BACK TO CENSUS

Help & What's New

Get up to speed and stay current with the system.
The architecture, the daily-use guides, and what's shipped recently — all in one place.

§ Epic & EHRdoctor quick start · 2 clicks

OPEN THE PHRASES, SETUP, AND DAILY PASTE GUIDE
Open Epic Bridge guide →
From any main workspace
1. Click Help in the top navigation. 2. Click Open Epic Bridge guide on this page. That guide contains the Epic → somaNotes snapshot phrase, the somaNotes → Epic progress-note phrases, one-time setup, daily use, and the paste splitter.
Faster from Census
After selecting the correct patient, click Epic Intake in the patient actions to open the snapshot guide directly. Or open Add Data and click Set up the interim Epic snapshot phrase.
Bring Epic data into somaNotes Set up progress-note phrases Use the phrases today

§ Architecturehow the system works

THE THESIS · published 2026-04-25
somaCURA isn't an AI scribe. It's a clinical reasoning engine that happens to produce notes.
The full architecture, traced end-to-end. ~80% of clinical fragments routed deterministically, 0 LLM calls during accumulation, 2 scoped LLM calls per finalized note, 3 physician decision points before signature. The note is a reasoning artifact, not a transcription byproduct.
0LLMDuring fragment routing
~80%Deterministic
2callsLLM hops per note
3gatesPhysician decisions
READ THE INFOGRAPHIC

§ Episode Tapestrythe default Problems view

DEFAULT VIEW · replaced the problem board / kanban
What it is
Select a patient and the Problems column renders the Episode Tapestry — the admission as one woven surface instead of a stack of cards. The ledger view lists problems with their A&P history and pending changes; the Tapestry toggle switches to the course weave: one ribbon lane per problem, lane height tracking clinical salience, per-day segments colored by status (active → worsening → improving → resolved). Every ribbon is grounded in recorded daily state — nothing on the weave is invented.
Reading the weave
The day spine across the top is clickable — scrub any hospital day (or use ←/→) to pivot the whole workspace to that day. A phase spine marks derived DETERIORATION / TURNING POINT / RECOVERY stretches when the course supports them. Knot discs on a lane mark changes awaiting your reconciliation; the teal LIVE pill confirms the weave reflects current state. Chronic background problems fold below the acute story. Press C to toggle the course panel.
Compile Course
The course panel compiles a hospital-course narrative deterministically from the weave — zero LLM, one sentence per story lane, each sentence carrying chips that link it back to the exact lanes and days it came from. Hover a sentence to light its source lanes, and vice versa. Copy to clipboard when it reads right. The "A&P as it stood" time machine shows any problem's assessment exactly as it was written on any prior day, with a diff against today.
Reference evidence
Each problem lane carries a small ref button. Open it to pull cited clinical guidelines plus this patient's own relevant labs and meds into a drawer beneath the lane — decision support at the moment you are reading the timeline, not buried in a menu. It is reference only: everything is cited to its source and nothing is ever written into your note. It loads on demand when you open it and clears when you switch patients.

§ Prepare a shifthandoffs now · notes when you are ready

Use Prep shift when you have sign-out data but are not ready to write notes. Use Import Note when you already have an actual progress note and may want the rail to start from it. Neither action generates a progress note.

Prep a new census from handoffs

  1. From the Census left sidebar, click Prep beside Add. On an empty census, you can also click Prep shift in the center welcome card.
  2. Paste one patient's complete handoff. Confirm the Handoff date; it defaults to the current Central Time hospital date.
  3. Click Fill labeled identity if the paste contains labeled Name, MRN, Room, Age, or Sex fields. Verify every field; MRN is required. If that MRN already exists, verify the named patient before clicking Add existing patient instead.
  4. Click Create & Prep Next. The raw handoff and parsed problems, labs, vitals, and medications are stored in that chart. The form clears for the next patient.
  5. Repeat for the full list, then click Done. Select any patient later to review the chart, add current data, and generate only when ready.

Import an actual prior progress note

  1. Select the correct census patient, open the rail's secondary actions, and click Import.
  2. Paste the full note, choose Progress Note, and confirm its Note / Service Date and source.
  3. Check Use for my next Progress Note only when this exact note should seed the next rail generation, then click Import Note.
  4. Set the new note's service date to today or tomorrow, enter the new clinical update, and click Generate when ready.
  5. If you did not select it during import—or return another day—use Prior Notes → Progress → Use as Template.

