Warning

Phlox is an experimental project. Please read the Usage Warning section carefully before proceeding.

Phlox is a free, open-source, AI scribe with a built-in patient management system and agentic AI capabilities. It's designed as a local-first alternative to SaaS medical scribes that you can run on your own hardware.

Key Features

• 🔒 100% Local & Private: Runs entirely on your machine with no third-party services - all data stays local.
• 🎤 Ambient Note Generation Automatically generate structured clinical notes with customizable templates.
• 💡 Adaptive Refinement: Outputs improve the more you use it; Phlox learns from your previous notes.
• 📝 Flexible Template System: Including automated template generation from example notes you provide.
• 🤖 AI-agent: Your local assistant with access to literature in your own local knowledge base.
• 🔌 MCP Server Support: Connect external tool servers to give your agent new capabilties.
• ✅ Task Manager: Parse clinical plans into to-do lists to keep up-to-date with your outstanding tasks.
• ✉️ Correspondence Generation: One-click generation of patient letters based on clinical notes.
• 📄 Document Processing: Fill-in forms, extract demographics, and more using local Vision Language Models.

Getting Started

Desktop App

Pre-built Apple Silicon (macOS) binaries and Flatpaks (Linux - Vulkan) are available from GitHub Releases.

The desktop app comes bundled with both transcription and LLM inference engines. Models can be downloaded from within the application.

Docker/Podman

Pre-built images are available from GitHub Container Registry:

docker pull ghcr.io/bloodworks-io/phlox:latest

Minimal docker-compose.yml for the pre-built image:

services:
  phlox:
    image: ghcr.io/bloodworks-io/phlox:latest
    container_name: phlox
    ports:
      - "5000:5000"  # Use "127.0.0.1:5000:5000" if not behind a reverse proxy
    environment:
      - DB_ENCRYPTION_KEY=          # Required: generate a strong random key
      - TZ=                         # e.g. America/New_York
      - ALLOWED_ORIGINS=*           # Or your origin, e.g. https://phlox.example.com
      # Optional — proxy auth + rate limiting (see https://phlox.bloodworks.io/docs/setup#critical-security-warning)
      # - PROXY_AUTH_ENABLED=true
      # - PROXY_AUTH_USER_HEADER=X-Forwarded-User
      # - PROXY_AUTH_ALLOWED_USERS=user1,user2
      # - RATE_LIMIT_ENABLED=true
    volumes:
      - ./data:/usr/src/app/data    # Persistent data (database, vectors)
      - ./logs:/usr/src/app/logs    # Optional: persist logs

Then docker compose up -d. See the Setup guide for full instructions including .env configuration.

The Docker image does not have any inference or transcription capability built-in. OpenAI compatible endpoints are required for transcription and note generation.

Note quality benefits from speaker diarization. parakeet-diarized provides an easy to use Docker container that serves a diarization-enabled OpenAI Whisper-comptaible endpoint.

Architecture

Ambient scribing is a relatively simple task for LLMs. In particular, large frontier models are very adept at one-shotting a decent note given a transcript and a style example. Smaller models capable of running on consumer hardware are able to summarise medical consultations reasonably well; however, they often struggle with replicating specific note styles.

Phlox approaches this by chunking transcripts per template field and constraining outputs to structured JSON. After getting the model to make a targeted summary for a given field, a dedicated refinement pass then allows the model to focus on matching output to the users personal style example. Finally an adaptive-refinement feedback loop allows the model to improve note quality as it is used more.

Technical Stack

• Frontend: Chakra UI (React)
• Backend: FastAPI (Python)
• Database: SQLCipher
• Vector DB: sqlite-vec
• Desktop Wrapper: Tauri
• LLM Backend: Any OpenAI-compatible endpoint (incl. Ollama), or bundled llama.cpp server
• Transcription: Any OpenAI Whisper-compatible endpoint or bundled parakeet.cpp server

Usage Warning

Phlox is an experimental project intended for educational and personal use only. It is not a certified medical device, should NOT be used for clinical decision-making, and is not suitable for production deployment as provided in this repo. If you intend to use it in a clinical setting, you are responsible for ensuring compliance with local applicable regulations (HIPAA, GDPR, TGA, etc.)

AI outputs can be unreliable. Always verify AI-generated content and use professional clinical judgment. The application displays a disclaimer on startup with full details.

License

MIT License

Third-party models, runtimes, and library attributions: Credits.

Contributing

Contributing Guidelines

This repo has made extensive use of AI development tools. All AI generated code has been vetted by me and I ask that any contributors do the same prior to submitting PRs.