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Mako AI Scribe is an AI-powered clinical documentation assistant built directly into StrataEMR. It listens to your therapy sessions, generates structured SOAP note content, and lets you transfer that content into your documentation, reducing the time you spend writing notes after each visit. This article covers how the feature works, how to get the best results, and answers to the most common questions from clinicians already using it.

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How It Works

Mako AI Scribe records audio from your therapy session using your device’s microphone (built-in or external). When the session is complete and you stop the recording, the audio is securely uploaded and processed. Mako will provide two outputs: Summary Tab: A structured clinical summary organized into SOAP note sections:
  • Subjective: Patient-reported symptoms, history, and concerns discussed during the session
  • Objective: Clinical observations, measurements, and findings verbalized during the encounter
  • Assessment: Clinical interpretation, progress toward goals, and functional status
  • Plan: Treatment recommendations, goals, and next steps
Transcription Tab: A full transcript of the session with speaker identification, labeling dialogue as CLINICIAN or PATIENT.

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Transferring Content Into Your Note

Once processing is complete (typically a few minutes), you have two options for getting AI-generated content into your documentation:
If your note template includes the Mako AI Scribe fragments (Mako Subjective, Mako Objective, Mako Assessment, Mako Plan of Care), click the Transfer to Documentation button at the bottom of the Summary tab to push content directly into the corresponding sections of your note.
You can also copy content from the Summary or Transcription tabs and paste it into any section of your note. This approach works regardless of your template setup and gives you full control over where content is placed.
Important: Mako AI Scribe is a clinical documentation assistant, not a replacement for clinical judgment. The generated summary must be reviewed for accuracy before finalizing your note. You are responsible for the accuracy and completeness of your documentation.
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Getting Started

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Requirements

  • A laptop or tablet with a modern web browser (Chrome, Edge, or Safari recommended)
  • A built-in microphone or an external wireless microphone
  • Microphone access granted in your browser settings

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Activation

Mako AI Scribe must be activated for your account by a member of the StrataPT team. You will see the Mako AI Scribe card on your note in one of two pre-activation states:
  • “Mako AI Scribe is not active for your practice.” Your practice has not yet been enabled. Ask your account administrator to request activation from StrataPT.
  • “Recording has been disabled for your user account.” Your practice is enabled, but your individual user account needs to be activated. Contact your account administrator to enable recording and dictation for your notes.
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Once activated, the Start Recording button will become active.
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Granting Microphone Access

When you start your first recording, your browser will ask for permission to access your microphone. You must allow this for Mako AI Scribe to function. If you accidentally deny the request, you can update your browser’s microphone permissions in its settings.

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Recording a Session

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Step-by-Step

1

Start a Recording

Open your patient’s clinical note in StrataEMR. The Mako AI Scribe card will be located at the top of the sidebar to the right of the note. Click Start Recording.
2

Confirm Patient Consent for Recording

Once you’ve clicked Start Recording, a Recording Consent Required dialog will appear. This reminds you that the encounter will be audio recorded for transcription and documentation assistance, that you are responsible for obtaining patient consent per your organization’s policy, that the generated summary must be reviewed for accuracy, and that recording data is encrypted and stored in compliance with HIPAA.Confirm that you have obtained verbal or written consent from the patient and click Continue
3

Set Microphone Permissions

The first time you use Mako AI Scribe in a browser, you’ll be asked to give it access to your device’s default microphone. Click “Allow” to begin your recording.
4

Continue your Session

Conduct your therapy session as you normally would. A live recording indicator with a timer will confirm audio is being captured. If you need to step away or pause for any reason, click Pause. Click Resume to continue when ready.
5

Complete your recording

When the session is complete, click Stop & Submit to send the session’s recording to StrataEMR. The card will show a Processing Recording… message while Mako transcribes and generates your summary. This usually takes only a few minutes.
6

Review your Summary and Transcript

Once processing is complete, review the Summary tab for your SOAP-organized content and the Transcription tab for the full speaker-labeled dialogue
7

Transfer to your Note

When the Mako AI Scribe fragments are present in your document, you can click Transfer to Documentation to send the four separate summary sections to their corresponding fragment in your document. If your document does not have these fragments, click a section heading to add the corresponding document from the Mako AI Scribe fragment family. Alternatively, you can copy and paste information from your summary to your existing fragments. 
8

Review

Review and edit the content as needed, then finalize your documentation as you normally would.

