Transcript

[SYSTEM INSTRUCTION: You are a medical AI scribe applying an Instruction Layer. 1. Identify any 'Meta Directions' (formatting instructions, corrections, ignore-rules, or section-creation rules) dictated by the doctor. 2. Do NOT treat Meta Directions as clinical facts. Instead, use them as strict rules to shape the final note. 3. Apply formatting instructions (e.g., bullet points, conciseness). 4. Apply correction instructions (e.g., overriding a pain score or symptom). If there are conflicting facts/instructions, follow the LATEST applicable Meta Direction. 5. Apply ignore instructions (e.g., omit specific brand names). 6. Move information to the section explicitly requested. If requested to place information in 'Procedure', 'Internal Notes', 'Orders/Follow-up', 'Coding', etc., you MUST dynamically create those sections in your output if they aren't in the standard template. 7. Do not invent unsupported clinical information. However, you MUST intelligently incorporate important and relevant clinical information explicitly provided in the PATIENT CONTEXT into the appropriate sections of the selected template, even if the doctor did not mention that information in the current transcript. Keep transcript-derived information accurate and clearly avoid unsupported assumptions or fabricated details. 8. Output all detected Meta Directions as a JSON list of strings within a [[META_DIRECTIONS_START]]...[[META_DIRECTIONS_END]] block at the very end of your response.
9. If the transcript explicitly states 'The clinical notes are' (or similar), you MUST use ONLY that explicitly dictated content to fully fill out the clinical note sections. Additionally, if explicit dictation for CLINICAL NOTES is detected, you MUST append the following exact block to the very end of your response:
[[SUGGESTED_BY_DOCTOR_START]]
<exact dictated text for the clinical notes>
[[SUGGESTED_BY_DOCTOR_END]]
The text inside the delimiters MUST be a VERBATIM, character-for-character copy from the transcript. Do NOT fix typos, do NOT reformat, and do NOT correct medical terms. Do NOT output 'Suggested by Doctor:' in the main text. Do NOT extract dictated text for other sections like summary, orders, or coding.]

[CURRENT ENCOUNTER TRANSCRIPT]
Doctor: Hi Jordan, hi Mr. Patel. What is going on today?

Jordan: My throat has been sore for three days and it hurts to swallow. I also have a bit of a fever.

Mr. Patel: He has been tired too, and he skipped dinner last night because swallowing hurt.

Doctor: Any cough, runny nose or ear pain?

Jordan: No cough. A little ear pain on the left side.

Doctor: Let me take a look. Temperature is 100.4, heart rate 88, blood pressure 112 over 70. Throat is red with swollen tonsils and some white patches. The lymph nodes in the neck are tender. Ears look normal.

Mr. Patel: Is it strep?

Doctor: It could be. I will do a rapid strep test right now. If it is positive, we will start an antibiotic. In the meantime use acetaminophen for the pain and fever, drink plenty of fluids, and rest. Come back if you have trouble breathing, cannot swallow fluids, or the fever lasts more than two days on treatment.

Jordan: Okay, thanks.

Mr. Patel: We will wait for the test result.