherapy guide, see every profession on the specialties hub, and read how the scribe works on the wai Clinicians page.

Frequently asked questions