How Applover helped save up to 2 hours per day of doctors’ time using AI Assistants. Enhancing medical encounters | Nabla integration

Enhancing medical encounters - using AI Assistants to improve patient care and save practitioners time - Nabla integration | TopDoc case study
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TopDoc is a premier concierge care service dedicated to helping patients achieve the fastest possible recovery through expertly coordinated care. The personal concierges manage every aspect of users’ healthcare journey, ensuring they gain priority access to top doctors without the usual wait, receive cutting-edge treatments exclusive to top providers, and save time by handling all communications, saving users over 70 hours on average. Additionally, it secures insurance authorizations to save patients’ money and prevent surprise bills, a common issue for 57% of Americans today.

The Challenge and TopDoc’s Business Goal

TopDoc aims to enhance the digital experience for patients, addressing common issues like doctors’ divided attention during visits. The goal was to provide top doctors and improve patient experience through technology, ensuring patients feel heard and see efficient recovery progress.

In the AI era, automating many tasks doctors typically handle manually allows them to focus more on patient care. We chose Nabla.ai as our AI assistant, which met all criteria and significantly reduced development time. Our objective was to help doctors optimize consultation time and improve patient focus. To standardize and improve patient communication, we adopted the SOAP format for clinical notes (Subjective, Objective, Assessment, Plan), ensuring compliance with the FHIR standard. Let’s dive into the details.


Development time (weeks)

How Applover helped TopDoc save up to 2 hours per day of doctors’ time

Business Aspect

Our team began by thoroughly analyzing the business and market requirements essential for TopDoc. We involved the client in workshops to assess needs, clarify priorities, and define the project scope, ensuring alignment on objectives. A primary challenge was to reduce visit times by automating manual tasks, making the experience smoother and more efficient for doctors and patients. This allows doctors to spend more time on patient care and provide better service in less time.

To achieve this, we explored AI solutions and selected Nabla, a leading ambient AI assistant. Nabla met our criteria by reducing documentation time from an average of 16 minutes per patient visit to less than a minute, freeing doctors to engage more with patients. By utilizing the SOAP format, Nabla standardizes and enhances communication between doctors and patients, ensuring accurate and understandable documentation. With reduced administrative burdens, doctors can spend more time with patients, leading to higher satisfaction and improved care outcomes. Nabla is also SOC2-certified and HIPAA-compliant, ensuring secure handling of patient data in line with regulatory standards.

Based on insights from the Nabla team, we developed an implementation architecture that significantly reduced setup time. We also defined the structure of post-visit notes, detailing action items and next steps for doctors.


Technology Implementation: Flutter, Python and Nabla

We leveraged Python and Flutter technologies to efficiently address development needs and ensure seamless integration with providers like Nabla. Python was chosen for its robust support from third-party providers and its capability to develop end-to-end solutions that integrate various systems and platforms. Additionally, Python offers many libraries and frameworks tailored for data processing and AI. Flutter was the clear choice for creating a cross-platform application that supports both mobile and web platforms.

Nabla’s API enables the quick generation of structured clinical notes from patient visit transcripts. For typical 10-minute encounters, Nabla’s API generates notes in about 20 to 40 seconds. The first challenge was to reduce this time since doctors needed to sum up the visit while the patient was still present. We implemented a system that generates notes every few minutes during the encounter, reducing the generation time to under 10 seconds. This approach ensures doctors can promptly summarize visits while patients are still in the office.

To maintain a high level of user experience despite network interruptions, we used a WebSocket API to stream audio chunks directly from the mobile app to Nabla API, along with a buffering mechanism to handle network interruptions. This ensures the app sends buffered data at the fastest possible rate once the network is restored. Nabla also offers the flexibility of synchronous HTTP calls or asynchronous webhook callbacks, which prevent blocking calls and improve resilience to network issues. To enhance the results, we utilize data from patients’ health profiles and medical histories obtained from the EHR system, ensuring a cohesive and comprehensive solution.


