Stream

How does problem-based charting work?

Stream captures a visit by ambient listening or dictation in 22 languages and writes either a classic SOAP note or a problem-based note. A pre-visit view called Huddle shows active problems, ones that are "falling off" attention and compliance flags. Each problem has a timeline and recap, and a Scratchpad merges free-text jots into the note. The vendor also lists ICD, CPT and HCC coding support and states there is no clinical decision support.

An optional fax product, Stream Inlet, summarizes inbound faxes and records, files them under problems with links to the source pages and files nothing without review.

Who built it?

River Records, Inc. was started by physicians. Jacob Kantrowitz, MD, PhD is CEO and an assistant professor at Tufts, Jackson Steinkamp, MD is CTO, and Abhinav Sharma, MD is a co-founder. The about page says the three began as medical students in 2018 by automating the discharge summary. Two papers by the founders sit behind the idea: a 2022 JAMA Network Open study on duplicate information in the electronic record, and a 2021 JMIR Formative Research paper on a prototype noteless collaborative record. Neither evaluates Stream. The vendor claims 30,000 or more documented encounters.

What are the plans?

Pricing on the page in November 2026: Stream Pro is $149 per clinician per month, or $99 billed annually at $1,188 a year, with unlimited visits, a 30-day free trial without a card and no minimum term. The first non-clinician seat is free, and extra staff are $25 a month. Stream Lite is $59 a month for scribing only, with audio, transcript and note deleted after 48 hours. Inlet runs $89 for 500 pages, $199 for 1,500 and $349 for 3,000, with extra pages at $0.14 and a one-time $299 fax-number setup. Clinics of three or more clinicians are quoted.

What about security?

The vendor says a BAA comes with every plan, trials included, with encryption at rest and in transit, audit logging and no training on patient data. It states that it is not SOC 2 certified.

The verdict

Stream is for a clinician who accepts copy and paste in return for notes organized by problem, at $99 to $149 a month depending on billing. Stream Lite at $59 a month is the scribe-only option that deletes everything after 48 hours.