exetazo / oe-module-grapheus

v2.0.3 2026-10-21 03:28 UTC

Requires

• php: >=8.1
• ext-curl: *
• openemr/oe-module-installer-plugin: ^0.1

Conflicts

• openemr/openemr: ~7.0.0

GPL-3.0-or-later

• Exetazo Health

• openemr
• openemr-module
• ai scribe
• ambient documentation
• grapheus
• clinical documentation
• soap note
• medical coding

Published on Packagist.org on 2026-10-21 03:28 UTC

README

Grapheus for OpenEMR

Grapheus by Exetazo is an AI medical scribe built by a practicing physician. This module puts it inside OpenEMR: record the visit, then review a drafted SOAP note, problems, allergies, prescriptions and fee-sheet codes right in the encounter. Clinicians review and sign everything; nothing is sent or billed automatically.

• Website and sign-up: https://scribe.exetazohealth.com
• Support: [e-mail]
• Issues: https://github.com/mikebirkheadmd-maker/oe-module-grapheus/issues

Which version do I need?

Your OpenEMR	Module version	Git branch	Composer
8.x (tested on 8.4.1)	2.x	main	composer require exetazo/oe-module-grapheus:^2.0
7.0.x (tested on 7.0.3)	1.x	openemr-7.0	composer require exetazo/oe-module-grapheus:^1.0

The two editions share features; they differ only where OpenEMR's internals changed between 7.0 and 8.x.

What it does

In every encounter: the "Grapheus" tab (clinicians)

• Connect your Grapheus account in one click. The key is stored encrypted with OpenEMR's CryptoGen.
• Start recording opens a small recorder window (browsers block the microphone inside OpenEMR's frames). Pause any time; it stops on its own after 5 silent minutes or 90 minutes.
• See drafts from this encounter, the Grapheus Chrome extension or the phone (last 14 days).
• Never left without a note. If the note-writing service is busy, Grapheus tries again by itself. If a note still fails, the page shows why, the transcript, and Write this note again. A note written with part of the recording missing says so at the top.
• Write this note again and Delete this draft on every draft.
• The recorder keeps a part that could not be uploaded and sends it again, and a long pause no longer ends the visit.
• Right patient, once. A draft is added only to the patient and encounter the page was showing: if another patient was opened in a second tab, nothing is added. A draft whose label does not match the open chart asks first. A draft cannot be added twice.
• Review and add what you approve:
  • SOAP note (editable before saving)
  • Problems with ICD-10 codes
  • Allergies
  • Prescriptions, entered with request_intent "proposal" and never transmitted
  • Fee-sheet lines with billed = 0, justified by the diagnoses, plus a time statement for time-based billing

Main menu: "Grapheus" (everyone, by permission)

• Set it up like… (administrators): practice and facility, globals, lists, fee schedule, visit types and forms. Every change is proposed, approved, logged and can be undone.
• Show me how to…: step-by-step OpenEMR directions.
• Schedule Molly with Dr Bob at 2:30: the patient is found in OpenEMR's own records and confirmed before anything is booked.
• Authority follows OpenEMR ACLs: administrators can do everything; clinicians and schedulers can do daily tasks and how-to; everyone else gets how-to. An option limits the Assistant to administrators.
• Security settings, passwords and integrations are always blocked.

Install

Option 1: Module Manager / Composer

From the OpenEMR root, as the web server user:

composer require exetazo/oe-module-grapheus:^2.0    # OpenEMR 8.x
composer require exetazo/oe-module-grapheus:^1.0    # OpenEMR 7.0.x

openemr/oe-module-installer-plugin places it in interface/modules/custom_modules/oe-module-grapheus. Then go to Modules > Manage Modules, press Install, then Enable.

Option 2: Git

cd /var/www/localhost/htdocs/openemr/interface/modules/custom_modules
git clone https://github.com/mikebirkheadmd-maker/oe-module-grapheus.git                    # OpenEMR 8.x
# git clone -b openemr-7.0 https://github.com/mikebirkheadmd-maker/oe-module-grapheus.git  # OpenEMR 7.0.x

Then Modules > Manage Modules → Install → Enable, or from the command line as the web user: su -s /bin/sh apache -c "php oe-module-grapheus/install/autoinstall.php"

Option 3: New practice, OpenEMR with Grapheus built in

Download distribution/docker-compose.yml, change the passwords, and run docker compose up -d. It uses ghcr.io/mikebirkheadmd-maker/openemr-with-grapheus; Grapheus installs and enables itself on first start.

Connect

Create an account at https://scribe.exetazohealth.com, then press Connect in any encounter's Grapheus tab.

Subscription

The module is free and open source. Transcription, AI drafting and the Assistant run on the Grapheus service:

• AI scribe: $120 per provider per month, 120 recorded hours included, then $1.50 an hour.
• Grapheus Assistant: $30 per practice per month, 100 requests included, then $0.30 a request, billed to the practice's Grapheus account. Months with no requests are not charged.

Details: https://scribe.exetazohealth.com

Privacy and HIPAA

Grapheus runs on AWS, with AI drafting on Amazon Bedrock under an AWS Business Associate Agreement, so protected health information stays in a HIPAA-eligible environment. Audio is deleted after transcription. Transcripts and drafts are retained for 14 days for clinician review and model-quality evaluation, unless deleted earlier by the user. Practices sign a BAA with Exetazo Health when they sign up.

Support

• Email: [e-mail]
• Bugs and feature requests: https://github.com/mikebirkheadmd-maker/oe-module-grapheus/issues
• Website: https://scribe.exetazohealth.com

License

GPL-3.0-or-later (see LICENSE), the same license as OpenEMR. The Grapheus service the module connects to is a separate, paid product of Exetazo Health.