Berta: an open-source, modular tool for AI-enabled clinical documentation

Ambient documentation systems are rapidly gaining adoption, yet their impact on clinical note quality remains poorly characterized. We introduce MedConv, a multilingual dataset of 300 clinical encounters in English, Danish, and German, and use it alongside the Ambient Clinical Intelligence benchmark (ACI-BENCH) to compare Corti, a clinical AI platform, with two leading, accessible ambient scribe software applications built on general-purpose AI. We present a controlled clinical evaluation framework that combines entailment metrics with LLM-judged pairwise comparisons across eight dimensions adopted from PDSQI-9. Results show that Corti's API-based text-generation infrastructure is on par with or outperforms leading commercial scribes. We further show that Corti's configurable API provides the flexibility necessary to fine-tune quality dimensions for specific documentation use cases. We present the evaluation methodology and release a dataset to support future reproducible comparison of ambient documentation systems.

Ambient AI scribes draft clinical notes under the reassurance that a clinician signs every note. We audited three commercial AI scribes on the same 142 consultations: 565 notes from recorded UK primary-care and US ambulatory encounters plus authored scenarios. Twelve discovery passes proposed 13,678 candidate errors; the 5,898 clearing an importance filter went to an adversarial panel of two models from different families, each told to refute what it could, and 618 survived. One note in three (31.3% [27.0, 35.6]) carries a verified failure, concentrated in allergy and medication information, invented patient identity, and history written up as examination on telephone consultations that can contain none. No product was given a patient record; setting aside the two classes a record would have prefilled, invented identity and dates, the rate is 24.8% [20.8, 29.0]. One failure mode did not fit our scheme, drawn from published scribe-error taxonomies: a treatment the clinician retracts, recorded as delivered care. Two clinicians adjudicated blind, disjoint samples: a physician author upheld 20 of 21 findings (95.2% [77.3, 99.2]) and an independent clinician, not an author, 12 of 12 ([75.8, 100]); both judged every sampled refusal genuine. A failure rate depends on the instrument as much as the scribes. With model, evidence and settings fixed, the review instruction alone moves the share of candidates verified from 9.3% to 79.0%, and the reviewing family moves it too: alone at that instruction the gentler flags 54.8% of notes against 27.8%. Between 28% and 97% of sampled notes carry a failure depending on the standard. Published audits disagree among themselves by a margin instrument differences alone can produce: omission is 54-86% of their errors against our 23.1%. We release all 618 findings with transcript-side evidence, every prompt and model version, and the re-runnable pipeline.

Automatic SOAP note generation can ease the documentation burden on physicians, but existing reasoning methods often omit clinically important information and generate unsupported content. Progress in Thai is further hindered by the lack of publicly available datasets. We propose ASCRIBE, a physician-inspired reasoning framework that ascribes a clinical-significance level to each extracted atomic fact in the conversation before summarization, making a general-purpose LLM a more reliable scribe. We also release ThaiClinicBench, the first de-identified Thai clinical summarization benchmark of real encounters, together with a synthetic training corpus derived from real clinical notes. As a prompt, ASCRIBE outperforms chain-of-thought prompting on GPT-5.4 and Gemini 3.1 Pro across the physician-aligned LLM-judge metrics and improves on standard prompting by up to 10.3 points on the completeness LLM-judge metric. As a GRPO reward, it enables a Gemma-4-E4B model trained solely on synthetic data to match Gemini 3.1 Pro in factual precision and surpass it in completeness. Code and data can be found at https://github.com/loolootech/ascribe.