Rethinking Pediatric Rheumatology Notes: Dr. Tommy Gerschman’s’s Case for AI Scribing

Dr. Tommy Gerschman x Heidi at a glance

"I used to say the bane of my clinical existence was charting and documenting. Now, I just talk to my patients. Heidi handles the rest." - Dr. Tommy Gerschman, Pediatric Rheumatologist in North Vancouver, BC

Key outcomes:

• Streamlined documentation for all new consults
• Eliminated variability and stress from end-of-day note writing
• Increased efficiency without sacrificing clinical detail or nuance
• Improved patient interactions by allowing full focus during sessions
• Enhanced workflow collaboration with national and provincial health organizations

Read on if you might also be experiencing:

• Frustration with the time and cognitive load of consult letters
• Stress from documentation delays or inconsistent processes
• Burnout from juggling charting, patient care, and clinical leadership
• Lack of trust in other AI scribes due to hallucinations or poor customization

Background

Dr. Tommy Gerschman is a pediatric rheumatologist based in North Vancouver, BC. In addition to his clinical work, he plays a national role in healthcare innovation, helping lead digital documentation pilots through the Canadian Rheumatology Association, Doctors of BC, and the Specialist Services Committee. A long-time early adopter of digital tools, he has spent years refining his approach to new consults and specialist documentation.

Challenges

Dr. Gerschman sees an average of12 pediatric patients a day, with up to two-thirds being new consults that require detailed, personalized letters to referring physicians. Documentation has always been a major source of friction.

Heavy admin load with consult letters

• "If I dictated my letter right after the consult, it took four or five minutes. But if I left it until the end of the day, it could take 10 to 12."
• That time variability created stress and impacted patient flow, especially with more complex pediatric cases.

Frustrations with older dictation tools

• "Dragon Dictate was good for its time, but it made so many mistakes that it took brainpower just to fix the errors. I just wanted to be done."
• He relied on audio files and staff transcription, but it still required tight coordination and timing.

Disruption to patient interaction

• "I used to take notes during the session. Now, I just listen and talk with the patient, which is actually quite nice."
• Charting often got in the way of presence and rapport-building, particularly in pediatric care where family history and multiple voices are involved.

Solution

Dr. Gerschman explored various scribe platforms before landing on Heidi in late-2023. Right out of the gate, he noticed Heidi was more mature, accurate, and intuitive than the alternatives.

"What stood out was the lower hallucination rate and the fact that Heidi felt built for clinicians. It just made sense."

Key features that won him over:

• Powerful, intuitive templating: Especially for complex consults and SOAP follow-ups
• Ask Heidi: Used for advanced operations like splitting sibling sessions into two notes
• Dictation fallback: "When recording fails or I forget to hit record, smart dictation saves the day. Better than any other voice tool I've used."
• Context setup with Ocean: He pre-loads structured patient history into context using Ocean forms, improving accuracy and speed

Workflow walkthrough

Dr. Gerschman’s Heidi use centers on new pediatric consults. He combines Heidi with Ocean (for patient intake) and Acuro (his EMR).

1. Before the session:
   
   • The patient fills out an Ocean questionnaire, which exports background history and medication details in paragraph form.
   • He copies this into Heidi’s context field or directly into the letter post-session.
2. During the session:
   
   • He starts transcription with patient consent.
   • He modifies his language slightly (repeating dates, confirming relationships) to help Heidi capture context (e.g., "your maternal grandmother").
   • Instead of taking notes, he focuses fully on conversation, including history, physical exam, and care planning.
3. Post-session:
   
   • He dictates the physical exam aloud immediately after the patient leaves.
   • Edits the generated document in Heidi, then pastes into Accuro, sometimes section by section.
   • Occasionally adds patient explainers or uses translation features for Arabic, Ukrainian, and others.
4. Follow-ups and summaries:
   
   • Uses a streamlined SOAP-style template for follow-ups
   • Maintains a library of tailored notes for conditions like juvenile arthritisor specific summary types

"I created a note to capture everything I needed and a document to present it how I wanted. That structure made the whole process feel seamless."

Impact

"It's not just that Heidi saves time. It saves thinking time. Now, I can leave notes to the end of the day and it still takes five minutes—not double that."

Time consistency and reduced stress

• Eliminated the cognitive tax of delaying documentation
• Maintains steady 4–5 minute review/edit process, even after hours

Better patient care and relationships

• No more mid-session notes
• Greater verbal flow and rapport with pediatric patients and families

Trust and accuracy

• Lower hallucination rate than other platforms
• Smart dictation and Ask Heidi reliably fill gaps when needed

Unexpected benefit

• "Honestly, the smart dictation feature is underrated. It works when everything else breaks."

What’s next

As one of the leading clinician voices in digital health and specialist documentation, Dr. Gerschman continues to help shape best practices through his involvement with CRA and provincial health leaders.

He’s exploring ways to standardize workflows further and would like to see tighter integrations with Accuro and Ocean, including screen-grab capabilities for attachments.

"Heidi isn't just a tool. It's part of how I practice now. It's made documentation not just tolerable, but reliable."

Ready to experience similar benefits in your specialist workflow? Learn how Heidi can help you reclaim your time and focus at www.heidihealth.com.