Know what was—and was not—done

  1. Prep shift creates the patient chart and saves source data. It does not create a progress note.
  2. Import Note stores the pasted note. It does not rewrite it or generate today's note.
  3. The prior-note chip names the exact note queued for the next Progress Note. With no selected prior note, the rail does not silently choose one.
  4. After a generated note is saved, its chart history records which prior note actually seeded it.

§ Shift WorkspaceNote Evolution · step by step

Use Shift Workspace after a progress note from this hospitalization has been saved. Admission is day 0; the H&P and first daily progress note stay in their usual workflows. Shift Workspace then evolves that saved progress note on each following day without sending the one-shot rail through Note Evolution.

OPT-IN · CURRENT HOSPITALIZATION · PROGRESS-TO-PROGRESS
What it does
Carries the latest saved progress note forward, then lets you review focused changes instead of regenerating the whole document. The prior note remains the base until you explicitly accept or edit an amendment.
What it does not do
It does not start from an H&P or a progress note from another admission. It does not automatically accept changes, and it does not silently place an unmatched proposal into the note.

Start with the right note

  1. Admission is day 0. Create the H&P through the usual admission workflow; an H&P is not a Shift Workspace base.
  2. Create the first daily progress note with Create Note → Progress Note. Review it, then use Save Draft or Sign & Finalize.
  3. On a following day, select the same hospitalization and click Shift Workspace. If prompted, choose Create Initial Progress Note, save that note, then reopen Shift Workspace.

Capture and decide

  1. Review the note-level Brief Hospital Course card. Carried forward unchanged needs no action. For a proposal, inspect the completed milestones and prior BHC, then choose Accept, Edit, or Keep prior.
  2. In Today’s Update, type or dictate what changed. Use Add Entry as you round; if text remains in the composer, Propose Amendments saves it before starting the round.
  3. Click Propose Amendments. In Problem Review, compare the current wording, source evidence, and proposed wording for each problem. Choose Accept or Reject; use Edit, Re-run for problem, or the exact-target picker when shown.

Read and finish

  1. Clear every visible blocker. Use Jump to next blocker for unresolved high-risk, failed-placement, or unmatched changes. High-risk changes require an evidence review and explicit confirmation.
  2. Open Review Full Note or the Full Note tab and read through to the end. Only accepted or physician-edited changes enter the note; Reject and Keep prior preserve the base wording.
  3. When the footer says Ready to finalize, click Finalize once. In the rail’s Review Progress Note screen, make final edits, then use Save Draft or Sign & Finalize. Copy or paste back the EHR-final version through the usual controls.
STATE GUIDE · WHAT THE WORKSPACE IS TELLING YOU
Brief Hospital Course
Carried forward unchanged means no new, verified completed milestone was found. Roll-forward failed or No roll-forward available also leaves the prior BHC intact; use Retry for a transient request failure. The automatic BHC proposal reads the saved prior progress note, not pending text in Today’s Update.
Unlinked or blocked
An Unlinked amendment has no single safe note target. Choose the exact problem or reject it. A disabled Finalize button means an individual-review, high-risk, evidence, or placement decision is still open; the footer names the blocker.
Earlier hospital days
Selecting a prior Dn shows that day’s captured A&P in read-only mode. Return to Today before proposing, editing, or finalizing. Switching patients closes the workspace and clears the active review.

§ Transfer Centerinbound calls, decided cleanly

Built around the real decision — you are the accepting physician. The workspace leads with disposition (accept / consult / decline), not logistics fields.

Take the call

  1. Open Transfer Center from the header nav
  2. Start a new transfer — record the call right in the workspace
  3. Fields fill themselves live during the call: demographics, clinical picture, requesting facility, callback numbers
  4. Correct anything mid-call — spoken corrections update the extracted fields

Decide

  1. Pick the disposition: accept, consult first, or decline
  2. The routing advisor surfaces destination guidance by diagnosis
  3. Paste any faxed/EHR chart material — it merges into the extraction

Document

  1. Generate the transfer note from the assembled workspace
  2. Call recording and transcript stay attached to the transfer
  3. Active transfers badge shows on the nav until closed

§ AdmissionsH&P from sources, not from vibes

The H&P document itself is the workspace — one row per section, always editable, with the source evidence in a margin rail beside it.

