Introducing the Pediatric Well Visit Note Type, Enabled by the Contextual Reasoning Engine
Pediatric well visits are the cornerstone of pediatric primary care. These encounters set the foundation for establishing strong, trusting relationships between the pediatric provider, child, and caregiver.
About one third of pediatric primary care visits in the U.S. are well visits. Unlike sick visits and other types of encounters, well visit documentation is highly structured and responsive to the age and development of the child. The protocol for an infant’s 6-month checkup is different from that of the annual physical for a 15-year-old adolescent.
Abridge is designed to automatically detect care settings, specialties, and languages, and then generate the appropriate, clinically useful and billable documentation. Leveraging the Contextual Reasoning Engine, Abridge understands prior note context and specialty, and identifies the correct note type using the clinical conversation.
Within this new pediatric note type, the templated History of Present Illness is structured around key subsections and lists the Well Visit and Anticipatory Guidance as primary problems in the Assessment and Plan.
Abridge developed this product enhancement in collaboration with pediatricians at partner health systems and with inputs from two on staff: Dr. Hilary Stempel and Dr. Mondira Ray.
“Pediatrics is all about relationships,” said Dr. Stempel, a pediatrician and Clinical Success Director at Abridge. “In each visit, you're setting up your relationships over longitudinal periods of a patient's life and childhood. Abridge enables you to move seamlessly from topic to topic and to know that your output is going to be structured.”
Pediatrics is often overlooked in health technology, and pediatricians are too often handed tools built for adult care and asked to make them work. Yet, pediatric primary care clinicians face some of the highest levels of burnout, and the work they do is uniquely complex. Abridge designed this new note type to meet the specific needs of pediatrics, so clinicians can focus on the child and family in front of them—the most meaningful and rewarding part of the work—and reconnect with the joy that drew many of them to pediatrics in the first place.
“As a pediatrician and clinical informaticist, I’ve experienced firsthand how the documentation burden affects our ability to be present with patients and families,” said Dr. Ray, a pediatrician and a Clinician Scientist at Abridge. “We built this technology not just with AI, but with deep clinical context. I use it when I see my own patients in clinic, which has given me a unique perspective to also ensure it continues to meet the needs of our practice.”
Hundreds of clinicians across 24 health system partners provided feedback on this note type, giving an average rating of 4.5 stars across hundreds of thousands of notes; many also left anecdotal feedback:
The “magic” is enabled by the Contextual Reasoning Engine, a new AI architecture that connects the clinical conversation with a world of context from disparate sources, including prior notes, specialty, and more.
“Abridge can infer directly from the electronic health record: What is the clinician’s specialty? What is the patient’s age?” said Dr. Katherine Choi, one of the Abridge product managers who helped design the well visit note type along with Dr. Mike Myerburg, a Clinician Scientist at Abridge. “Then the AI platform captures the conversation itself, combining that with the context to determine the necessary note type, automatically and in real time.”
While each well visit is different, for a 9-month-old infant, instead of generating a well visit note in typical narrative fashion, Abridge structures the information captured from the conversation in the following sections, depending on the contents of the conversation:
- Diet
- Elimination
- Sleep
- Oral health
- Development
- Social/home
Pediatric well visit notes may often include other subsections, like “school,” “activities,” “puberty,” or many others, depending on where the patient is in development and the contents of the conversation.
“How did I feel the first time that I used the well visit template?” asked Dr. Joel Davidson, a pediatrician at Akron Children’s. “‘There it is! That’s what we were looking for!’ Now I can read what I want to in the space that I need to.”
The pediatric well visit note type deepens Abridge’s support for pediatrics in a way that is intelligent, thoughtful, and invisible, without requiring any extra input from the clinician whatsoever.
“That’s the secret sauce, what makes this feel like magic to the end user,” added Dr. Choi. “Abridge already knows, and the right note is generated for the right encounter automatically. Making AI do the heavy lifting behind the scenes and enabling a seamless experience for our clinicians is our North Star at Abridge.”
With Abridge, clinicians across care settings, specialties, and languages don’t need to fiddle with settings or indicate to the AI who they are and what they’re doing; they just have to walk into the room, connect with patients, and address their problems.
“The feeling you get using Abridge as a clinician is a true sense of ease, because you’re able to be present with the kids and families,” said Dr. Stempel. “You can talk without being distracted by documentation, and all the advice and guidance you are giving caregivers is being captured. You are giving the best-possible care because you are fully present.”
