eCW Scribe It Conversion Modes: Lossless vs Assisted
Two ways to move your note into eClinicalWorks — explained in plain English
DeepCura converts your finished note into eCW Scribe It format — the special text layout that eClinicalWorks files into the right chart fields when you paste it. There are three conversion modes. Assisted, the default, lets AI draft the Scribe It commands from any note — structure, billing suggestions, and order lines included. Mapped keeps every sentence word-for-word while AI maps the structure and proposes the diagnosis codes. Lossless is for power users whose note template already writes Scribe It commands: formatting fixes only. This page explains what each one does, so you can pick with confidence.
The 30-Second Version
Assisted — drafts it all for you
DefaultThink of it as a documentation assistant. Whatever style your note is written in, AI reorganizes it into eCW's preferred structure and writes the Scribe It commands eCW looks for: recognized headings, treatment notes linked to each diagnosis, a suggested E/M billing level, order lines built from your plan, and diagnosis wording matched to the official database. Because it rewrites and adds suggestions, you review the draft before pasting it into eCW.
Mapped — your words, structured
NewThink of it as a librarian, not a writer. AI reads your note and maps its structure — which block is the HPI, which lines are diagnoses — then DeepCura builds the eCW commands around your own sentences, transferred word-for-word. The one thing the AI writes is the ICD-10 code it proposes for each diagnosis line (each is checked against the official database before it can appear, and flagged for your review). An independent check then verifies the result; if anything deviates, you get your original note back unchanged.
Lossless — your words, exactly
Power usersThink of it as a careful typist, not a co-author — built for practices whose note template already writes Scribe It commands into the note itself. It fixes only what breaks eCW's parser (stray colons, odd characters, markdown, heading names) and verifies diagnosis wording; every clinical sentence transfers word-for-word, and nothing is ever invented. A built-in safety check compares the result to your original sentence by sentence — if anything unauthorized is found, you get your original note back with a warning instead, and a change log lists every fix it made.
Side by Side, In Plain English
| What happens to… | Assisted (default) | Mapped (new) | Lossless (power users) |
|---|---|---|---|
| Best for | Practices that want the AI to draft structure, billing and orders | Most practices — any note style, with every sentence kept verbatim | Power users whose note template already writes Scribe It commands |
| eCW Scribe commands | Built for you — headings, diagnosis lines, billing, orders | Built for you — headings and diagnosis lines mapped onto your own text | Must already be in your note; Lossless never invents them |
| Your sentences | May be reorganized and rephrased for eCW's structure | Transfer word-for-word — the AI maps structure, it never rewrites | Transfer word-for-word, exactly as you wrote them |
| ICD-10 diagnosis codes | AI selects codes and matches official wording | AI proposes the code — the one thing it writes; verify it before pasting | Only codes you already cited in the note; wording verified and logged |
| Billing codes (E/M, CPT) | AI suggests an E/M level for you to review | Never added | Carried over only if you already wrote them in the note |
| Lab & imaging orders | Built from the tests mentioned in your plan | Only from an explicit Orders section in your note | Only from an explicit Orders section in your note |
| New clinical text | Adds per-diagnosis treatment and clinical note blocks | Never added | Never added |
| Safety check | You review the draft before pasting | Independent verification; returns your original on any deviation | Sentence-by-sentence verification; returns your original on any issue |
| AI involvement | AI writes the draft (several AI passes) | One AI pass that maps structure and proposes codes — never writes sentences | None — pure formatting rules, same result every time |
Which Mode Should I Use?
Stay on Assisted if you want the converter to do the most for you: recognized headings, diagnosis lines with database-exact wording, an E/M suggestion, and order lines built from your plan. It is the default because it works on any note style — but it rewrites and adds suggestions, so review the draft before pasting.
Try Mapped if you write normal clinical narrative — SOAP format, custom headings — and you want eCW structure without your sentences being touched. Every word transfers exactly as you wrote it; the AI only decides where sections begin and which lines are diagnoses, and proposes an ICD-10 code for each. The proposed code is the one thing to check: an amber “review” marker in the app counts the lines where the AI’s code and your wording may disagree. If verification finds any other deviation, you get your original note back unchanged.
Switch to Lossless if you are a power user whose DeepCura note template already outputs Scribe It format — the note itself contains ICD diagnosis lines, billing lines, or Order lines. Then the last thing you want is an AI touching them, and Lossless guarantees it never will: your phrasing, your negatives (“denies chest pain”), your doses, dates and certainty language transfer exactly, while the converter fixes only the technical details that break eCW’s parser. Because there is no AI in the path, the same note always converts the same way.
One thing to know: Lossless never invents commands. If you run it on a plain narrative note, the result contains nothing for eCW to import, and eCW will report that no Scribe commands were recognized. Building the commands is Assisted’s or Mapped’s job — flip the toggle and re-generate.
You can switch on any note with the toggle at the top of the Scribe It window, then press Re-generate. Your latest choice becomes your default.
What Lossless Actually Fixes
“Already in Scribe It format” is usually only almost true. On real template-formatted notes, Lossless still makes about 17 small fixes per note — each one a way eCW’s parser silently fails.
Stray colons
eCW treats any colon as structure, so a colon inside a sentence can hijack content into the wrong field. This is the most common silent Scribe It failure — Lossless fixes each one and logs it.
Characters eCW can't read
Smart quotes, long dashes, and invisible spaces sneak into generated notes and break eCW's parser. Lossless replaces them with plain equivalents.
Markdown leftovers
Bold markers and formatting symbols that look fine in DeepCura would be pasted literally into eCW. Lossless strips them without touching your words.
Exact heading names
eCW only recognizes its exact heading strings — “Treatment notes:”, not “Treatment Plan:”. Lossless renames your headings to the recognized ones.
