Ailacra: Ambient + Template Charting for Emergency Medicine

Two ways to chart — Ambient or Template. A built-in diagnostic backstop quietly working alongside. Ailacra writes the narrative, codes the encounter, and surfaces the differential — in seconds, not minutes.

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Two modes. One note.

Ambient or Template — Ailacra meets the encounter however it unfolds.

Ailacra Ambient

When the conversation is the note. Hands-free at the bedside.

When the room tells the story

Ambient capture turns the patient encounter into a clinical note in real time. The conversation in the room becomes the documentation.

Step out. Come back.

Pause one encounter, see the next patient, then resume — Ailacra preserves each chart and stitches the segments back together.

Ailacra Template

You choose what to document. Not a form.

  • Fast — Single-tap marking. Circle for present, backslash for absent.
  • Organizing — Structure built in. No blank-page cognitive load.
  • No composition — AI writes the prose; you make the clinical calls.
  • Read at a glance — Any clinician can see the picture in seconds.

Phone. iPad. PC. — capture wherever you are.

Phone
Ambient at the bedside. In your pocket.
iPad
Ambient + Template, together. Anywhere.
PC
Template, fast and complete. At the workstation.
The reality in U.S. emergency departments

Diagnostic error in the E.D., at scale.

7.4M
Misdiagnoses
5.7% of 130M U.S. ED visits each year
~370K
Serious harms
≈250,000 deaths and ≈100,000 permanent disabilities, each year
AHRQ Systematic Review · 2022
Harvard / Stanford · Science · April 2026

AI now outperforms attending physicians
at diagnostic reasoning.

67%
OpenAI o1
exact or close diagnosis at ED triage
55% · 50%
Attending clinicians
same 76 ED cases
Rodman et al., Science · April 2026 · Beth Israel Deaconess ED · Harvard / Stanford

An AI diagnostic backstop is built in to every encounter — a quiet AI consultation at the clinician’s discretion.

The Backstop.

An AI diagnostic consultation on request with either capture mode.

MDM discussion, drafted

Ailacra drafts the medical decision-making discussion that supports the physician’s plan — capturing the reasoning that often goes undocumented under time pressure.

Diagnostic concern, evaluated

The encounter is continuously evaluated for diagnostic concern. If the picture doesn’t fit, Ailacra alerts the clinician — and a counterargument is available on request.

Example case

55-year-old male, 3 days of worsening, constant, moderate right-upper-quadrant pain with anorexia and nausea — appearing pale, diaphoretic, anxious, very distressed.

Exam: RUQ tenderness with positive Murphy sign and guarding. Vitals normal.

Labs: CBC, CMP, UA, lipase — all normal.

Imaging: RUQ ultrasound — cholelithiasis, biliary sludge, positive sonographic Murphy sign.

MEDICAL DECISION MAKING

This utility generates text supportive of the indicated diagnoses and plan, not an AI diagnostic assessment.

This 55-year-old male presents with right upper quadrant abdominal pain. Cholecystitis is the working diagnosis given the patient’s report of three days of constant, dull, worsening RUQ pain associated with nausea and loss of appetite, combined with exam findings of RUQ tenderness, moderate guarding, and a positive Murphy sign. This diagnosis is confirmed by the RUQ ultrasound, which shows cholelithiasis, biliary sludge, and a sonographic Murphy sign. Pancreatitis was considered as a potential cause of the abdominal pain; however, it is unlikely given the normal lipase, CBC, and CMP. Small bowel obstruction was considered given the nausea and pain, but it is considered unlikely as the patient reports passing gas and the physical exam reveals normal bowel sounds. The normal UA makes a urinary tract infection or renal colic unlikely.