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Tips for a Successful Recording

Verbalize your clinical observations. Mako can only document what it hears. Speak your measurements, observations, and findings aloud during the session. For example, say “left knee flexion is 130 degrees” rather than silently noting it. Record the full encounter. Start recording when the session begins and stop when it ends. Recording the entire session in one continuous take produces better results than starting and stopping multiple times. Be aware of your environment. In a quiet, private room, your device’s built-in microphone will generally work well within about 4-6 feet. In open gym settings or multi-therapist environments, an external wireless microphone will significantly improve audio quality and reduce background noise. Use Pause when needed. If a sensitive conversation arises or you step away from the patient, click Pause and Resume when ready rather than stopping and restarting the recording.
Note: Each note supports one recording. If you need to start over, you will need to duplicate the note and begin a new recording on the duplicate.

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Hardware Recommendations

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When Your Built-In Microphone Is Enough

If you primarily treat patients in a private room or quiet environment and your device is within a few feet of the conversation, your laptop or tablet’s built-in microphone should work well.

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When to Use an External Microphone

An external wireless microphone is strongly recommended if:
  • You work in an open gym or multi-therapist setting
  • There is background noise, music, or cross-talk from adjacent sessions
  • You move around the treatment area during sessions
  • Your device is more than a few feet from the patient
The Hollyland Lark M2S Combo is a wireless lavalier microphone that clips to your clothing and connects to your device via a USB receiver. It provides strong noise isolation and is the most commonly recommended option among clinicians using Mako AI Scribe. Any similar microphone will also work.
Pro tip: If you see patients back-to-back throughout the day, consider a dual-microphone setup (included in the Hollyland Lark M2S Combo package) so you can rotate between them and always have a charged microphone ready.In noisy environments, a foam windscreen (“dead cat” cover) on the microphone can further reduce ambient noise pickup.
Recording therapy sessions involves patient consent considerations that vary by state. The Recording Consent Required dialog within Mako AI Scribe reminds clinicians of their responsibility before every recording session, but your practice should also establish broader consent practices. Regardless of your state’s specific requirements, we strongly recommend the following:
  1. Update your intake forms. Add a recording consent section to your Consent and Policies intake template. Recommended language is provided below in both English and Spanish.
  2. Post visible signage. Place a notice at your front desk informing patients that sessions may be recorded for clinical documentation purposes.
  3. Verbally disclose recording. At the start of each recorded session, briefly let the patient know the session will be recorded to support clinical documentation.
  4. Always allow opt-out. If a patient declines recording, respect their decision. Declining recording does not affect their care. Consider creating a case notification to flag patients who have opted out so all clinicians on their care team are aware.
  5. Document acknowledgment. Keep a record that the patient was informed and did not object (or provided written consent, depending on your state’s requirements).
Add the following to your Consent and Policies intake template below the “Digital Images and Videos” section: 
SESSION RECORDING NOTICE AND CONSENT

For the purpose of clinical documentation, your therapy session may be audio recorded. The recording is used to help your clinician accurately document your visit and may be transcribed to support completion of your medical record. Recordings and any related transcripts are stored securely as part of your health record and are accessible only to authorized members of your care team. All documentation remains under the review and control of your clinician. Recording is limited to your therapy session and is not used for marketing, advertising, or any non-clinical purpose.

You may ask questions or request that recording not be used for your session. Declining recording will not affect your care or treatment.
A Spanish version is available below: 
AVISO Y CONSENTIMIENTO DE GRABACIÓN DE SESIÓN

Con el propósito de documentación clínica, su sesión de terapia puede ser grabada en audio. La grabación se utiliza para ayudar a su profesional clínico a documentar su visita con precisión y puede ser transcrita para facilitar la completación de su expediente médico. Las grabaciones y cualquier transcripción relacionada se almacenan de forma segura como parte de su expediente de salud y solo son accesibles para los miembros autorizados de su equipo de atención. Toda la documentación permanece bajo la revisión y el control de su profesional clínico. La grabación se limita a su sesión de terapia y no se utiliza con fines de mercadeo, publicidad ni ningún otro propósito no clínico.

Usted puede hacer preguntas o solicitar que no se utilice la grabación durante su sesión. Rechazar la grabación no afectará su atención ni su tratamiento.

