An ambient AI scribe pilot can affect more than how a clinician writes a note. It may introduce new recordings, transcripts, integrations, vendor relationships, and review steps into a clinical workflow. Before patient information is involved, ask questions to ask ambient AI scribe vendors that help your practice understand the entire process, not just the generated note.
Use the answers to decide whether the tool is appropriate for your setting, what safeguards need to be in place, and how you will judge the pilot. Ask vendors to provide important answers in writing, then review them with the people responsible for privacy, security, clinical operations, and your EHR.
Map what happens to every piece of visit data
“The note is deleted” may not explain what happens to the audio, transcript, draft, backups, or data shared with service providers. Ask the vendor to describe the data lifecycle from the start of a visit through the end of the pilot.
- What data does the tool create or receive? Ask about live audio, temporary files, transcripts, generated drafts, signed notes, metadata, and support records.
- Where is each type stored? Ask which systems and locations hold the information, who can access it, and whether storage differs for recordings, transcripts, and notes.
- How long is each item retained? Ask for the retention schedule, including what happens to backups and temporary files.
- How can deletion be verified? Ask what happens when the practice ends the pilot, requests removal, or stops using the service. Clarify whether the vendor can provide written confirmation and whether data can be returned or exported first.
- Is patient information used to train or improve models? Ask whether this applies to audio, transcripts, prompts, or generated notes. If the vendor offers an opt-out, find out how it is enabled and documented.
Make sure the vendor distinguishes between data that is deleted, data retained for an agreed purpose, and data that may remain in backups for a period. Do not rely on a general statement about privacy if it does not specify the data types and processes covered.
Request evidence of security and clear contract terms
Ask what security documentation the vendor can provide and what commitments will appear in the contract. A verbal assurance may not answer how access is controlled or what the vendor will do if an incident affects your information.
- Will the vendor sign a business associate agreement before protected health information is processed? Ask who signs it, which services it covers, and whether the same commitments apply to subcontractors.
- Which subcontractors and model providers may handle data? Request their roles, the information they can access, and the agreements governing that access. Ask how the vendor will tell you about changes.
- What security materials can you review? Ask for relevant security documentation, a description of access controls, and information about audit logging. Clarify how access is granted, reviewed, and removed.
- How are incidents reported? Ask who will contact your practice, how the vendor investigates, and what notification commitments are written into the agreement.
- What happens when the pilot ends? Confirm the process for returning or exporting data, destroying remaining copies, and documenting completion.
A business associate agreement is an important item to discuss, but do not treat its existence alone as proof that every operational or security question is resolved. Have the appropriate privacy and security stakeholders review the agreement, supporting materials, and actual workflow. For more background on organizing safeguards, see Zevonix’s guide to protecting patient data and its overview of compliance considerations for medical practices.
Test the EHR connection and clinician workflow
An integration needs to work safely in the practice’s actual environment. Ask the vendor to demonstrate the workflow with the EHR configuration and roles your clinicians will use, and agree on what happens when the connection is incomplete or unavailable.
- How does the tool identify the patient and visit? Ask how it prevents a note from being attached to the wrong chart and what the clinician sees if patient matching fails or information is ambiguous.
- Where does the generated note go? Confirm whether it appears as a draft, how it is associated with the visit, and whether it can be saved or signed without clinician review.
- Can clinicians review and edit every note before it is saved or signed? Ask how corrections are made, whether edits are captured, and how the final author and approval are represented in the workflow.
- What happens during an outage or failed integration? Ask how the clinician can continue documenting, whether any information queues for later transfer, and how staff can check that a note was not lost or duplicated.
- What support is available during the pilot? Identify how staff report issues, who helps troubleshoot, and how workflow changes are communicated.
Use a test environment where available, and define who is responsible for checking the EHR configuration before the pilot begins. A network and workflow review can help uncover operational dependencies; Zevonix’s article on assessing a medical practice network offers related planning context.
Agree on patient communication and clinical safeguards
Ask how patients will be told that an ambient scribe is being used, how they can raise concerns, and what staff should do if someone does not want the encounter recorded. Establish a process that fits your organization’s policies and have the appropriate compliance and clinical leaders review it. Do not assume the vendor’s default notice or consent workflow fits your practice.
Also ask what happens if the audio is unclear, the generated note contains a suspected error, or the tool performs differently for a specialty or visit type. The tool should support clinician work, not replace clinical judgment. The AMA’s principles for augmented intelligence provide additional context for considering physician involvement in AI use.
Define pilot measures and pause conditions
Set expectations before the first live encounter. Choose measures that reflect both documentation quality and the work required to use the tool. Depending on the practice, that could include how often clinicians correct notes, the time spent reviewing them, failed patient matches, integration issues, patient opt-outs, and staff feedback.
Decide how the pilot will account for differences among specialties, visit types, and patient populations. Specify who reviews results, how issues are escalated, and what kinds of problems require pausing use while the practice investigates. The SAFER Guides can be useful context when considering the safety of health IT workflows.
Keep the pilot limited to the agreed purpose and workflow. If the vendor changes its data practices, subprocessors, integration, or model, ask how the practice will be notified and whether the change requires a fresh review.
Make the decision from documented answers
Before launch, bring together the vendor’s written data lifecycle, security materials, agreement terms, integration plan, patient communication process, and pilot measures. Unclear answers are issues to resolve before patient information is involved, not details to leave for later.
A careful review helps a practice evaluate whether an ambient scribe fits its clinical and technology environment, while keeping responsibility for the note and workflow clear. Zevonix provides managed IT and technology services for healthcare organizations across the country. To discuss the IT and security considerations for a healthcare AI pilot, contact Zevonix at (904) 658-0777.