User Guide
Around Notes Documentation
Learn how to get the most out of Around Notes — from building your first note to fine-tuning templates and reviewing AI-generated content.
Dashboard
Overview
The Dashboard is your home base in Around Notes. From here you can start a new note, access your note history, and monitor your monthly credit usage and plan status.
Pro tip: Your most recent note is always one click away — no digging required.
Dashboard
Your Notes at a Glance
Recent notes appear as tiles showing note type, patient context, and timestamp. Open, copy, or continue working on any note directly from this view. Notes are organized chronologically so your most recent work is always at the top.
Note Builder
Overview
The Note Builder is the core workspace in Around Notes. You provide chart context and a brief clinical prompt, and Arno generates a structured inpatient note in your preferred style — ready to paste into any EMR. The quality of the output reflects the quality of what you give it.
Note Builder
Note Types
Choose your note type from the purple dropdown at the top of the Note Builder. Each type shapes the structure and focus of the generated output.
Available note types: H&P, Progress Note, A&P Only, DC Summary, Summarizer, ED Note / MDM, and Consult H&P. Select the one that matches what you're writing — the structure of the output will follow.
H&P builds a full admission narrative from scratch. Progress Note focuses on interval updates and today's plan. DC Summary synthesizes the full hospital stay. A&P Only generates just the assessment and plan section when the rest of the note is already written. Summarizer condenses a complex chart or long note into a clean summary.
Pro tip: Selecting the right note type matters more than you might think — it tells Arno what structure to apply before it reads a single word of your input.
Note Builder
The Prompt Field
This is where you tell Arno what's going on with this patient and what you need. Type or dictate the clinical story and any specific direction for the note — what to emphasize, what problems to focus on, or any clinical details you want captured.
Keep it focused on the clinical picture and what matters for this note. You don't need to specify formatting or style here — those are handled by the Style dropdown and the Settings gear icon. The prompt is for the medicine: what's the story, what's the priority, what do you want Arno to pay attention to.
You can add clinical specifics that the dropdowns can't capture — for example: 'give at least 5 differentials for the primary problem,' 'write a detailed CHF workup plan for a resident,' or 'focus the A&P on the respiratory failure and hold off on the chronic problems today.'
The prompt field supports web dictation — tap the mic icon and speak your clinical instructions naturally. Useful when you're mid-rounding and want to keep your hands free.
Progress note with clinical focus
H&P with teaching detail
Discharge summary focus
Pro tip: Style, complexity, and formatting are set in the Style dropdown and the gear icon — save the prompt for clinical direction.
Pro tip: Even a short, specific prompt outperforms a long, vague one. 'Focus on the AKI and dispo barriers' is more useful than a paragraph of background.
Note Builder
Style & Complexity
The Style dropdown controls how Arno writes the note — from a brief bedside update to a detailed academic note. Choose the style that fits your audience and documentation context before generating.
Available styles: Concise, Academic & Concise, Academic, Basic, and ICU (Systems). Concise produces tight, efficient notes suited for busy hospitalist rounding. Academic adds reasoning, differentials, and more expansive plan logic. Basic is a stripped-down format. ICU (Systems) reorganizes the note by organ system rather than problem.
Style is separate from the detailed formatting options in the gear icon — think of Style as the register of the note, and Settings as the structural details.
Pro tip: Academic & Concise is often the sweet spot for attendings who want clinical reasoning without bloat.
Pro tip: Use ICU (Systems) when rounding on a complex patient where the team thinks in systems rather than problem lists.
Note Builder
Settings (Gear Icon)
The gear icon opens Additional Formats & Options — the most detailed layer of customization in the Note Builder. Settings are organized by SOAP section so you can fine-tune exactly how each part of the note is written.
Each section below corresponds to one part of the SOAP structure. Adjust the controls that matter for your workflow and leave the rest at defaults.
S — SUBJECTIVE
- Review of Systems: All Negative, AI and Contextual, or No ROS (H&P-only unless prompted).
