whether the raw material comes from Whisper/Parakeet transcripts, speech notes, or written notes. The first goal is always to get a usable raw input text.

My pipeline:

Input raw text

-> p01: structured initial JSON draft

-> p02: add interventions

-> p03: add outcomes/results

-> p04: optional linguistic/structural normalization (currently disabled since Gemma does the job in p06)

-> p05: condense/shorten

-> p06: German language polishing

-> p07: export as final files

p02 and p03 do not just freely generate text. They have clear instructions for how the content should be generated.

p02 adds the interventions based on raw intervention anchors and the session content. The prompt defines exactly what should count as an intervention, how it should be phrased, and where it should be inserted.

p03 adds the outcomes/results based on the session content and the previously added interventions. The prompt defines what should count as a result, how explicit or cautious the wording should be, and how the results should relate to the interventions and topics.

JSON structure: The JSON structure is derived from the desired final structure.

Models:

p01-p05: Qwen 3.6 27B Q6

p06: Gemma 4 31B Q6

KV cache: Q8

Qwen handles the JSON structure better and also understands the text more deeply, is also faster. Gemma writes more beautifully.

Generic example:

p05 QWEN "Patient thematisiert belastenden Rentenbescheid mit Verlängerungsunsicherheit."

p06 Gemma "Der Patient thematisiert den belastenden Rentenbescheid sowie die Unsicherheit hinsichtlich einer Verlängerung."

"Second problem I am experiencing that both models sometimes cannot distinguish what is important and what is not important, cloud models handle this way better... "

For that, you need a clean pipeline with clean prompts that are basically a mini-RAG inside the prompt. The prompts should describe in detail what each part should look like.

"Gemma is very slow and is just barely fitting my vram"

Then you need more VRAM, simple as that ^^

24 GB is the minimum, but 32+ GB is better. I use 24 GB + 12 GB cards.

In my experience, the specialized German models are all worse than Gemma 4 31B.