> ## Documentation Index
> Fetch the complete documentation index at: https://docs.medera.info/llms.txt
> Use this file to discover all available pages before exploring further.
# Quickstart — Real-time Ambient Scribe
> Build a real-time SOAP scribe in under 20 minutes.
Spin up a real-time ambient scribe with the AI Services clinical endpoints — diarized capture, in-encounter SOAP drafting, ICD-10 / CPT code suggestions, and EHR sync.
## Architecture
## Prerequisites
* A
Medera Console account and a Developer API Key with `write:phi` and `execute:agents` scopes.
* A microphone — see [Microphone Devices](/multimodal/stt/microphones).
* An EHR target configured under **Console → Integrations**.
Set your API key as an env variable.
```bash theme={"system"}
export MEDERA_API_KEY=""
```
Open a clinical session — this anchors the transcript, note, and code suggestions.
```typescript JavaScript theme={"system"}
import { MederaClient } from '@medera/sdk'; const client = new MederaClient({ apiKey: process.env.MEDERA_API_KEY! }); const { session_id } = await client.clinical.start({ session_type: 'clinical_visit', patient_id: 'pat_abc', });
```
```python Python theme={"system"}
from medera import MederaClient client = MederaClient(api_key=os.environ["MEDERA_API_KEY"]) session = client.clinical.start(session_type="clinical_visit", patient_id="pat_abc",)
```
```bash theme={"system"}
cURL curl -X POST https://api.medera.info/api/clinical/start \ -H "X-API-Key: $MEDERA_API_KEY" \ -H "Content-Type: application/json" \ -d '{ "session_type": "clinical_visit", "patient_id": "pat_abc" }'
```
Send PCM audio chunks (16 kHz 16-bit mono recommended) as the clinician speaks.
```typescript JavaScript theme={"system"}
// Encode PCM as base64 const audio_data = btoa(String.fromCharCode(...pcmBuffer)); const { transcript } = await client.clinical.chunk({ session_id, audio_data, });
```
```python Python theme={"system"}
import base64 audio_b64 = base64.b64encode(pcm_buffer).decode res = client.clinical.chunk(session_id=session.id, audio_data=audio_b64,)
```
```bash theme={"system"}
cURL curl -X POST https://api.medera.info/api/clinical/chunk \ -H "X-API-Key: $MEDERA_API_KEY" \ -d '{ "session_id": "ses_abc", "audio_data": "" }'
```
Local Medera STT is the default with Medera STT as fallback. The response returns the accumulated transcript so far.
Finalize the transcript and trigger the initial clinical analysis.
```typescript JavaScript theme={"system"}
const result = await client.clinical.stop({ session_id }); // result.transcription, result.clinical_data
```
```python Python theme={"system"}
result = client.clinical.stop(session_id=session.id)
```
```bash theme={"system"}
cURL curl -X POST https://api.medera.info/api/clinical/stop \ -H "X-API-Key: $MEDERA_API_KEY" \ -d '{ "session_id": "ses_abc" }'
```
Use the enhanced generator for specialty templates and inline code suggestions.
```typescript JavaScript theme={"system"}
const note = await client.therapy.generateSoapNoteEnhanced({ session_data: { session_id }, specialty: 'psychiatry', template_config: { format_version: 'v3', include_assessments: true, include_billing_codes: true, }, });
```
```python Python theme={"system"}
note = client.therapy.generate_soap_note_enhanced(session_data={"session_id": session.id}, specialty="psychiatry", template_config={ "format_version": "v3", "include_assessments": True, "include_billing_codes": True, },)
```
```bash theme={"system"}
cURL curl -X POST https://api.medera.info/api/therapy/generate-soap-note-enhanced \ -H "X-API-Key: $MEDERA_API_KEY" \ -d '{ "session_data": { "session_id": "ses_abc" }, "specialty": "psychiatry", "template_config": { "include_billing_codes": true } }'
```
The response includes the structured SOAP plus a list of suggested ICD-10 / CPT codes anchored to transcript spans.
After clinician sign-off, finalize the note. Medera posts the signed note and code set to the configured EHR target via the integration adapter.
```bash theme={"system"}
curl -X POST https://api.medera.info/api/therapy/notes/{note_id}/finalize \ -H "X-API-Key: $MEDERA_API_KEY"
```
## Best practices -
Capture audio at **16 kHz 16-bit PCM mono**.
Higher rates work but waste bandwidth.
* Use a dedicated lavalier or beamforming mic. See [Microphone Devices](/multimodal/stt/microphones).
* Always require clinician sign-off before posting. Never auto-post to the EHR.
* Use the transcript span IDs to render the documentation anchor next to every code suggestion.
***
## What's next
Agent-level documentation.
How code suggestions work.
Connect Epic, Cerner, athenahealth.
Audio quality recommendations.