Speak a client note and the words appear on the machine in front of you. The speech model ships inside the download, so the audio is never uploaded to anybody, which is the one thing a transcription service cannot offer somebody who works in confidence. Around it sits the rest of a practice: your clients, your week, and a written record encrypted with a passphrase only you know. The application makes no network requests of any kind, and it costs fifteen dollars once.
One payment. No subscription, no account, no per client pricing, no renewal.
Three speech models ship inside the download, so you can trade speed against accuracy without connecting to anything. Session audio goes to a process on your computer, comes back as text, and is discarded.
Not a setting you can leave switched on. There is no code in the application that opens a network connection, and the build refuses to compile if any is added.
AES-256. The key is derived from your passphrase and nothing else, so a stolen laptop is a stolen brick without it.
No subscription, no account, no per client fee. There is no meter to raise later and nobody who can change the terms.
Four things and no more: the people you see, the appointments you keep, the notes you write, and the documents you attach. Everything else a practice management subscription sells you is deliberately absent, and the price reflects that.
This is the part no cloud product can copy honestly. Otter, Rev, Word dictation and every other transcription service works by uploading your audio to somebody else. You cannot do that with a session, which is why most practitioners who would benefit most from dictation do not use it at all.
Session Notes ships three speech models inside the application. When you dictate, the audio goes to a process on your own computer, comes back as text, and is discarded. It is never written to disk and there is nowhere for it to be sent.
A note takes a few seconds to transcribe, faster than it took to say. You can send the window to a small strip in the corner of the screen while you talk, the way a screen recorder does, so you can look at something else without wondering whether it is still listening. That strip deliberately carries no name and no clinical detail, because it floats above whatever else is on screen.
If you have an accent that transcription software usually mangles, this is the part that matters. There is no accent setting here, because no such thing exists: one model covers every English accent and the only thing that changes is how much of it the model can hold on to. So the application ships three, from a fast one that is fine on clear speech in a quiet room to a slow one that gets difficult audio right, and you pick. They are all in the download and none of them needs a connection.
Speech to text gets names, numbers and the word "not" wrong, and those are exactly the words that matter in a clinical record. A dictated note is marked as an unchecked draft until you edit it. Read it through every time. Anybody who tells you their transcription is accurate enough to sign unread is selling something.
Pick yours on the first screen. The application changes the words it uses, the note format it starts you in, the default length of an appointment, and the extra fields it offers. It is the same product underneath: one way of storing a person, a date and what you wrote about it.
If yours is not on the list, choose Something else. Nothing is missing, you just keep the neutral words.
The honest comparison, including the places where the subscription wins. If you bill insurance electronically, take card payments through your notes software, or need a client portal, the cloud product is doing work this does not do and you should keep it.
| Feature | Paper or Word | Cloud practice software | Session Notes |
|---|---|---|---|
| Notes stay on your own machine | Yes | NoOn their servers, by design | Yes |
| Encrypted at rest with a key only you hold | No | PartlyEncrypted, but they hold the keys | Yes |
| Searchable across every note | No | Yes | Yes |
| Dictation without uploading the audio | No | No | Yes |
| Works with no internet connection | Yes | No | Yes |
| Price stays where it started | Yes | NoRaised for existing customers | Yes |
| Keeps working if the maker disappears | Yes | No | Yes |
| Insurance claim submission | No | Yes | NoNot built and not planned |
| Card payments and client portal | No | Yes | NoNeeds a server, so no |
| Reaches you on your phone | Partly | Yes | NoOne Windows computer |
All of these are deliberate. Most of them follow directly from the notes never leaving your computer, and none of them are going to change in version 1.
Practice management subscriptions for solo practitioners run from about 50 to 100 dollars a month, plus a percentage of every card payment and a fee per claim. This is fifteen dollars, once, and then nothing.
A major version 2 with substantial new work would be a new purchase, and it would be optional. That is said here rather than discovered later, because a perpetual licence with unlimited free work behind it is how small software companies quietly die, and a product that dies is worse for you than one that charges again in three years.