- Writing Personalization: Off (default clinical voice), Subtle (narrative, less repetition), or Warm (empathy and functional impact).
- PHI Minimization: strips timestamps, dates, and names from the output. Pair with the Clear PHI toggle in the Data Bin and Note Bin.
- Home Medications: controls whether home meds with doses appear in the assessment.
O — OBJECTIVE
- Physical Exam: Basic, Only Mentioned, AI Implies Findings, or My Physical Exam via Universal Instruction.
- Labs/Rads in Output: controls whether results appear in the objective section. Excluded results are still analyzed for the A&P.
- Vital Sign Format: Min-Max with Current, Line Entry, or No Vital Signs.
- S/O Lists: line-by-line, comma-compacted, or comma-separated for PMH/PSH/SH/Meds.
A — ASSESSMENT
- Specialty: biases the A&P toward General Medicine, Cardiology, GI/Hepatology, ID, Nephrology, Neurology, Onc/Heme, Peds, Psych, Pulm, General Surgery, Neurosurgery, or Ortho. Selecting one presumes a consult context.
- Problem Grouping: controls how diagnoses are clustered.
- Problem Formatting: ALL CAPS, --- CAPS ---, Title Case, or Sentence case.
- DDx List: toggles differential generation.
- AI Diagnosis Suggestion: Enabled (aggressive, including home meds), Disabled (sticks to your list), or Analysis Only (respects only problems you explicitly listed).
P — PLAN
- Plan Style: Expert (concise, attending level), Advanced (standard), Novice (detailed, student level), or User Plan and Updates Only.
- A&P Format: Hashtags (#PROBLEM / A: / P:), Indent (PROBLEM / Assessment: / Plan:), Line (single line per problem), or All Dashes.
- Hospital Checklist: toggles Arno's standard admission checklist.
- Hospital Course by Day: Date-based, Narrative, or Disabled.
Pro tip: Specialty is one of the most impactful settings on subspecialty services — it completely reframes how Arno prioritizes and writes the A&P.
Pro tip: Pair PHI Minimization with the Clear PHI toggle in the Data Bin and Note Bin for the most thorough pre-processing before any data is transmitted.
Pro tip: Calibrate Plan Style to your audience — Novice when teaching a resident, Expert when you need speed on a straightforward patient.
Note Builder
Templates & Template Tags
Templates let you attach structured instruction overlays to your note with a single click. They appear as tag chips in the Note Builder and stack — you can apply multiple templates to one note.
Available template tags include: MDM-Labs (adds medical decision-making language for lab review), Hospital Checklist (appends a standard admission checklist covering DVT ppx, diet, telemetry, code status, and dispo), NIHSS (embeds a full NIH Stroke Scale section), Spanish Instructions (generates patient education in Spanish), Ultra Shorthand (ultra-brief abbreviation-heavy format), and Extensive Cancer History (detailed oncologic history section).
Templates are additive — MDM-Labs and Hospital Checklist can both be active at the same time. Remove a tag by clicking the X on the chip.
Custom templates let you save your own instruction sets — your preferred A&P phrasing, service-specific reminders, or recurring clinical rules — and apply them in one click. Use the Create Custom Template option in the template dropdown.
Pro tip: MDM-Labs is particularly useful for billing documentation — it embeds language that supports medical decision-making complexity in the A&P.
Pro tip: Build a service template at the start of a rotation and share the instructions with your team — everyone's notes will read consistently.
Note Builder
Universal Instructions
Universal Instructions are persistent rules that apply to every note you generate — no matter the note type, style, or template. Set them once and they run in the background on everything.
Access Universal Instructions from the settings area. Write them as plain rules or preferences — for example: 'Vancomycin is always per pharmacy unless oral,' 'No inpatient endocrine consults,' or 'If the patient is 75 or older and going to surgery, flag: needs SENIOR ASSESSMENT in the plan.'
Universal Instructions are best for durable clinical preferences and service-level rules that should never be forgotten — not one-off requests that belong in the prompt field.
