AI scribes that record doctor visits are spreading fast. Louisiana and Rhode Island now require patient notice, and HIPAA does not.
If your doctor is typing less during your visit, an AI scribe may be recording the conversation. Louisiana and Rhode Island now have laws about that. In Louisiana, the doctor must say out loud that the visit is being recorded for AI. In Rhode Island, patients must be notified, and the doctor must check the AI-written note for accuracy.
An AI scribe uses a microphone in the exam room. It records the talk between doctor and patient, writes a draft note from the audio and hands it to the doctor to review before it goes into the medical record. The doctor does not have to type, but the visit becomes a recording.
Use is growing quickly. Abridge, a major scribe maker, is live in more than 300 health systems and supports upward of 100 million clinical conversations a year, Fortune reported in June. Microsoft said more than 100,000 clinicians use its Dragon Copilot scribe. Cleveland Clinic used Ambience Healthcare's scribe in more than 3.5 million patient encounters in its first year.
Doctors say the paperwork is heavy. In a Doximity survey of 3,151 physicians, use of ambient listening and AI scribes rose to 29% from 20% between two survey waves. Three-quarters of physicians who use AI said it has already cut their administrative work.
Louisiana's law took effect Aug. 1. Rhode Island's took effect in June, when it passed. Rhode Island Sen. Pamela Lauria, the bill's sponsor and a nurse practitioner, said patients "want as much transparency as possible."
HIPAA is the federal health privacy law. It does not set a specific patient-notice rule for AI scribes. It does let a hospital use patient information for treatment without your authorization. It also requires transcription vendors to sign an agreement to follow the same privacy rules. So the duty to tell you comes from state laws, and state recording laws can add notice and consent duties of their own.
Hospitals are still working out their own policies. In the Doximity survey, 47% of physicians said the AI decision-making process at their institution is still evolving. Only 8% said it is clear. If you are unsure whether a visit is being recorded, ask the doctor or the front desk before the appointment starts.
If you are not sure whether your doctor is recording the visit for AI, ask, because in some states you must be told first.
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