Overview
Ambient Listening is a powerful feature in ICANotes+ that automatically drafts a clinical note based on the provider's conversation with the client during a session. This feature uses ambient voice capture technology to listen passively in the background—requiring no manual typing during the session—helping providers save time and maintain focus on the client.
Using ambient listening feature, you can record both In-Person and Telehealth sessions.
Currently, this is available only for the Progress Note type. Support for additional note types will be introduced in future updates.
⚠️ Provider Responsibility Disclaimer
Use of the Ambient Listening feature acknowledges that your practice will obtain patient consent where applicable. ICANotes does not monitor or enforce consent collection. By enabling and using this feature, your practice acknowledges full responsibility for:
Informing patients of AI usage
Obtaining and documenting informed consent
Reviewing all AI-generated content before finalizing clinical notes
Use of AI tools is at your discretion and should not replace clinical judgment.
Important Notes
Best Practices
Be clear and structured when speaking during the session. The clearer you speak, the better the AI can understand and summarize the conversation.
Avoid background noise as much as possible.
If your microphone is not connected or detected, a microphone troubleshooting popup appears with detailed instructions.
Always review the note before finalizing. Although AI-generated, the provider is responsible for the clinical content.
Step 1: Enable Ambient Listening
To enable this feature for your practice, fill out the form using this link: Plus - AI Scribe Feature
Once the form is received by our team, and your access is turned on, you will receive an email confirmation. Take the following steps after receiving the email to finalize access.
Step 2: Grant Access to the Feature
Access to the ambient listening (AI Scribe) feature is restricted to authorized users. Admins can access the feature by default, but they must assign permissions for other users.
To grant access:
Go to Settings > Practice Settings > Roles & Permissions.
Create a new role or edit an existing role.
Expand the Notes tab.
Select the AI Scribe checkbox.
Step 3: Confirm Clinician Role Assignment
For the Ambient Listening (AI Scribe) feature to function correctly, the user must have the Clinician role assigned in Account Management. Even if the user has Administrator access, AI Scribe will not activate unless the Clinician role is also enabled.
To verify and assign the Clinician role:
Go to Settings > Account Management.
Locate the user’s account in the list.
Under Roles, ensure that Clinician is selected (in addition to any administrative role).
Click Save to apply the changes.
Without the Clinician role, the Ambient Listening (AI Scribe) feature will not appear or function, even if permissions are correctly configured under Roles & Permissions.
Step 4: Set Microphone Permission to Default
Ensure that your microphone permission is set to prompt automatically:
Step 5: Allow Microphone Access
When prompted by your browser while initiating Ambient Listening:
Allow while visiting this site – Grants access every time you use this site.
Allow this time – Grants access only for the current session.
Never allow – Denies access and disables the feature.
Selecting Never allow prevents the feature from functioning.
To proceed with recording, you must allow microphone access. The following screen allows you to adjust permissions.
Click Try Again to re-enable microphone access.
Select Tab for Telehealth Session
When you start a Telehealth Session, you must choose which tab or screen to share. After selecting the Telehealth option from the dropdown, a screen appears with the following sharing options:
Chrome Tab
Window
Entire Screen
Important: To include audio in the session, make sure to turn on the Also share tab audio switch.
Step 6: Verify System Sound Settings
If your system detects silence after selecting In-Person or Telehealth session, a pop-up prompts you to verify sound settings. For telehealth sessions, the silence check applies to the clinician’s microphone.
Step 7: Start Recording
Once microphone access is granted:
Click Start Listening.
Begin speaking clearly. Transcription occurs in real time.
A green indicator in the audio level meter confirms successful input.
Use Pause to temporarily stop recording if needed.
Step 8 (Optional): Hide/Show Transcript
During your recording session:
Show Transcript option
Hide Transcript option
Step 9 (Optional): Pause/Resume Session
During your recording session:
If you try to navigate away while the session is paused, the system notifies you that the recording will be saved and stopped.
Pause Session option
Resume Session option
Notification on Exiting an Active Session
If you attempt to leave the session before it ends, the system will display a notification indicating that the recording will be stopped and saved.
The following is the message you’ll see when exiting mid-session:
Step 10 (Optional): Restart Session
If you wish to begin a new recording from scratch, click Restart Session. A confirmation dialog will appear.
Restarting will delete the recorded session and its transcript.
Step 11: Finish Session and Create Note
Once the session is complete:
Click Finish Session and Create Note.
The system processes the session and generates a draft note.
Review the transcribed content and make necessary edits before finalizing.
FAQs
Who Is Responsible for Patient Consent?
You are. As the provider or practice administrator, you are responsible for obtaining informed patient consent before using either AI feature with a patient. This includes explaining:
- That the session may be recorded (audio + metadata)
- That AI may be used to help draft the clinical note
- That third-party processors will help power these features
If you are not able to obtain consent, you should not use the AI features for that patient.
What Data Is Captured?
When using the AI features, the following types of data may be collected:
- Text you enter
- Your voice and your patient’s voice
- Session metadata required to properly structure the documentation
This data may include PHI (Protected Health Information).
How Is Data Handled?
- Data is processed by third-party AI providers:
- AWS Bedrock for Note Readability
- ICANotes maintains Business Associate Agreements (BAAs) with these vendors.
- All processing is conducted in accordance with HIPAA requirements.
- Data and AI-generated output may be used to improve model quality, under HIPAA-compliant safeguards.
Will AI Notes Be Automatically Saved to the Patient’s Chart?
No. All AI-generated output is saved as a draft and must be reviewed and accepted by the clinician before it becomes part of the patient’s medical record.
You are solely responsible for reviewing, editing, and finalizing the content.
Can I Use the AI Output As-Is?
We do not recommend relying on AI output without review. The AI tools are designed to assist you—not replace clinical judgment. Output may contain inaccuracies or require editing to meet your documentation standards.
Important Reminders
- You must obtain patient consent before using Ambient Listening.
- ICANotes does not verify consent—this is your responsibility.
- Review all AI-generated notes before saving them to the chart.
- These features are designed to assist, not diagnose or treat.
Common Questions About Ambient Listening
Q1. Does the client know they are being recorded?
A: Ambient Listening only transcribes audio locally and does not record or store any audio files. However, practices should inform clients that the session is being transcribed for clinical documentation purposes, as per HIPAA guidelines.
Q2. Is the note generated immediately after the session?
A: The draft is typically available within a few minutes after stopping the ambient listening session, depending on the length of the session.
Q3. Can I edit the auto-generated note?
A: Yes, you can and should review and edit the draft for accuracy before finalizing.
Q4. What happens if I forget to stop the listening session?
A: If you forget to manually stop it, the system will automatically time out after a pre-configured duration. However, it’s recommended to stop listening manually for better accuracy.
Q5. Can I use Ambient Listening on mobile devices?
A: Ambient Listening is currently supported only in the web application on desktop or laptop devices.
Q6. Can I access a note during the session?
A: Yes. While the session is running, you can navigate to the note to review details such as the client’s current medications, diagnoses, services, and more.
Proprietary Notice Information: This article is provided for informational purposes only, and the information herein is subject to change without notice. While every effort has been made to ensure that the information contained within this article is accurate, ICANotes cannot and does not accept any type of liability for errors in, or omissions arising from the use of this information.