Safeguarding Patient Data and Ensuring Compliance

Security is paramount in any digital solution, especially for patients’ data in healthcare. To ensure the platform’s safety for both patients and doctors, we implemented a range of robust security measures. While AI agents can raise data security concerns, our integration with Nabla offers a smooth and secure approach.

Nabla de-identifies all protected health information (PHI) during note generation. It operates statelessly, meaning it does not store any data we send; it processes the data and returns the output generated by its algorithms. All data is securely stored on our end, giving us complete control. Nabla holds SOC2 certification and is HIPAA-compliant. Their services fully adhere to HIPAA regulations for business associates, following the HIPAA Security Rule through stringent administrative, technical, and physical safeguards. This includes policies managing workforce access and advanced technologies to control ePHI access, ensuring their physical infrastructure is protected from potential threats.

The TopDoc platform is deployed on AWS, utilizing Docker containers for application components to enable easy horizontal scaling. This setup simplifies deployments and ensures the application can handle increased loads by adding more container instances. For security and traffic control, we use AWS Web Application Firewall (WAF) and Security Groups. The WAF protects against common web exploits, while Security Groups act as virtual firewalls, controlling inbound and outbound traffic. Our infrastructure is hosted within an AWS Virtual Private Cloud (VPC), providing isolation and security through a private network. The VPC segments the network into subnets, ensuring sensitive data remains secure and internal communication is isolated from external threats.

We further enhance security with AWS CloudTrail, providing comprehensive logging of account activity and API usage. For authentication, we implement YubiKey for two-factor authentication (2FA), adding an extra layer of protection against unauthorized access.

Technological Solutions

A mobile app to help treat spine-related ailments.
Enhancing medical encounters - using AI Assistants to improve patient care and save practitioners time - Nabla integration | TopDoc case study

Results and Business Impact

The integration of Nabla allowed TopDoc to deliver superior concierge care. The implementation led to improved patient satisfaction, translated into 81% enhanced patient-physician interaction and 90% fewer burnout doctors, which also influenced their care of patients! The time required to generate EHR notes decreased dramatically to less than a minute, compared to the market average of 16 minutes per patient visit. This efficiency gain enabled doctors to focus more on patient care and less on administrative tasks, enhancing overall patient experience and care, and driving better business results. Moreover, TopDoc will be able to save up to 2 hours per day on doctors’ time. 

By adopting the SOAP format for clinical notes, we standardized and improved communication with patients, ensuring that doctors’ assessments and interpretations are clearly documented. This structured approach helps in meeting the medical necessity requirements set by insurance providers, reducing the likelihood of rejections because of insufficient information. Well-documented SOAP notes prevent administrative errors and improve the efficiency of prior authorization processes. What is more, generated notes can be further normalized to meet FHIR-compliant structure by extracting ICD-10 and LOINC codes, and categorizing key medical information within the notes, thereby ensuring compatibility with standardized medical data frameworks. Aligning with FHIR protocols is crucial for the integration of clinical notes into Electronic Health Records (EHRs) and that is what we did for TopDoc!  

Meet our team!

Piotr Sobusiak CTO of Applover


Member of the Board

szymon, project manager at applover


Project Manager

kuba qa specialist


QA Specialist

Anton Zaporozhets QA Specialist


QA Specialist

bartosz back end dev


Back-end Developer

Daniel Kosytorz Back-end Developer


Back-end Developer

Marcin Sawicki Back-end Developer


Back-end Developer

mateusz anikiej backend developer


Back-end Developer

Jakub Czaplicki, Flutter Dev at applover


DevOps Engineer

Michał, Flutter Developer at Applover


Flutter Developer

Kamil, flutter dev at applover


Flutter Developer

filip kwiatkiewicz flutter dev


Flutter Developer

Adrian Niglus Flutter Developer


Flutter Developer

tomasz, flutter developer at applover


Flutter Developer

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