Medical Dictation Software for Doctors
That Can Run on Your Own Computer
Contextli is medical dictation software for physicians who chart in the minutes between patients. You speak the history, the exam and the plan, and it types a structured note into whatever field your cursor is in. Switch on the on-device setting and the recording and the text are processed on your computer, so no company receives them, us included. It is not the right tool for every practice, and this page says where it falls short.
Last updated September 28, 2026
Where Your Patients' Words Go
Out of the box, Contextli does its medical speech to text in the cloud, which is fastest. For patient notes, change two settings, Transcription and AI Processing, to Your Device. With both set, the recording and the finished note stay on your computer. The steps are further down this page.
Structured Notes
The Medical Visit Note context turns a spoken recap into Patient, Subjective, Objective, Assessment and Plan, and keeps every dose and figure exactly as you said it. To format one note without installing anything, try the free SOAP note generator.
Your Terms, Spelled Right
Add drug names, eponyms and the names of the specialists you refer to into the Dictionary once. After that they come out spelled the way you spell them.
No Third Party in the Loop
In on-device mode no audio or note text is transmitted, so there is no dictation vendor holding patient data and no agreement to negotiate with one. Your own privacy obligations still apply.
Built for Clinical Workflows
Speak the way you would dictate to a colleague. The note comes out in the format you chose.
Patient Encounter Notes
Dictate the visit on the way to the next exam room:
- Chief complaint and history of present illness
- Physical examination findings
- Assessment, plus the plan as a list of the orders you state
In on-device mode, every clinical detail is processed on your computer.
Referral Letters
Letters to specialists, in the same voice as your notes:
- Specialist referrals with the relevant history
- Consultation requests with a clear clinical question
- Transfer summaries for care coordination
In on-device mode, the letter stays on your computer until you send it.
Procedure Documentation
Record procedures while the details are fresh:
- Surgical and procedural notes
- Post-procedure instructions
- Complications and findings
In on-device mode, procedure details are never uploaded.
Patient Instructions
Plain-language material for patients:
- Discharge instructions in plain language
- Treatment plan summaries for patients
- Follow-up care instructions
In on-device mode, instructions are written on your computer and go nowhere until you send them.
What You Say, and What Gets Typed
Medical Visit Note context
The example that ships with the context, dictated after a follow-up visit
You say:
Note on the patient I just saw, 54 year old male, here for follow up on his hypertension. He says he's been taking the lisinopril regularly, no side effects, but admits he hasn't been great with the low-sodium diet. Blood pressure today was 142 over 90, still a bit high. Heart and lungs clear on exam. Plan is to increase the lisinopril to 20 milligrams, reinforce the diet, and recheck in four weeks. I also want to order a basic metabolic panel to check his kidney function given the dose change.
Contextli types:
Visit note
Patient: 54M, follow-up for hypertension
Subjective: Taking lisinopril regularly, no side effects; admits poor adherence to low-sodium diet
Objective: BP 142/90 (still elevated); heart and lungs clear on exam
Assessment: Hypertension, suboptimally controlled
Plan: Increase lisinopril to 20 mg; reinforce low-sodium diet; order basic metabolic panel (kidney function, given dose change); recheck in 4 weeks
The context is told to keep figures and doses exactly as spoken and never to add a diagnosis, finding or order you did not state. Read every note before you sign it. Open the Medical Visit Note context
Set It Up So Nothing Leaves Your Computer
Six steps. Two of them are the settings that decide where patient data goes.
- 1
Install Contextli
Download the desktop app for Mac, Windows or Linux and start the 7-day trial. Your Device mode comes with the Pro plans; the pricing page shows what each plan includes.
- 2
Set Transcription to Your Device
Open Data Control in the app. Under Transcription, choose Your Device and download a speech model, which takes 1 to 3 GB of disk space.
- 3
- 4
Leave cloud sync off
Sync is off by default. With it off, your transcripts are kept only on this computer.
- 5
Add your context and your words
Add the Medical Visit Note context, then put your drug names and specialist names in the Dictionary.