Capture

  1. Open Admissions from the header nav
  2. The multiline Clinical intake workspace holds the complete source: paste chart material, dictate, or type across as many lines as needed
  3. Capture never closes — keep adding mid-compile or after; late material becomes a named PENDING item, never a lost one

Shape the note

  1. Every row is editable, always — machine text shows dotted, your wording plain
  2. The margin rail shows each section's captured fragments; refine or reset per section
  3. PINNED means compile keeps your wording verbatim — still editable by you

Compile & send

  1. Compile streams the H&P into the rows top-down — nothing blanks while it writes
  2. The receipt marks each section Δ changed / + new / = unchanged / kept verbatim; anything arriving after shows amber PENDING pills — Recompile folds it in
  3. Enter the real MRN / FIN, then send to Census when it reads right; the handoff waits for the latest edits to save first

§ Reasoning Corpuscross-tree thread tracking

SINCE 2026-04-28 · data infrastructure
What it is
A sidecar database that tracks how each diagnostic thread (problems, hypotheses) evolves across the days of an admission. When you sign a note with a reasoning tree, every node in the tree is matched against prior days' nodes for the same patient and assigned a stable lineage id. "AKI" on hospital day 1 and "Acute Kidney Injury" on day 4 collapse to one lineage.
Why we built it
Today, when you click Reasoning, you see a single snapshot of the current note. The natural next question is "how has each thread progressed across this admission?" Answering that requires identity for diagnostic threads across days. The corpus is that identity layer — the data backbone for the upcoming Today/Timeline view in the reasoning panel.
Visible right now (Phase A→C live)
A Today / Timeline toggle in the Reasoning panel header. It surfaces only on encounters with at least 2 prior signed notes (single-day admissions don't get a useless control). Click Timeline to see each diagnostic thread as a row of per-day status pills (active → confirmed → pruned), with the actual node text + rationale + top evidence one click into each slot.
Backstage
Every signed note quietly enqueues a corpus import job; an off-rail drain runs in the background. The next note's reasoning tree gets the patient's prior thread ids fed in as PRIOR-LINEAGE HINTS, which the LLM reuses (smoke-confirmed: 100% adoption with appropriate net-new ids on real prod data).
Backfill on launch
936 lineages across 67 patients from 120 prior tree-bearing notes. 0 parse errors. The clinical database was untouched — read-only access only.

§ Voice & Audiothree ways to dictate

Live Dictation

  1. Select a patient, open the note rail
  2. Click the mic on the floating bar at the bottom, or press Alt+Shift+V
  3. Speak — live words appear in the floating bar; finalized text routes to the target captured when dictation started
  4. Click the mic again to stop

Upload Audio

  1. Open the note rail for any patient
  2. Click Upload Audio — select MP3, M4A, WAV, or WebM (up to 75 MB)
  3. Choose a preset (Auto, General, ICU, Cardio) for better accuracy
  4. Toggle the speakers icon for multi-speaker diarization
  5. Transcript appears in the clinical update box

iPhone Pairing

  1. Select a patient
  2. Click iPhone in the header — QR code appears
  3. Scan with iPhone camera — no app needed
  4. Dictate at bedside — transcripts stream live to desktop

§ What's Newrecent changes

Loading recent changes…

§ Moreresources & reading

RESEARCH POSITION
Beyond the AI Scribe →
The philosophical argument behind somaCURA — why the clinical note is a reasoning artifact, not a transcription byproduct. ~36 cited papers.
WORKFLOW GUIDE
Rail Diff Review Guide →
How the rail’s optional per-problem diff review works. This is separate from Shift Workspace; use the step-by-step section above for Note Evolution.
EHR REFERENCE
Epic SmartPhrase Template →
Build the versioned .SOMAPROGRESS35 + .SOMAPROBLEM35 + .DISPO5 package, or use the exact-note paste path — canonical blocks, safe migration splitter, Avera token evidence, and setup checks.