They stack with everything else: the prompt, the style setting, templates, and Settings options all layer on top of Universal Instructions.
Service-level rules
Patient safety flag
Pro tip: Think of Universal Instructions as your standing orders for Arno. Set them at the start of a service and forget about them. They're always applied to every note.
Pro tip: Keep them short and imperative — 'Always include DVT ppx rationale' works better than a paragraph of explanation.
Note Builder
Data Bin
The Data Bin is where you paste raw chart data — labs, vitals, imaging results, medication lists, problem lists, and any other objective material. Arno uses this as the factual backbone of the note.
Paste it as it comes from the chart — you don't need to clean it up or reformat it. Arno interprets messy EMR output, copy-pasted lab tables, and raw data pulls. The goal is signal, not polish.
For a progress note, paste today's labs, vitals, any new imaging, and relevant nursing or consult updates. For an H&P, include the admission labs, ED vitals, medication reconciliation, and problem list. For a discharge summary, add the final labs, discharge medications, and disposition details.
A fast way to build a reusable Data Bin workflow is to create a transfer phrase in your EMR — a structured copy-paste of the key chart fields you pull on every patient. You can use AI Chat to help you design and refine a custom transfer phrase that works with your specific EMR layout. Once you have one, the Data Bin becomes a 10-second paste instead of manual assembly.
Pro tip: More relevant context means a better note. Don't over-curate — the goal is enough signal to support the output.
Pro tip: Use AI Chat to build a custom EMR transfer phrase. Describe your EMR layout and ask it to generate a structured copy template — then save that as your standard Data Bin input.
Pro tip: For complex patients with long stays, focus the Data Bin on today's data. Put the historical narrative in the Note Bin instead.
Note Builder
Note Bin
The Note Bin is where you paste prior notes, consult reports, ED documentation, or any narrative material that should inform the new note. Arno uses it to carry forward the clinical story and incorporate existing documentation.
For a progress note, paste yesterday's progress note. Arno will update the story with today's data from the Data Bin, carry forward active problems, and drop what's no longer relevant. For an H&P, paste the ED note or any prior records — Arno will decode and integrate them into the admission narrative.
The Note Bin is especially useful for service takeovers. When you inherit a messy list, paste the last progress note and any relevant consult notes — Arno will synthesize them into a clean starting point that reflects the current picture.
For discharge summaries, paste the admission H&P, recent progress notes, and key consult summaries. Arno will build a coherent hospital course from the combined narrative without you having to stitch it together manually.
You can also use the Note Bin to clean up a colleague's note. Paste their draft, describe what you want changed in the prompt, and let Arno rewrite it in your style.
Pro tip: Prior notes are useful for continuity — but review the output for stale details that may have carried forward from older documentation.
Pro tip: Pasting multiple consult notes into the Note Bin and asking Arno to 'synthesize specialist recommendations into the plan' is one of the highest-value uses of the tool on a complex patient.
Pro tip: The Note Bin works alongside the Data Bin — they're not either/or. Prior narrative goes in the Note Bin; current objective data goes in the Data Bin. Use both together for the best output.
Note Builder
Fast Mode
Fast Mode uses an accelerated model to generate notes in roughly 30 seconds instead of 1–2 minutes. It's ideal for straightforward progress notes and rapid updates during a busy rounding session. Fast Mode notes count as half a credit against your monthly plan.
Pro tip: Use Fast Mode for routine updates. Save standard generation for complex admissions, service takeovers, and discharge summaries.
Note Builder
MOUSE AI Review
After your note is generated, MOUSE AI performs a second-pass integrity check — comparing the draft against the raw data you provided to flag omissions, contradictions, missing follow-ups, and common inpatient documentation gaps.
Think of it as a skeptical chief resident taking a quick look before you sign. MOUSE AI doesn't just read the finished note — it cross-references it against the source material you pasted into the Data Bin and Note Bin, which is what allows it to catch internal contradictions that a plain spell-checker would miss.
