How documentation works in Rivet

Rivet has three practitioner-authored note templates: a SOAP note, a DAP note, and a treatment plan. You open them from the same Clinical templates ▾ button as PHQ-9, GAD-7, or any clinical worksheet. They render inside the session, fill from the templates you’ve already used, and save automatically as a draft on the client’s record while you work. When the session ends, the note stays. It lives on the client’s record as an unsigned draft until you’re ready to sign it. Signing locks the note; any later correction is an append-only addendum — the original entry stays visible, the correction is marked as such. That’s the shape colleges expect: an immutable record with a visible correction trail.

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The three templates

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SOAP note

Four sections — Subjective, Objective, Assessment, Plan. The clinical documentation format that originated in problem-oriented medical records and crossed over into mental-health practice. Common in psychiatry, hospital-based therapy, and any practice that grew up in a medically-flavoured chart.

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DAP note

Three sections — Data, Assessment, Plan. Collapses Subjective + Objective into one combined Data section. Common in psychology, counselling, and social-work practice where the Subjective/Objective split feels artificial. See SOAP vs DAP for the detailed comparison.

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Treatment plan

Six sections — Presenting concern, Treatment goals, Objectives, Planned interventions, Progress measures, Review schedule. Authored once at the start of treatment, then revisited at review points. Same practitioner-private posture as the session notes — you export it to your EHR when you’re done.

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What “practitioner-private” actually means

The note template runs separately from client-fillable templates. When you open it:

• Nothing is sent to your client’s device. Your client’s browser literally doesn’t know you’ve opened a note. There’s no overlay, no notification, no flicker on their side.
• No keystrokes are synced anywhere. Client-fillable templates send a snapshot of every keystroke so your live preview updates as the client types. Practitioner-private notes skip that path entirely — you’re typing into your own browser, so there’s nothing to sync.
• Saved to the client’s record, not to the session transcript. The note content is yours — stored against the client’s record, accessible between sessions, not visible to anyone else and not part of any session recording or client-facing view.
• Audit trail includes the note. Rivet records when you opened a SOAP or DAP template, in which session, when you signed it, and any addenda added afterward. The content is part of that record.

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Getting the note out

Once the note is saved — signed or still a draft — there are three ways to get it into your practice-management software:

• Copy for Jane — copies the note as plain text, formatted for pasting into a Jane chart note or similar free-text field.
• PDF — downloads the note as a PDF you can attach to a visit record.
• Client export — generates a full clinical-record document for the client: all notes (signed or draft, each labeled clearly), all completed assessment Q&A and scores, with a date-range filter. Useful for referrals, clinical reviews, or your own records.

Because Rivet is the session layer — not a replacement for your system of record — the handoff into Jane, Owl, or your paper chart is the point. See Getting notes out for the step-by-step.

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Why this matters

Privacy. A 50-minute therapy session is among the most sensitive PHI surfaces in healthcare. Your note content is stored on Canadian infrastructure, designed to be consistent with PHIPA/PIPEDA, accessible only to you and your practice. It’s not used to train any model, not surfaced to any third party, not retained beyond what you control. Clarity. When you paste a note into Jane, Owl, or your paper chart, you know exactly what’s in it — because you authored it. There’s no “AI generated this part, then I edited it” provenance question. The chart entry is your clinical judgment, with the structured template-driven data (PHQ-9 score, SUDS curve, thought record) as supporting context that auto-filled where it fit. Control. The structured data is captured in the templates — scores, target IDs, SUDS readings, worksheet content. The note is your interpretation of that data. Rivet’s job is to put the structured data in your hands; your job is the formulation, the plan, the clinical voice. That’s the line we drew, and it’s the line you reinforce every time you author a note here.

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Where the note fits in the session flow

A practitioner-private note can be open at the same time as a client-fillable template. They live in parallel — the client sees the PHQ-9 overlay on their device, you see the SOAP note overlay on yours, and the two don’t bleed into each other. When you minimize the SOAP overlay to take a break, the in-progress draft is saved. When you reopen it, the partial draft is still there. When the call ends, the note remains on the client’s record as an unsigned draft. The client list shows a count of unsigned notes so you can return to them between sessions. See Progress notes for the full lifecycle — draft, sign, addendum. The session-summary export — covered in Exporting notes — bundles your notes with every other completed template into a single PDF. Practitioner- authored notes lead the summary; screening + worksheet content follows as appendices. That ordering matches how clinical charts read: the practitioner’s note is the entry; the templates are evidence.

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