Diagnosis wording verification
eCW silently drops a diagnosis line whose description doesn't match the official database exactly. Lossless checks every code you cited and, when needed, substitutes the official wording — with a before/after entry in the change log.
A verified receipt
Every conversion is independently re-checked sentence by sentence, and every change is listed in the change log. If anything unapproved is detected, you get your original note back instead.
The Lossless Safety Check
Lossless mode does not ask you to take its word for it. After every conversion, an independent checker compares the converted note against your original, sentence by sentence, and confirms that every difference is one of the approved formatting changes (a renamed heading, a cleaned-up character, a repositioned section). Each approved change is listed in a change log you can open right in the Scribe It window.
If the checker finds anything else — a sentence added, removed, reworded, duplicated, or moved out of order — the converter refuses to release the result. You see a clear warning and your original note, untouched. In other words: when in doubt, it hands your note back exactly as you wrote it.
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Frequently Asked Questions
What is eCW Scribe It?
Scribe It is a built-in eClinicalWorks feature. When you paste specially formatted text into the progress note editor, eCW automatically files each part into the right place — Assessment, Treatment Notes, orders, and billing. DeepCura's converter produces that specially formatted text from your finished note so you can paste it in one step.
What does Assisted mode do?
Assisted mode is the default and the right choice for most practices. AI reorganizes your note into eCW's preferred structure and builds the Scribe It commands for you: recognized headings, per-diagnosis treatment notes, a suggested E/M billing level, order lines built from your plan, and diagnosis wording matched to the official database. Because it rewrites and adds content, review the result before pasting.
What does Mapped mode do?
Mapped mode keeps every sentence of your note word-for-word while AI maps the structure: which block is the HPI, which lines are diagnoses. DeepCura then builds the eCW Scribe commands around your own text. The one thing the AI writes is the ICD-10 code it proposes for each diagnosis line — every proposed code is checked against the official code database before it can appear, and the app flags those lines for your review. An independent verification then compares the result against your note; on any deviation you get your original back unchanged.
Does Mapped mode ever write anything itself?
Yes — exactly one thing, and the app says so instead of hiding it: the proposed ICD-10 code (with its official description) on each diagnosis line. Codes that cannot be verified against the code library or official database are never inserted — the line stays as your text with a notice. Everything else in the output is your own wording, transferred verbatim.
Who should use Mapped mode?
Practices that write normal clinical narrative — SOAP notes, custom headings — and want eCW structure without any rewriting. It is the middle path: Assisted drafts and suggests (most automation, needs the most review), Mapped structures your exact words and proposes codes (review the codes), Lossless changes formatting only (for notes already written in Scribe It format).
What does Lossless mode do?
Lossless mode is an opt-in for power users whose note template already writes eCW Scribe It commands — diagnosis lines, billing lines, order lines. It changes formatting only: every sentence transfers word-for-word while the converter fixes the details that silently break eCW's parser (stray colons, special characters, markdown, heading names) and verifies diagnosis wording against the official database. It never adds clinical text, billing codes, or orders, and it shows a change log of every fix.
Which mode is my account using?
Assisted is the default for eClinicalWorks accounts. Mapped and Lossless are opt-in — switch any time with the mode toggle at the top of the Scribe It window inside DeepCura; your choice is remembered for next time.
Who should use Lossless mode?
Practices whose DeepCura note template is already built to output Scribe It format — the note itself contains ICD diagnosis lines, Add EM/CPT billing lines, or Order lines. For those notes, Lossless is a final safety pass: it guarantees nothing is rewritten or invented, cleans up the characters and colons that break eCW's parser, and hands you a verified change log. If your notes are plain narrative without those command lines, use Assisted or Mapped.
Why did eCW say “no recognized Scribe commands”?
That message means the text you pasted contained none of the special command lines eCW looks for. It usually means Lossless mode ran on a plain narrative note — Lossless never invents commands that are not in your note. Switch the toggle to Assisted or Mapped and re-generate: both build the commands for you (Mapped does it without rewriting your sentences).
Why did I get my original note back with a warning?
That is the safety check working — Lossless and Mapped both have one. After converting, DeepCura independently compares the result against your original note. If any change is found that is not on the approved list, the converter refuses to release the result and shows your original note unchanged, along with the reason. Your note is never silently rewritten.
Will Lossless mode ever change my wording?
Your clinical sentences transfer word-for-word. There is one disclosed exception: the short description on a diagnosis line may be adjusted to the exact wording eCW's database expects, because eCW silently rejects diagnoses whose descriptions do not match. When that happens, the change log shows the before and after so you can review it.
Why does Assisted mode add a billing code?
Assisted mode is designed to suggest an E/M level based on the visit time and complexity documented in your note — it is a suggestion for you to review, not a final decision. Lossless mode never adds a billing code; it only carries over codes you already wrote in the note yourself.
Can I switch between the three modes?
Yes, on any note. Flip the toggle at the top of the Scribe It window and press Re-generate. Your latest choice is saved as the default for future conversions.
Related Resources
AI Scribe for eClinicalWorks
The full guide to DeepCura + eCW: pre-charting, the Scribe It engine, and native API structured-data automation.
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Ambient documentation, customizable templates, and bidirectional EHR write-back — the full platform tour.
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References
- eClinicalWorks, “eClinicalWorks EHR,” eclinicalworks.com (Scribe It is a feature of the eCW progress note editor). Accessed 2026-08-25.
- U.S. Department of Health & Human Services, “HIPAA Privacy Rule,” HHS.gov. hhs.gov/hipaa
- CMS, “Evaluation and Management Services Guide,” cms.gov. cms.gov
- DeepCura Help Center, deepcura.zendesk.com. deepcura.zendesk.com
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