Given the clinical diagnosis of cholecystitis, the presence of systemic distress with diaphoresis and guarding, and the imaging confirmation of biliary pathology, inpatient admission is appropriate for further management. This approach allows for continued monitoring, surgical consultation, and definitive treatment, as the patient’s clinical presentation and findings are inconsistent with stable outpatient management.
COUNTERARGUMENT

The patient, a 55-year-old male presenting with abdominal pain, has been assigned a working diagnosis of cholecystitis, yet his clinical presentation of diaphoresis and significant distress combined with a normal white blood cell count warrants consideration of alternative high-acuity etiologies. The cardiovascular system is a primary concern, as a Myocardial Infarction can frequently present with epigastric or right upper quadrant pain, particularly in middle-aged men. The patient’s diaphoresis and anxiety are classic findings for cardiac ischemia, and in the absence of documented cardiac enzymes or an electrocardiogram, this life-threatening condition has not been definitively excluded.

Within the gastrointestinal system, the findings of gallstones and sludge on ultrasound may be incidental, leading to the risk of under-recognizing Peptic Ulcer Disease. An acute ulcer or perforation could account for the patient’s severe distress and localized tenderness, even in the presence of cholelithiasis. While the current ultrasound provides information on the gallbladder, it does not evaluate for free air or mucosal integrity, and the absence of fever or leukocytosis does not sufficiently rule out a separate intra-abdominal process. Further diagnostic assessment is necessary to confirm that the symptoms are indeed secondary to biliary pathology rather than a proximal gastrointestinal or cardiac event.

How it works in practice.

Capture · Document · Connect.

Capture

Ailacra Ambient flow

When the conversation is the note.

  1. 1 Open — Tap the patient and start capture.
  2. 2 Talk — The conversation in the room is captured. Hands-free at the bedside.
  3. 3 Pause / Resume — Step out for the next patient; return without losing the thread.
  4. 4 Review — AI drafts the narrative; you confirm clinical findings.
  5. 5 Insert — Copy the finished note into your EMR.

Ailacra Template flow

You choose what to document. Not a form.

  1. 1 Open Template — Pick the chief complaint or mechanism (MVA, chest pain, GSW, … 120+ more).
  2. 2 Mark — Circle for present, backslash for absent. Single tap; no typing.
  3. 3 Expand — Tap a finding to open a subtemplate for finer detail when you want it.
  4. 4 Generate — AI curates the differential and writes the narrative.
  5. 5 Code & Insert — ICD-10, CPT, and MDM are assigned; one-click insert into the EMR.

See it in motion — a cholecystitis encounter, charted in real time

Chart as you go. Capture in the room.

Document

Two examples of how Template marks and anatomic drawings become physician-quality narrative.

Mark. Review.

Circle and backslash findings. AI writes the note.

MVA Template — Circle & Backslash
Ailacra MVA template with circled and backslashed findings
AI-Generated Narrative

CHIEF COMPLAINT: MVA
Historian: patient (good historian)

HISTORY OF PRESENT ILLNESS: This 55 YO male presents after an MVA that occurred just prior to arrival. He was the driver of the vehicle when it was struck from the front right side at a moderate speed, resulting in moderate vehicle damage. There was no rollover involved. He was utilizing both a seat belt and harness at the time of the impact. He required a brief extrication from the vehicle but was not ejected. He sustained a blow to the head and experienced a brief loss of consciousness, although he maintained a GCS of 15 at the scene.

Draw it. Read it.

A single stroke on the anatomic diagram becomes a complete clinical description.

Laceration drawn on anatomical head diagram
One stroke
Becomes

PHYSICAL EXAM:
Head: Laceration beginning at the right paramedian forehead, extending through the central forehead, glabella, nasion, and nasal bridge, and ending at the left paranasal area.

Lacerations, burns, GSW, shrapnel, ecchymosis — draw the finding, get the description.

Connect

Two ways into the EMR — pick whichever your hospital supports.

Inside the EMR — SMART on FHIR

Ailacra Embedded launches straight from the patient chart.

One-click launch

Open Ailacra straight from the patient chart. SMART on FHIR carries the patient and encounter context across automatically.

One-click insert

Paste the finished narrative back into the EMR with a single tap — or copy to clipboard for systems without write-back.

Full context awareness

Medications, allergies, problem list, surgical history, and lab results pull in automatically. Repeat values (e.g., serial troponins) are handled cleanly.

