High Country Behavioral Health: How an AI Scribe Became a Cultural Shift

The Turning Point

High Country Behavioral Health (HCBH) is a non-profit behavioral health agency that provides counseling, psychiatry, crisis services, and case management across some of the most rural regions in Wyoming and Idaho.

In July 2024, HCBH faced a seismic operational shift. Wyoming’s new reimbursement model meant the team had to increase productivity without adding hours or staff. “We had to give time back to our therapists,” recalled CBHO Jared Bingham.

They’d explored AI documentation years earlier, but the technology wasn’t affordable. “One company’s fee was more than what we were paying for our entire EHR,” he said.

Fast forward to 2024, and AI had matured. HCBH reevaluated the market, piloting a few options. One was sleek but prohibitively expensive. Another—bundled with their EHR—was underpowered and clearly an afterthought. Heidi stood out for being responsive, affordable, and relationship-driven.

“Heidi had the options we needed, the right price, and a team that acted like a partner. They were willing to learn with us.”

Notes That Outlast the Workday

Behavioral health documentation is uniquely demanding. Clinicians capture not only what was said, but how: a client’s tone, affect, and progress over time. Before Heidi, notes routinely piled up for days.

Some clinicians were spending Sundays catching up on paperwork, re-living the emotional weight of client trauma while writing.

“You listen to traumatic experiences all week, then have to relive them again as you document. It’s exhausting.”

Beyond burnout, there were structural challenges:

• Inconsistent note tone and completeness
• Workflow bottlenecks across telehealth and in-person sessions
• A mixed tech comfort level among therapists

Building a Rollout That Stuck

Phase 1: Pilot and Template Creation

HCBH began with five to seven therapists representing different specialties and tech comfort levels. Heidi’s implementation lead Will worked closely with them to map their note types and build templates that matched their EHR structure.

“Will met with us, built our templates, and fixed issues the same day.”

They started with three core templates—therapy, case management, supervision—and later added more advanced ones, including:

• Clinical Diagnostic Assessment
• ASAM placement criteria
• An enhanced supervision template

Template creation was collaborative: the team used Heidi’s community library as a base, personalized language to their organization, and iterated live.

“Template work seemed intimidating, but Heidi made it easy. We borrowed, personalized, and iterated.”

Phase 2: Company-Wide Training

At their weekly Wednesday meeting, Heidi trained the entire provider team. Early adopters left once comfortable, while new users stayed for hands-on support. Skeptics became converts within days.

“We had people who said, ‘I don’t believe in AI, it’s the Terminator.’ But they tried it, and almost every one came back saying, ‘Dang it, this is better.’”

A Typical Day with Heidi

When a client session starts, the therapist opens Heidi, selects the relevant template, and begins the conversation. Heidi runs in the background—no typing, no toggling screens.

After the session, the therapist reviews the note, makes light edits, and copies it into the EHR.

One session stood out for Jared personally. During a Clinical Diagnostic Assessment, a task that usually took an hour, he finished in 30 minutes—then built a 15-minute treatment plan and still had time for an actual therapy segment.

“For the first time, the client didn’t just leave with an assessment—they left with something to practice that day.”

Beyond Productivity

1. Time Back, Without Sacrificing Quality

The math was simple.

• Average note time dropped from 5–6 minutes to about 2 minutes
• 4 minutes saved per session
• Roughly 30 minutes saved per day, 2 hours per week

More importantly, therapists finished notes same day, instead of stacking them for the weekend.

“We had one clinician who used to come in on Sundays to finish her notes. She doesn’t anymore.”

2. Notes That Sound Like a Clinician, Not a Computer

Heidi’s natural language generation improved tone and professionalism across the board.

“AI does a better job of sounding like a therapist than some of our therapists. It makes me look smarter.”

Clinicians also discovered something deeper—Heidi reflected back their own therapeutic style.The system’s structured prompts (e.g., evidence-based model used) helped therapists see which modalities they naturally employed—motivational interviewing, CBT, internal family systems—and apply them with more intention.

3. Lower Cognitive Load, Better Presence

Heidi reduced cognitive and emotional fatigue. Clinicians could focus fully on the client, knowing documentation was handled.

“I don’t have to relive trauma when typing notes. Reading what Heidi captured is different—it gives distance and peace of mind.”

4. Rapid Cultural Adoption

The early skeptics turned into advocates. In leadership feedback, one phrase kept repeating:

“I love Heidi. Thank you for bringing this in.”

Removing Heidi now, Jared joked, “would cause an uprising.”

Lessons from the Rollout

1. Pilot small, but with intent. Choose a representative mix of tech-comfort levels to surface real friction early.

2. Meet people where they already gather. Use existing meeting cadences—don’t create new ones.

3. Let confidence spread peer-to-peer. Clinicians trust other clinicians more than they trust corporate training.

4. Start with fewer templates, but get them right. Three excellent templates beat a dozen mediocre ones.

5. Revisit training after 60 days. Once clinicians have real usage under their belt, retraining unlocks overlooked features.

What’s Next

HCBH continues expanding its use of Heidi across therapy and prescriber workflows. Next on Jared’s list: exploring underused features like diagnosis suggestions and creative applications in therapy, such as using Heidi’s Ask function to build patient-specific prompts.

“We’re still discovering what it can do. The key is keeping curiosity alive.”

Jared’s Advice to Other Leaders

“There are no regrets. This has been 100% positive. If you’re still making your therapists write their own notes, do them a favor—move to something like this.”