Stream — a different approach to clinical documentation
This is a short overview for clinicians.
No demo request. No signup required.
Written by Jacob Kantrowitz, MD, PhD 01-22-2026
Why Stream exists
Most documentation tools focus on writing the note.
The harder problem, especially in primary care and longitudinal care, is reviewing the chart:
Important context scattered across visits
Redundant or outdated information carried forward
Difficulty seeing what actually changed
Stream was built to address information scatter over time, not just same-day note creation.
This work grew out of my own primary care practice, where reviewing fragmented charts across years—not writing notes—became the most persistent source of friction.
The core idea
Stream organizes documentation by medical problem, longitudinally, instead of by visit or template.
Each problem becomes a living clinical record that:
Accumulates over time
Is updated incrementally
Preserves context from prior visits
The visit still matters—but it is no longer the primary organizing unit.
What this changes in practice
Clinicians using Stream most often notice the difference when:
preparing for follow-up visits with complex patients they're following longitudinally
reviewing prior assessments and plans across multiple visits
reconstructing histories of entire medical problems over time
The goal is not to write longer notes, but to reduce the cognitive load of finding and trusting information.
What Stream is (and is not)
Stream is:
Problem-oriented
Longitudinal
Designed for outpatient care
Built by practicing clinicians and informaticists
Stream is not:
A billing-first documentation tool (though high quality documentation supports billing)
An attempt to replace clinical judgment
A generic “AI note writer”
AI is used to assist with organization and synthesis—not to decide what is clinically true.
How clinicians try Stream
We offer:
1 month free
Hands-on onboarding
Direct support from physician informaticists
This is intentionally low-friction and low-pressure. Many clinicians simply use it for a subset of visits to see whether the approach fits their workflow.
If you’re curious
If this problem resonates, the easiest next step is simply a conversation.
You can reply directly to the email you came from, or reach out here:
jacob@riverrecords.ai
(No obligation. No sales script.)