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State-by-State Considerations

Some states require all-party consent for recording private conversations. Therapy sessions are generally treated as private conversations regardless of setting. All-party consent states (consent required from all parties): California, Connecticut, Delaware, Florida, Illinois, Maryland, Massachusetts, Montana, Nevada, New Hampshire, Oregon, Pennsylvania, Vermont, Washington One-party consent states (disclosure and opt-out strongly recommended): All remaining states and Washington, D.C.
Important: Even in one-party consent states, we strongly recommend full disclosure and opt-out as a best practice. This protects both the patient relationship and your practice.

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HIPAA Considerations

All recordings and transcripts generated by Mako AI Scribe stored securely and treated as Protected Health Information (PHI). They are accessible only to authorized members of the care team and subject to all applicable HIPAA requirements.
  • Never reuse recordings or transcripts beyond clinical documentation without separate patient consent
  • Treat both audio files and text transcripts as PHI
  • Follow your existing HIPAA policies for storage, access, and retention

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Best Practices from Early Adopters

Since launching Mako AI Scribe with our first group of customers, we have gathered real-world feedback that can help you get the most out of the feature.

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Start with Initial Evaluations and Re-Evaluations

These visit types involve the most narrative documentation and benefit the most from AI assistance. They are typically conducted in private rooms, which also provides better recording conditions. Once you are comfortable, expand to daily notes and other visit types.

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Use It as a Companion Tool

Think of Mako AI Scribe as a first draft, not a finished product. The AI-generated content gives you a strong starting point, especially for subjective sections where it performs best. Review everything, edit where needed, and continue to complete required template fields and objective measurements manually.

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Don’t Abandon Manual Documentation Skills

The AI is a productivity tool. Continue to develop and maintain your clinical documentation skills. Use the AI output as a reference and supplement, not a crutch.

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Focus on Subjective Sections First

Clinicians consistently report that the subjective section is where Mako AI Scribe adds the most value. Patient-reported symptoms, history, and the flow of conversation are captured well. Objective measurements, complex data structures, and medication lists still benefit from manual entry.

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Copy Specific Sections, Not Entire Summaries

Rather than transferring everything at once, many clinicians find it most effective to review each SOAP section individually and transfer or copy only the portions that are accurate and relevant to their note.

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Frequently Asked Questions

Usually just a few minutes. You can continue working on other parts of your note or move to your next patient once your recording uploads while you wait. The Summary and Transcription tabs will populate when processing is complete.
Mako AI Scribe works on laptops and tablets with a modern browser (Chrome, Edge, or Safari). It works best on desktop and laptop devices. A browser that supports microphone permissions is required.
While it may function on a mobile browser, the experience is optimized for laptop and tablet screens. We recommend using a larger device for the best results at this time.
Recording depends on an active browser session. If the browser is closed, crashes, or the device goes to sleep, the recording may be interrupted. Keep your device awake and the browser tab active during sessions. Mako will attempt to keep your computer awake via the browser when a recording is actively being captured.
No. Each note supports one recording. If you need to start over, duplicate the note and begin a new recording on the duplicate.
Very long recordings (such as extended initial evaluations) may approach file size limits. If you encounter issues, open a support ticket with Technical Support.
Respect their decision. Declining recording should not affect their care. Document your session manually as you would without the feature. Consider creating a case notification so other clinicians on their care team are aware of the patient’s preference.
It depends on your template setup. If your template includes the Mako AI Scribe fragments, you can use the Transfer to Documentation button to push content into the corresponding sections. Otherwise, you can copy and paste content from the Summary or Transcription tabs into any section of your note.
Accuracy depends on audio quality, how clearly clinical information is verbalized, and the complexity of the session. The AI does a strong job capturing the narrative flow of a session, especially subjective content. Always review and edit before finalizing. You are responsible for the accuracy of your documentation.
Mako AI Scribe is included as part of StrataEMR at no additional cost for all customers with a generous usage limit that most teams will never encounter. If you exceed these sensible limits we’ll reach out to have a conversation with you. 
Yes. After processing, the Mako AI Scribe card has two tabs: Summary (with SOAP-organized content) and Transcription (with the full speaker-labeled dialogue). You can review both and use whichever is most helpful for your documentation.

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Need Help?

If you have questions or run into issues with Mako AI Scribe, contact the StrataPT support team from your Dashboard in StrataEMR. A member of our team will help you get the most out of this feature.

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Have Feedback or Suggestions?

If you’d like to share your feedback on this feature, log into StrataEMR and navigate to the Feedback area from your top menu. From here you can share your thoughts on the Mako AI Scribe and other features of StrataEMR.