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Your First AI-Assisted Findings-Only Merge

This guide walks you through your first AI-assisted merge — dictating findings into the PowerScribe findings-only panel and using Presto to route them into the correct template fields and generate an impression. By the end, you’ll have a completed report with structured findings and an auto-generated impression.

Step 1: Confirm Presto is connected to PowerScribe

Section titled “Step 1: Confirm Presto is connected to PowerScribe”

With Presto open and PowerScribe 360 running, check the bottom status bar of the Presto widget. You should see “Ready” on the left and “PowerScribe360” with a link icon on the right. This confirms Presto is connected and listening.

The top-right corner of the widget will show “None” until you open a report.

Presto widget showing No findings available and Ready status before a report is opened

To create a test report, go to the Quick Search panel on the left side of PowerScribe 360. Enter a test accession number — any combination of letters and numbers will work (e.g., abcd12345) — and click Search.

Quick Search panel with a test accession number entered

A Create Temporary Order dialog will appear. Select any procedure code from the list and click OK.

Create Temporary Order dialog with procedure code list

Step 3: Verify Presto is tracking your report

Section titled “Step 3: Verify Presto is tracking your report”

A blank draft report will open in PowerScribe. Check that the accession number shown in PowerScribe matches the one displayed in the top-right corner of the Presto widget. This confirms Presto is tracking the active report.

Blank PowerScribe report alongside Presto widget showing matching accession number

Choose a template for your test. Pick one with several fields so you can see how Presto routes findings into the right places. Any structured template will work — Presto handles templates with or without fields, structured or prose.

In this example, we’re using a CT Abdomen and Pelvis template.

PowerScribe report with CT Abdomen and Pelvis template loaded, Fields tab visible on the left

Click the Fields tab on the left side of PowerScribe. At the bottom of the fields list, click Enter Findings Mode.

A Findings Only panel will appear below the report. This is where you’ll dictate or type the findings you want Presto to merge.

PowerScribe with Findings Only panel open and empty, ready for input

Dictate or type your findings into the Findings Only panel. You don’t need any special formatting — no bullet points, punctuation, or line breaks required. Just describe what you see, the way you normally would.

Both sentence-form prose and terse keyword-style dictation work.

For this example:

Right renal cyst status post cholecystectomy bibasilar atelectasis 4.1 cm AAA with moderate mural thrombus

Findings Only panel with sample findings entered

Click the → (right arrow) button in the bottom-right corner of the Presto widget. You can also press Ctrl+M.

Presto widget with arrow pointing to the merge button

The status bar in the Presto widget will update as the merge progresses: ExtractingMergingApplying. This typically takes a few seconds. When complete, the status bar returns to Ready.

After the merge, your PowerScribe report will have:

  • Findings routed into the correct template fields — Presto reads your template structure and places each finding where it belongs.
  • An automatically generated impression — based on your findings and template context.
  • Merged text highlighted in bold — so you can see exactly what Presto placed. (This can be turned off in the web portal settings.)

PowerScribe report after merge showing findings placed in template fields and auto-generated impression

All fields remain fully editable after the merge. You can tab through fields, use picklists, dictate corrections, and edit freely — your normal PowerScribe workflow is unchanged.

What about Auto Merge? You may notice an Auto Merge toggle in the Presto widget. This is used in enterprise deployments where a VLM provides findings automatically — when enabled, findings are merged as soon as you open a report. It does not apply to the findings-only workflow described in this guide.