AI and clinical safety
Clinical safety and accountability
AI in ArkCloud prepares drafts. The clinician reviews them, decides what goes in the note, and signs it as their own documentation. This page explains the safeguards around that, and the limits of each one.
Written for: PT, OT and SLP clinicians · Clinical leads and supervisors · Compliance reviewers
Review before you sign
An AI draft appears beside the note, never inside it. You choose which sections to insert, and replacing text you have already written is a separate choice. After inserting, edit freely: the draft is a starting point, not a record.
- Read every inserted sentence against what happened in the visit, not against the draft.
- Check every number, side (left or right), assistance level and measurement.
- Delete anything you did not observe, test or hear from the patient.
- Add what the draft left out. A shorter draft is not a sign that less happened.
- Discard the draft entirely if it is not useful; writing the note yourself is always available.
The AI review attestation
If a note contains AI-drafted text, or an AI draft was delivered for it, ArkCloud will not sign it until you confirm this statement:
This note contains text drafted by AI. I reviewed every AI-drafted section against the patient and this visit, corrected what was wrong, and the signed note is my own clinical documentation.
The check is made when the signature is saved, not only on screen, so no route to a signature skips it. It is in addition to the normal signing confirmation with your authenticator code or password.
AI review attestation at signingAvailable
A note that contains AI-drafted text, or for which an AI draft was delivered, cannot be signed until the clinician confirms they reviewed every AI-drafted section and that the signed note is their own documentation.
Who is accountable for the signed note
The clinician who signs. Only the note's author can sign it, and signing records their name and credentials with the note. The AI never signs. Where a note needs a co-signature (for example an assistant's note under supervision), the co-signer is accountable for their review as well.
For billing, a signature releases the visit only when the signer is set up to sign for their discipline with a current licence. See Roles and permissions.
Clinical record integrity
| Field or control | What it means |
|---|---|
| Signing freezes the note | The text, your credentials, and the allergies and precautions shown at signing are frozen with the note. The database itself refuses changes to a frozen note other than through an amendment. |
| Changes are amendments | Amending a signed note requires a reason. The earlier wording is kept, the note shows who amended it, and any co-signature is cleared so it is reviewed again. |
| Locking is permanent | A locked note cannot be amended. Use an addendum to add information. |
| Nothing is copied forward silently | Values from a previous visit are never carried into today's note for you. Where a screen offers to start from the last visit, it is a proposal you must tick, not a copy. |
| Voice does not write the note | A visit transcript is added to your rough notes under an unverified heading only when you choose. Entries proposed from an evaluation recording are written to the record only when you accept or correct each one, and reach the note text only when you add them. |
Signed notes are frozen; changes are amendmentsAvailable
Signing freezes the note text and the signer's credentials. A later change is an amendment with a reason, and the earlier wording is kept. Locking is permanent.
Step by step: Signing, co-signing and amending notes.
Missing information stays missing
ArkCloud is built to leave a gap visible rather than fill it with something plausible.
- A draft section with no usable source is left empty.
- A draft sentence with a number, side or assistance level its source does not contain is removed, and you are told.
- A progress report or discharge summary section that fails the checks is left blank with the reason.
- From a recording, an uncertain value is shown without a value, a measurement with no side is not proposed, and silence is never treated as a no.
- A required note section left blank does not stop you signing, but the visit is held from billing as an incomplete note.
Example (synthetic patient)
The therapist records "R shoulder AROM flexion 120" and nothing for abduction. The draft's Objective may state right shoulder active flexion of 120 degrees. It may not state an abduction value, and a sentence that says "left shoulder" or "135 degrees" is removed before the therapist sees the draft.
The patient AI agreement
A clinic can install a patient agreement about AI on its Forms page. The patient receives it like any other form and signs with their typed name. It asks two separate yes-or-no questions: whether AI may help prepare their notes, and whether their visits may be audio recorded. A no is a valid answer, and the most recent signed agreement is the one that counts.
| Field or control | What it means |
|---|---|
| AI visit-note (SOAP) draft | Refused unless the patient answered yes to AI-assisted notes. The note builder without AI stays available. |
| Starting a visit recording | Refused unless the patient answered yes to audio recording, in addition to the consent of everyone present that the recorder asks for. |
The episode header shows the patient's current agreement. If the clinic has not installed the agreement, nothing is gated by it.
Patient AI agreementAvailable with configuration
A form the patient signs with two separate yes-or-no choices: AI-assisted notes, and audio recording. Once installed, it is enforced for AI visit-note (SOAP) drafts and for starting a visit recording.
Requires: An administrator installs the agreement on the Forms page, after the practice has reviewed its wording. If it is not installed, nothing is gated by it.
Privacy
- AI and speech-to-text run on servers ArkCloud operates on its own private network, over an encrypted connection. Patient information is not sent to an outside AI company.
- Drafts receive the minimum facts they need, without the patient's name, date of birth, record number, address or payer.
- Recorded audio is never stored: it is transcribed and discarded. Transcripts are encrypted, kept for 90 days by default and then erased, or deleted at once if the patient withdraws consent or the clinician discards them. Values you already accepted stay in the record.
- AI requests are audited without storing the question, the facts or the answer.
Discipline differences
ArkCloud does not apply one physical therapy model to every discipline. Notes carry PT, OT or SLP sections according to the episode's discipline. Entries proposed from an evaluation recording cover physical and occupational therapy screening, not SLP. The AI visit-note draft has not been checked on speech-language pathology visits, and every clinical pick-list in ArkCloud is still awaiting clinical review, so treat suggestions as prompts, not standards.
Current status
| Capability | Status | What that means here |
|---|---|---|
| AI draft of a visit note (SOAP) | Available with configuration | Inside a visit note, proposes Subjective, Objective, Assessment and Plan from what the clinician recorded for that visit and the episode's own record. The clinician inserts, edits or discards each section.Requires: The organisation AI switch on (the default). Where the clinic has installed the patient AI agreement, the patient's signed yes to AI-assisted notes. |
| AI draft of progress report and discharge summary narratives | Available with configuration | Drafts the progress-toward-goals and reassessment sections of a progress report, and the course-of-care and goals-met sections of a discharge summary, from recorded facts only. It never drafts goals, the plan of care, discharge status or recommendations.Requires: The organisation AI switch on (the default). |
| Visit recording and dictation with speech-to-text | Limited preview | Built into Rehab visit and evaluation notes: speech is transcribed on ArkCloud's own servers and the clinician decides what to use. Accuracy has been tested on synthetic speech only, and it is not released for routine clinical use.Requires: The organisation's voice setting switched on, the recording permission, and in-the-room consent for each recording. |
| Notes written and signed without the clinician | Not available | ArkCloud never writes, completes or signs a note on its own. Every draft waits for the clinician. |