How do you run an agent-drafted clinical note into Epic, Oracle Health, or Notable without losing the named clinician signature?
You keep the chart in the EHR. You keep the draft, the agent that wrote it, the clinician review, and the timestamp in Dock. The note only goes into Epic, Oracle Health, or Notable after a human clinician signs the Dock row, and the clinician files it there with their own access. The agent never holds the pen. The clinician does. Dock holds the record of who held it, when, and why.
Healthcare data is sensitive. Hold any tool, Dock included, to your own HIPAA policies and your compliance team's review before you connect clinical systems.
The architecture
Epic, Oracle Health, and Notable stay the system of record for the patient chart. Dock holds the work around it: what the agent drafted from the visit transcript, prior notes, and problem list your team brought in, plus the reasoning and who approved it. Each Dock row carries a pointer back to the source chart (epic_encounter_id, oracle_encounter_id, or notable_visit_id), the agent that drafted the note, the clinician who reviewed it, the decision, and the timestamp. When the clinician needs current medication or allergy state, they check the EHR directly rather than trusting stale data.
This separation matters because the EHR records every entry as a clinician action. Without a separate record, an agent draft either gets attributed to the clinician (false authorship) or gets stripped of its provenance (lost reasoning). The Dock row carries the provenance the chart cannot.
The Dock surface: clinical_note_drafts table
| draft_id | epic_encounter_id | agent_id | draft_summary | reviewing_clinician | status | signed_at |
|---|---|---|---|---|---|---|
| cnd_8821 | EPC-44910 | scribe-agent-v3 | 62F follow-up, HTN stable on lisinopril 10mg, A1c 7.1 trending down, continue current regimen | dr.okafor@clinic | signed_and_posted | 2026-05-30T14:22Z |
| cnd_8822 | ORC-77204 | scribe-agent-v3 | 48M new c/o R-sided chest pain x 3d, pleuritic, no SOB, EKG WNL, plan CXR and trop | dr.lin@clinic | edits_requested | null |
| cnd_8823 | NTB-V-3301 | scribe-agent-v3 | 7yo well-child, immunizations UTD, growth 50th %ile, no parental concerns | dr.patel@clinic | signed_and_posted | 2026-05-30T15:04Z |
The workflow
- The team brings the visit transcript and prior problem list into Dock using its own EHR access. The scribe agent drafts a SOAP note and writes a row to
clinical_note_draftswith statusawaiting_review. - The reviewing clinician opens the Dock row, reads the draft against the chart, and either edits and signs or rejects with a reason.
- On sign, the clinician files the finalized note in the EHR under their own login, and the status flips to
signed_and_posted. - The row stays. The agent, the clinician, the edit diff, and the timestamp remain on record and searchable.
This is a two-key handshake as a team practice: the agent drafts, the clinician signs, and nothing goes into the EHR until both have happened.
Why it matters
CMS requires that services provided or ordered be authenticated by the author, and the medical record must clearly identify who performed the service (CMS MLN Signature Requirements). When an agent helped draft a note, your team will want a separate record of that help. The Dock row gives your compliance team a clear record to review.
AHIMA's clinical documentation integrity guidance emphasizes documentation that is "clear, concise, consistent, and accurate" and treats authorship as a first-class concern (AHIMA Clinical Documentation Integrity). Dock makes authorship layered and explicit: the agent authored the draft, the clinician authored the signed note, and both are recorded.
The compliance team gets one searchable surface for every agent-touched note. The clinician gets a faster draft without giving up signature authority. The patient gets a chart entry signed by a human.
Talk to us about clinical documentation workflows on Dock.
FAQ
Q: Does the agent ever write directly to the EHR? A: Not in this workflow. The agent writes only to Dock. The clinician files the note in the EHR after signing the Dock row, under their own login. See agent audit and compliance.
Q: What happens if the clinician edits the draft before signing? A: The edit diff stays on the Dock row. The original agent draft, the clinician's edits, and the final signed text can all be pulled up later. This is the agent identity record working as intended.
Q: How do you handle agent version changes mid-workflow? A: The row records which agent version drafted it. When the scribe agent is upgraded, prior rows still attribute to the prior version. See agent identity lifecycle.
Q: Does this work for amendments and addenda? A: Yes. Amendments follow the same pattern: a new Dock row points to the original chart entry, the agent drafts the amendment, and the clinician signs. The history extends rather than overwrites. See Dock for compliance.