Common catches include: antiplatelet therapy missing for a patient with CAD, DVT prophylaxis not addressed in a GI bleed patient, a PE not considered when D-dimer is elevated and tachycardia is present, missing follow-up for a lung nodule mentioned in imaging, and plan items that don't reflect the most recent lab trend.
You can accept individual suggestions directly into your note, or review them and dismiss what doesn't apply. MOUSE AI is a tool for increasing awareness — the clinical judgment on what to accept always belongs to you.
Toggle MOUSE AI on or off depending on the situation. It adds a few seconds to the workflow but is most valuable on complex patients, new admissions, and discharge summaries where omissions are highest-stakes.
Pro tip: MOUSE AI works best when the Data Bin is fully populated. The more chart context it has, the more it can catch.
Pro tip: Don't dismiss suggestions automatically — even ones that don't apply often point to something worth a second look.
Pro tip: MOUSE AI is a safety and quality feature, not clinical advice. It surfaces things to consider, not things to blindly accept.
Radiology Review
Overview
The Radiology Review module is an AI-powered educational tool for engaging with radiological images. It's designed primarily for medical students and trainees who want structured practice reading films — not a replacement for formal radiology reporting.
Radiology Review
How to Submit an Image
Upload or paste a radiology image directly into the module. The AI will analyze the image and provide educational commentary on visible findings. Results are intended for learning and discussion — not for clinical decision-making or documentation in a patient's chart.
AI Chat
Overview
AI Chat is a HIPAA-safe conversational assistant built into Around Notes. Use it for medical questions, clinical translation tasks, building transfer phrases, or any general medical and scientific task — all without leaving the workspace.
AI Chat is not a note builder — it won't generate a clinical note for you. That's what the Note Builder is for. Think of it instead as a capable medical assistant you can have a back-and-forth conversation with.
Common uses include: looking up clinical topics, translating medical content into patient-friendly language, converting discharge instructions into another language, building or refining a custom EMR transfer phrase, and general scientific or documentation-adjacent tasks.
All conversations are HIPAA-safe and operate under the same zero-retention data handling as the rest of the app — inputs are not stored or used to train any model.
Pro tip: AI Chat is great for tasks that don't fit neatly into note generation — translation, patient instructions, quick clinical lookups, or thinking through a differential before building the note.
Pro tip: It won't replace the Note Builder for structured documentation, but it's a powerful complement for everything around the note.
AI Chat
Building a Transfer Phrase
The Transfer Phrase setup is how you connect your EMR's data to Around Notes. Paste your existing EMR templates — your H&P, progress note, or any smart phrases that pull patient chart data — and the AI does the rest.
The way it works: you paste your full EMR template as-is, tokens and all. This could be your Epic SmartPhrase, your Cerner template, or any structured note format your hospital uses that pulls live chart data — vitals, labs, medications, problem list, whatever your EMR populates automatically when you run it.
The AI reads through your template, identifies the data components it recognizes, and maps them to Around Notes' gold standard data list — the structured set of inputs Arno uses to make clinical decisions when building your note. You don't need to label anything or restructure your template first. Just paste it whole.
A graphical interface then shows you what was found and mapped, what's missing from the gold standard list, and any tokens or data links that couldn't be matched automatically. You can review the results, fill in any gaps, and save your finalized transfer phrase. From that point forward, running your EMR template and pasting the output into the Data Bin is a single step — Arno already knows how to read it.
Epic SmartPhrase paste (example)
Freeform progress note template paste
Pro tip: Paste your template exactly as it looks in your EMR — tokens, brackets, and all. The AI is looking for the structure, not clean text.
Pro tip: If your EMR populates multiple note types differently (H&P vs progress note vs discharge), set up a separate transfer phrase for each. A few minutes of setup saves time on every note going forward.
Pro tip: The graphical interface will show you what data Arno is missing from your template — use that as a checklist to add any smart phrases or tokens your EMR supports that you weren't already using.
