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: Here, let me help you get these slippers off. You did a great job on that walk. You sure did, Ms. Adams. How are you feeling?
Patient: Well, I'm kind of glad it's over. It will get easier, won't it?
Doctor: Oh, it will, hon. It will. That's what we're working towards. So if you both look at the board here, it's spelled out.
Doctor: Mr. Adams, I'm really glad that you're able to be here when we're walking with your wife because I think it's going to give you a better sense of what to expect once you're home and how her recovery is progressing.
Family Member: It certainly will.
Doctor: Now, we gave her the pain medication an hour before she walked so that she would feel comfortable. Then, as you saw, when we got her out of bed, we had her sit on the edge of the bed to make sure she wasn't dizzy from the medications. Then we had her stand for a minute to make sure she was okay before she started walking. That's going to be important to continue once you're at home.
Family Member: Wow.
Doctor: We also talked about how it's important for Ms. Adams to get all of her medications on time at home. She's on a blood thinner to prevent blood clots, and walking also keeps her blood circulating and will prevent clotting as well.
Family Member: Yeah, I really like that little calendar you showed me that has all the times charted out, but, you know, I'm not sure either one of us is clear on the dose of each medicine.
Patient: He's right about that.
Doctor: I'm really glad you told me this. This is exactly the kind of information I need to know. I'll go over the doses now, and we'll review them again when Ms. Adams is discharged. Plus, I have some printed materials to give you when you go home as well.
Family Member: Thanks. That'll be really helpful.