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Choosing an AI Scribe: The 20 Questions Clinicians Should Ask a Vendor

A clinician-first evaluation: data retention, access controls, auditability, failure modes, and what happens when the model is wrong.

Review date
Jan 2026
Reading time
8 min read
Author
Dr Kola Tytler MBBS CertHE MBA MSt MRCGP
On this page
IMG pathwayThis guide is updated for 2026 regulations (UK/US/Aus/Can). Always verify with official bodies.

Key points

  • Ask about failure modes and governance before you ask about ‘accuracy’.
  • Your key risks are confidentiality, record integrity, and workflow brittleness.
  • Look for evidence aligned with NHS expectations (DTAC, clinical safety, audit logging).
Most AI scribe comparisons over-focus on demo performance. In real practice, the differentiators are: where data goes, what gets stored, whether you can audit every change, and whether the system degrades safely when it fails (rather than quietly producing plausible nonsense).
1

Data & privacy

Where is audio processed? Is audio stored? For how long? Can we enforce deletion? What is the default retention? Who has access and how is access logged?
2

Clinical record integrity

Is every note clearly marked as ‘AI draft’? Is there a tamper-evident audit trail of edits? Can you export logs for governance review?
3

Safety & escalation

What happens when the system is unsure? Does it flag uncertainty? Can we switch it off instantly? Is there an incident reporting + vendor response SLA?
4

Operational fit

How does it handle accents, interruptions, multiple speakers, phone calls, and background noise? Is there a ‘pause’ protocol? How do staff learn it safely?
5

Procurement readiness

Do you have DTAC-aligned documentation? Clinical safety artefacts? A clear stance on medical device classification where applicable?

The red-flag answer

If a vendor can’t clearly explain data flow, retention, access controls, and auditability in plain English, treat that as a ‘no’ until proven otherwise.
SourceNHS England: DTAC (what buyers assess)
Open Link
SourceNHS England: Ambient scribing guidance (policy context)
Open Link

Official Sources

NHS England — DTAC
NHS England — Ambient scribing guidance
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  • Where is audio processed? Is audio stored? For how long? Can we enforce deletion? What is the default retention? Who has access and how is access logged?

    Return to this section

  • Is every note clearly marked as ‘AI draft’? Is there a tamper-evident audit trail of edits? Can you export logs for governance review?

    Return to this section

  • What happens when the system is unsure? Does it flag uncertainty? Can we switch it off instantly? Is there an incident reporting + vendor response SLA?

    Return to this section

  • How does it handle accents, interruptions, multiple speakers, phone calls, and background noise? Is there a ‘pause’ protocol? How do staff learn it safely?

    Return to this section

  • Do you have DTAC-aligned documentation? Clinical safety artefacts? A clear stance on medical device classification where applicable?

    Return to this section

United Kingdom · Starting work · Article 9 of 28