- 6
Dictate between patients
Put your cursor in the note field, press Option+Space on a Mac or Ctrl+Space on Windows and Linux, speak, and press it again. The note is pasted where your cursor is. If your EHR runs inside a remote desktop such as Citrix, test one paste before you rely on it.
Why On-Device Mode Matters for a Small Practice
Cloud dictation brings a vendor into your data path. On-device mode keeps it out.
No Vendor to Vet
A cloud service that processes patient information needs a Business Associate Agreement with you. In on-device mode Contextli sends no audio or note text, so there is no dictation vendor in the picture to sign one.
Nothing Stored on Our Side
With Your Device mode on and cloud sync off, our servers hold no copy of your notes, so a breach on our side could not expose them.
A Clear Answer About Where Data Goes
If a colleague asks how you dictate, the answer is easy to check: the speech model runs on this computer and the note is pasted into the chart. That describes where the data goes. It is not a compliance review, and your practice's own security rules still apply to the computer itself.
What Contextli Does Not Do
Clinicians usually check three things first: HIPAA, a signed BAA, and EHR integration. Here is where Contextli stands on each, and on a few more.
- It does not sign Business Associate Agreements and makes no HIPAA compliance claim. The on-device mode is a way to keep patient data off every server, not a certification. Security reviews for an organization go to enterprise@contextli.com.
- It has no integration with Epic, Oracle Cerner or athenahealth. It pastes text into the field you are in. It cannot read the chart, pull results or place orders.
- It is not an ambient scribe. It does not listen to the visit; you dictate your recap afterwards.
- It uses general speech models, not a medical vocabulary like Dragon Medical. Unusual terms need the Dictionary, and every note needs a read before you sign it.
- The default mode is cloud. Keeping everything on your computer takes the setup above, including a local AI app for the formatting step.
- It is not a medical device and does not make clinical decisions.
Which Medical Dictation Software Fits Your Practice
A medical dictation app, an ambient scribe and free speech to text each suit a different practice. Start from where you work.
| If you are | Look at | Why |
|---|---|---|
| In a hospital or health system on Epic, Oracle Cerner or MEDITECH | Dragon Medical One (Microsoft) | Cloud speech recognition built for clinical documentation, with integrations Microsoft lists (September 2026) for Epic Haiku, Canto and Rover, Oracle Cerner PowerChart Touch and MEDITECH Expanse. Licensed through your organization; Microsoft does not publish a price. |
| Hoping to stop dictating altogether | An ambient AI scribe, such as Microsoft Dragon Copilot, Freed or Abridge | It listens to the conversation during the visit and drafts the note for you to review. That is a different job from dictation, with a different privacy trade-off, because the whole conversation is recorded. |
| Wanting your phone as the microphone for any computer | Mobius Conveyor | An iPhone and iPad app that dictates into any computer and EMR, sold on month-to-month subscriptions according to Mobius. |
| After something free that is already installed | Windows voice typing (Win+H) or Apple Dictation | No cost and no setup. General vocabulary and no clinical formatting. On a Mac, Keyboard settings show whether your dictation is processed on the device. Our Windows voice to text comparison covers the free options in detail. |
| A solo or small-practice physician who wants formatted notes and the option to keep everything on your own computer | Contextli | Structured notes from a spoken recap, your own terms in the Dictionary, and an on-device mode. No BAA and no EHR integration. |
Voice note contexts for doctors
Ready-made contexts built for how doctors work. Copy one, add it to Contextli, and start turning rambles into clean, structured notes.
Medical Visit Note
Speak patient observations and get a structured clinical visit note.
Med Management Note
After a short med-management visit, speak a DRAFT note to review, not the same scaffolding retyped.
Code Recap Note
Right after a code, speak the timeline into a DRAFT sequence of events and times.
Triage Note
Speak the chief complaint and your read into a DRAFT triage snapshot with acuity rationale.
Medical Dictation Questions
Try It on Your Next Five Notes
Set up Your Device mode, add the Medical Visit Note context, and dictate your next five notes between patients. The trial lasts 7 days.