AI Chat
Deep Search Mode
Deep Search anchors AI responses to real-time web sources and connects them to your current patient context. Use it when you need evidence-based answers with supporting citations — antibiotic duration, guideline thresholds, diagnostic criteria, or anything where you want sources behind the answer.
Coming soon.
Pro tip: Paste your current A&P into the chat before running a Deep Search — the more patient context it has, the more targeted the results.
Note Pad
Overview
The Note Pad is a simple persistent text box — nothing more. Paste notes, jot down reminders, or stage a generated note before copying it into your EMR. Whatever you type is automatically saved and syncs across devices, so it's there whenever you log in.
Pro tip: Think of it as a sticky note that follows you. It's not a note manager or archive — just a single box that's always there and always saved.
Templates
Overview
Templates are saved instruction sets that shape how Arno writes every note they're applied to. Use them to ensure consistent structure, enforce billing requirements, or capture clinical logic you'd otherwise have to retype.
Templates are great for medical decision-making and billing — you can include custom problem lists, diagnostic logic, instructions for specific conditions, and language that ensures your documentation supports the complexity level you're coding.
Templates can be applied to any individual note, or set to apply to all new notes automatically — click the template and select 'Apply to all new notes' to make it your default. You can also edit the system default templates if the built-in options aren't quite right, and restore to default anytime if you don't like the changes.
Pro tip: Be careful with strong directive language in templates — words like ALWAYS, MUST, and NEVER are followed very strictly by the AI. Use them intentionally and sparingly, or you may get results that are more rigid than you intended.
Pro tip: Set a billing-focused template as your default if MDM documentation is a consistent priority — it'll apply without you having to think about it.
Templates
Using Templates
Select a template from the template dropdown in the Note Builder before generating. It pre-loads your saved instructions into the note without you having to re-enter them. Multiple templates can be active at once — they stack.
Pro tip: Templates don't replace the prompt — they run alongside it. Use the prompt for patient-specific direction and templates for your standing clinical and formatting preferences.
Templates
Creating Custom Templates
Create a custom template from the Templates section. Name it, write your instructions in plain language, and save. It becomes available in the template dropdown immediately.
Good template use cases: ensuring DVT prophylaxis rationale is always documented, adding a custom checklist for a specific condition like CHF or COPD exacerbation, embedding billing-support language for high-complexity visits, or setting diagnostic logic for conditions you manage frequently.
System default templates can be edited directly — if the built-in Hospital Checklist or MDM-Labs template isn't quite what you need, modify it. Use Restore to Default if you want to go back to the original.
Billing support template
Condition-specific logic
Pro tip: Write template instructions the way you'd brief a smart colleague — clear and directive, but not so rigid that every edge case becomes a problem.
Pro tip: Avoid ALWAYS, MUST, and NEVER unless you mean it absolutely — the AI treats these as hard rules with no exceptions.
Security
Overview
Around Notes is built for licensed medical professionals and takes a privacy-first approach to every part of the product. Patient data is never used to train AI models, never sold, and is not retained after processing ends.
Security
HIPAA & BAA
Around Notes signs a Business Associate Agreement (BAA) with all licensed medical users — a requirement under HIPAA when a covered entity's vendor processes PHI. Your BAA is available in account settings. SOC 2 certification is currently underway.
Security
Zero Data Retention
All AI processing runs under zero-retention configurations with our model providers. Your inputs are not stored, logged, or used to improve any model after your session ends. What you paste into Around Notes stays in Around Notes — and then it's gone.
Settings
Overview
The Settings area is where you manage your account, subscription, and app-wide preferences — including note defaults, template management, and BAA access.
Settings
Account & Subscription
View your current plan, monthly credit usage, and billing details. Upgrade, downgrade, or cancel at any time. Unused credits do not roll over month to month. Your BAA document is also accessible from this section.
Settings
Preferences
Set app-wide defaults — note type, style complexity, and other settings that apply whenever you start a new note without a template. Think of Preferences as your baseline, and templates as overrides for specific workflows.