TCM SOAP Notes

A high-fidelity TCM SOAP note must bridge the gap between Western clinical data and Traditional Chinese Medicine diagnostics. The Subjective section captures the patient's chief complaint and history, while the Objective section is critical for documenting the 'Four Examinations,' specifically detailed descriptions of tongue color, shape, and coating, as well as pulse qualities (e.g., wiry, slippery, or thready). The Assessment then synthesizes these findings into a TCM pattern differentiation (Zheng), and the Plan outlines the specific acupuncture points, herbal formulas, or dietary recommendations prescribed.

Drafting these notes from memory often leads to the omission of specific diagnostic nuances. By recording the encounter, Aduvera captures the real-time dialogue and exam findings, automatically organizing them into the SOAP format. This allows the clinician to focus on the patient during the tongue and pulse exam, then spend their time reviewing and refining the AI-generated draft rather than starting from a blank page.