聆聽醫生診症的 AI：工程師應該向環境式病歷記錄工具問甚麼

Your doctor might soon have a third person in the room: an AI, listening.

It's called an ambient scribe. It records the visit and writes the clinical note, so the clinician looks at you instead of the screen. Heidi Health is one of the best known. Its own site says it goes beyond notes into coding, referral triage, refills and pre-charting, and Fierce Healthcare reported in September 2026 that it landed $340 million: a $100 million Series C at a $900 million valuation, plus a $240 million growth investment. I have not tested any scribe, so everything here about the companies comes from their sites and the press.

The promise is simple: less typing, more eye contact. The engineering questions are just as simple, and they are the ones I would ask before trusting one.

1. Where is the recording stored?

Audio of a medical visit is some of the most sensitive data there is. As a builder I'd want to know whether the audio is kept at all once the note exists, for how long, and in which country. The safest design is the one that keeps the least.

2. Who can access it?

Not just "is it encrypted", but who inside the vendor and the clinic can open it, and whether that access is logged. A recording nobody can audit is a liability.

3. Who checks the note before it enters the record?

This is the one I'd care about most. A scribe's worst failure is a line that was never said, written in a calm clinical voice. Two things would make a sign-off real: the transcript sits next to the note so the clinician can check one against the other, and the note is not filed until someone signs it.

What I could not find

I have not seen independent data on how often scribe notes are wrong, so I won't invent a number. That evidence is exactly what I'd want to see before anyone claims these tools are safe.

What I did differently

Tabibu has the same shape of problem on the patient side. When someone uploads a lab report, the file is not stored, the answer is kept for about 48 hours, and there is an opt-in "Keep for 30 days" for people who want it. I chose the shortest default because I'd rather someone choose to keep their data than have to chase me to delete it. The limit: it is a design choice, not an audit.

If your clinic uses a scribe, you are allowed to ask those three questions. Would you be comfortable with an AI listening to your visit? I'd like to know why or why not.

I post short videos in this series on LinkedIn and TikTok; come say hi.

General information, not medical advice.