Terms of Service
These terms govern use of Tributary, a clinical documentation tool operated by Waterway LLC, an Idaho limited liability company. Using Tributary means accepting them.
Who may use Tributary
Tributary is for licensed behavioral health clinicians and the staff of practices that hold an agreement with Waterway. Access is by seat, assigned by an administrator at your practice. Seats are personal — do not share sign-in credentials, and do not let anyone else work under your seat.
Your practice must have a Business Associate Agreement with Waterway before any client information is put into Tributary.
Tributary drafts. You decide.
Everything Tributary produces is a draft. You are responsible for reading, correcting and clinically approving every word before it becomes part of a client's record. Tributary does not practise and cannot exercise clinical judgement.
AI-generated documentation can be wrong in ways that read as plausible. It can omit something that mattered, state something that did not happen, or describe a session in terms you would not have chosen. The clinician who signs the note is accountable for it, exactly as they would be for a note they typed themselves.
Your clinical record lives in your EHR
Tributary is a drafting tool. Your electronic health record system holds the clinical record, and Tributary's contents are working material that we destroy on a schedule. Do not rely on Tributary as a system of record.
Your obligations
- Obtain informed consent from each client before using AI-assisted documentation with them, as your licence and your state require.
- Review and approve all generated content before it enters a record.
- Keep the security of the device and Google account you sign in with, and report a suspected compromise promptly.
- Use Tributary only for your own clients, in your own practice.
- Maintain your own relationship and agreements with your electronic health record vendor. Ours do not replace them.
- Supply an accurate API key for your record system if your practice uses the treatment plan sync, and revoke it with your vendor if your agreement with us ends.
What you may not do
- Share a seat, or use someone else's.
- Attempt to reach another clinician's material, or to probe the service for weaknesses without our written agreement.
- Put information into Tributary that your practice has no right to process.
- Resell or sublicense access.
- Use Tributary where a licensed clinician is not reviewing the output.
Security researchers: write to privacy@waterway.health first. We will not pursue good-faith research conducted under an agreement with us.
Seats, suspension and termination
Your practice administrator assigns and removes seats. A seat may be suspended, which prevents use but destroys nothing, or terminated, which begins a 30-day countdown after which that clinician's material is permanently deleted.
We may suspend a seat without notice if we believe it is being used in a way that endangers client information. We will tell the practice administrator why.
Nothing is exported at termination. Your clinical record is in your health record system; Tributary's contents are working material. Thirty days after a seat is terminated, that clinician's material is destroyed, including all stored versions. Plan accordingly.
Availability
We do not promise uninterrupted service. Tributary depends on third-party services that can fail, and we may take it down for maintenance. If Tributary is unavailable, your documentation obligations are unchanged — which is among the reasons your health record system, and not this tool, holds the record.
Warranties and liability
Tributary is provided as it is. We do not warrant that generated documentation will be accurate, complete, or adequate for any clinical, billing, licensing or legal purpose. We do not warrant that it will meet the requirements of any payer, licensing board or accreditor.
To the extent the law allows, Waterway is not liable for indirect, incidental or consequential damages, or for lost profits, arising from use of Tributary. Our total liability for any claim is limited to the fees your practice paid us in the twelve months before the claim arose.
Nothing here limits liability that cannot be limited by law, and nothing here limits our obligations under a Business Associate Agreement.
Fees
Fees are set in your practice's agreement with Waterway. Non-payment may lead to suspension. Suspension destroys nothing; only termination starts the 30-day countdown.
Changes to these terms
We may change these terms. If a change materially affects your rights or obligations, practices under an active agreement are notified before it takes effect. Continuing to use Tributary after that means accepting the change.
Governing law
These terms are governed by the laws of the State of Idaho, without regard to its conflict of law rules. Disputes are heard in the state or federal courts of Latah County, Idaho.
Contact
support@waterway.health for questions about these terms or about your practice's agreement.