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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.

The Bottom Line

  • 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.
Practice

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SourceNHS England: DTAC (what buyers assess)
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SourceNHS England: Ambient scribing guidance (policy context)
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Official Sources

NHS England — DTAC
NHS England — Ambient scribing guidance