Ambient Listening in Your Allergy EHR: What to Check Before You Rely On It

The short answer: many EHRs now offer ambient listening, and more

allergy practices are being asked whether to switch it on. Whether it lives

inside your EHR or comes from a separate vendor, judge it on allergy visits.

Check six things on a week of your own clinic days:

1. Does the note keep the skin-test record together?
2. Does it handle a shot visit?
3. Does each assessment item carry an ICD-10 code you can review?
4. Does the patient go home with a plain-words handout the doctor has signed?
5. How is consent to recording handled?
6. Can you get your data back?

The question in the title usually comes up the same way. A sales rep, or a

banner in the EHR, says ambient listening is available, and someone at the

front desk asks the allergist whether to try it. Where the tool lives matters

less than whether it can write an allergy note. The six checks below are

the ones that show the difference.

1. The skin-test day

A skin-test visit is a record, not a paragraph. It has an order, the

controls, the sites and allergens tested, the values staff charted and the

person who signed. A tool that only listens to the conversation will miss

most of that. Much of a skin-test visit is quiet work at the arm, not talk.

Check: run a real skin-test morning. Does the note sit with the

skin-test sheet in one record, or do you end up re-typing results into a

free-text box? What happens to a site that was never placed, for example

when a child pulls their arm away before the panel is finished? A blank

should never be read as "no reaction".

2. The shot visit

Immunotherapy visits are short, frequent and easy to under-document: build-up

or maintenance, the dose, any reaction since the last injection, and the

pre-shot check. A general-purpose template built for a full consult tends to

pad them or skip them.

Check: is there a template for the shot visit, or only for a new-patient

consult? Our immunotherapy visit note template

shows what the shot note has to carry.

3. An ICD-10 code on every assessment item

Allergy assessments often run to four or five items: allergic rhinitis with

its trigger, asthma with its severity, a food allergy, urticaria. Each one

needs its own code, and the coder needs to see which part of the plan goes

with which code.

Check: does the draft attach a code to each assessment item for the

clinician to review, or one code to the whole visit? Codes should always be

suggestions. The clinician decides.

4. The handout the family takes home

This is the check most demos skip, and it is the one patients notice. After

an allergy visit the family needs the plan in plain words: which medicine,

what dose, what to avoid, when to come back, and what to do if a reaction

starts. If the ambient tool stops at the clinician's note, someone still has

to write the instructions by hand, or the family leaves with nothing in

writing.

Check:

• Does the tool draft patient instructions from the visit, and does the

doctor review and sign them before the patient sees them?

• Do the medicines and doses on the handout match the visit, and does it

flag anything it is unsure of to the doctor before printing?

• How does the handout reach the family: paper only, the portal, or their

own phone? If it is a link, can the doctor revoke it, and does it expire?

5. Consent to recording

Ambient listening records the visit, so consent is part of the setup, not a

detail. Florida, for example, makes interception of a conversation lawful

"when all of the parties to the communication have given prior consent"

(Florida Statutes §934.03(2)(d)). Rules differ from state to state, so ask

your own counsel what your practice needs.

Check:

• How does the tool expect you to tell the patient and record their

consent?

• Can recording be paused for part of the visit, for example a sensitive

conversation or a family member who would rather not be recorded?

• What happens to the audio afterwards?

6. Getting your data back

Ask before you start, not when you leave:

• Will the vendor offer your practice a BAA?
• Where does the data live?
• Can you export your notes and handouts if you stop using the tool?

The answers should be in writing.

Run it on your own week

A demo shows the vendor's best visit. A trial shows yours. Give any ambient

tool a week of real clinic days, including a skin-test morning, a shot

clinic and a follow-up where most of the history is negative. Then judge it

on what you can see:

• how much you change before you sign;
• whether the handout matches the visit;
• whether your notes are signed before you leave the building.

For the wider checklist, see [what an allergy practice should look for in an

AI copilot](/what-an-allergy-practice-should-look-for-in-an-ai-copilot/?utm_source=blog&utm_campaign=seo).

Where Medora fits

Medora is an AI copilot built only for allergy and immunology practices, and

it is built together with a working allergy practice, Allergy Affiliates in

Bradenton, Florida.

• Medora Copilot listens to the allergy visit and drafts an

allergy-structured SOAP note with pertinent negatives. Recording can be

paused and resumed during the visit. It has visit templates for new

patients, follow-ups, skin testing, immunotherapy, asthma, and drug and food

challenges.

• Each assessment item in the note carries its ICD-10 code, ready for the

doctor to review.

• It drafts patient instructions from the visit for the clinician to review.

The patient letter lists real medicines and doses from the visit, and

anything Medora is unsure of is shown to the doctor to confirm before

printing.

• After the doctor signs, the patient can scan a QR code to read the handout

on their phone. Links expire, and the doctor can revoke them.

• Medora works with supported EMRs, and the clinician reviews, edits and

signs every note.

• Medora runs on HIPAA-eligible AWS, and we offer a BAA to each practice.

In a 60-day pilot at Allergy Affiliates, the time an allergist spends signing

off each skin-test visit dropped sharply

(the case study).

Frequently asked questions

Our EHR offers ambient listening. Is that enough for an allergy practice?

It depends on how it handles allergy visits. Test it on a skin-test morning,

a shot clinic and a follow-up where most of the history is negative, and

check the six points above: the skin-test record, the shot visit, an ICD-10

code on each assessment item, the signed patient handout, consent to

recording, and getting your data back.

What should an allergy note from ambient listening include?

An allergy-structured history with pertinent negatives, the skin-test record

kept with the note, the immunotherapy details on shot visits, an assessment

with a reviewable code on each item, and a plan the patient can take home in

plain words.

Do we need patient consent to use ambient listening?

Recording rules differ by state. Florida, for example, requires the prior

consent of all parties to a conversation before it is intercepted (Florida

Statutes §934.03). Ask your own counsel what your practice needs, and choose

a tool that lets you pause recording.

Who is responsible for the note and the handout?

The clinician. The tool drafts, and the clinician reviews, edits and signs.

Nothing should reach the chart or the patient without them.

Try it on your own visits

• See how Medora handles allergy documentation
• Start the 14-day free trial of Medora Scribe (no card needed)
• Book a demo
• Read the buyer's guide to AI for allergy and asthma practices

*Source: Florida Statutes §934.03(2)(d), Interception and disclosure of wire,

oral, or electronic communications prohibited,

https://www.flsenate.gov/Laws/Statutes/2025/934.03 (read 2026-11-03). This

article is general information, not legal advice.*