No-Interface Mode — Scan. Capture. Paste.

No SMART integration needed. Works with Epic, Oracle Health, Meditech, Athena, and anything else.

Scan the wristband or sticker, capture in Ambient or Template, paste the note into any EMR.

Under the hood.

What makes Ailacra Ailacra.

Template depth

120+
Clinician templates
750+
Diagnoses managed
6,900+
Diagnostic rules
1,100+
Complexity rules

More than the note

Expert-system rules work in the background as you document.

Differential, curated live. 6,900+ rules organize 750+ possible diagnoses into tiers as findings are marked. Common diagnoses demote when findings don’t fit; rare diagnoses promote when evidence supports them.
Red-flag alerts. Dangerous patterns are flagged the moment they appear in the documentation — a visual cue that survives a busy shift.
AI diagnosis harvesting. Beyond the rule-based differential, AI analyzes documented findings across all tabs and surfaces additional diagnoses for the clinician to confirm, rule out, or dismiss.
COPA, data, risk — assessed. Hundreds of rules score AMA 2021 problem complexity in real time, feeding MDM Element 1 and the E/M level. Data reviewed and risk are tracked the same way.

Automated coding — no separate step

ICD-10, CPT, and E/M assigned as you document.

ICD-10 coding. Diagnoses confirmed on the DDx tab are automatically matched to ICD-10-CM codes. Expert-system engine with AI assistance, plus a review queue for edge cases.
CPT procedure codes. Procedure codes are assigned automatically when procedures are documented. Rules account for laceration length, burn depth, procedure type.
Real-time MDM scoring. All three AMA 2021 MDM elements are computed live: problems addressed, data reviewed, risk of complications. The E/M level (99281–99285) updates as documentation progresses.
Data reviewed tracking. Labs ordered, imaging reviewed, consultations obtained, and outside records are automatically tallied toward MDM Element 2. Independent interpretation and external discussion are tracked separately.

Multi-provider by design. Nursing and clinician staff work the same encounter simultaneously — nurses on their own templates and a shared history view; the signing clinician reviews and imports with one tap. Role-based access throughout.

Other niceties

120+ chief-complaint templates. Adult, pediatric, and infant. Medical and trauma. From chest pain and altered mental status to MVA, GSW, blast, stab, fall.
Dynamic templates. Template content adapts to patient sex, age group, and findings already marked. Items that don’t apply simply don’t appear.
Lab auto-population. Lab values import from the EMR and fill numeric fields and result arrows on the studies tab. Repeat values (e.g., serial troponin) handled cleanly.
Editable in place. JSON-based templates editable by site or by individual practitioner. Modify or extend with no rebuild or redeployment.
Freestanding mode. Run without an EMR. Built-in patient registration, encounter management, RxNorm medication autocomplete, direct chart data entry.
Session persistence. Every mark saved per-encounter and restored automatically. Multi-tab, multi-provider, multi-device.

Try it. Trust it.

60 days free. Built for HIPAA from the ground up.

Individual

Single clinician

Use Ailacra alongside your current EMR for two months at no cost.

Get in touch
Group

Practice or department

Team plan with shared templates, role-based access, and group analytics. We help your team get on board.

Talk to us
Hospital

System-wide deployment

Enterprise install with EMR integration, custom templates, MFA enforcement, and dedicated support.

Enterprise inquiry

Security & Compliance

Built for HIPAA from the ground up.

🔐

Multi-Factor Authentication

TOTP-based MFA with site-level enforcement. Trusted device support for 30 days.

📋

Full Audit Trail

All data access and clinical actions are logged with who, what, and when. Break-glass access is tracked and queued for review.

🏥

Multi-Tenant Isolation

Each site’s data is fully isolated. No cross-tenant access at the database or API layer.

🔒

Encryption

Data encrypted at rest (KMS) and in transit (TLS). Credentials managed via Secrets Manager — no hardcoded secrets.

Or just say hello — info@aistellor.com