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Our Approach to Clinical Documentation: A Philosophical Shift
Blog Jacob Kantrowitz Blog Jacob Kantrowitz

Our Approach to Clinical Documentation: A Philosophical Shift

At River Records, we believe documentation shouldn’t start from a blank page every time. Clinical care is continuous, and the record should reflect that. In this post, we share the philosophy behind Stream—our AI-powered, problem-oriented documentation platform—and explain why copy-paste behavior is not clinician error, but a system failure begging for a better solution.

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Notes Are Deadweight. Clinical Context Is the Future.
Blog Jacob Kantrowitz Blog Jacob Kantrowitz

Notes Are Deadweight. Clinical Context Is the Future.

For years, the clinical note has been treated as the centerpiece of medical documentation. But in practice, it’s become a relic of a paper-based past—bloated with repetition, slow to navigate, and ill-suited to the way clinicians actually think. At River Records, we’re reimagining documentation not as a series of static notes, but as a living, structured reflection of the patient. By organizing everything around medical problems rather than encounters, Stream gives clinicians the context they need without forcing them to dig through layers of outdated text. The result is faster reviews, clearer updates, and documentation that actually supports care.

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The Challenges of Information Review in Primary Care
Blog Jacob Kantrowitz Blog Jacob Kantrowitz

The Challenges of Information Review in Primary Care

Ideally, clinicians shouldn’t need to search for or surface information at all—because the information should never be lost to begin with. There are several chart review work flows prevalent in primary care, yet EHRs are not built to support them, or the workflows of any clinicians, beyond search and filter.

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Part 2: Siloed Documentation in a Collaborative World
Blog Alex Butler, MD, MS Blog Alex Butler, MD, MS

Part 2: Siloed Documentation in a Collaborative World

The clinical note has been a cornerstone of medical documentation for decades. While this structure may have worked in the past, the note paradigm is increasingly out of place in today’s healthcare environment. In this post, we’ll explore how notes — organized around visits and not around problems— create information chaos in healthcare and why we need to move toward a new documentation model.

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The Danger of Pre-Templated Information in Medical Records
Blog Jacob Kantrowitz Blog Jacob Kantrowitz

The Danger of Pre-Templated Information in Medical Records

Templating notes, exams, care plans, and histories can be bad for patient care, even if it's good for clinician efficiency. Clinical documentation ought to accurately reflect the hard work clinicians put into their care. Fortunately, large language models can help build better documentation that is reflective of the vibrancy of the patients they describe.

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