We have all heard it so often that we no longer hear it: “This call is being recorded for quality assurance.” We also see signs warning us that our every move is being captured on video. And yet, we grant our tacit consent by simply staying on the line or entering the business.
Louisiana’s 2026 legislative session has extended this into the exam room. Acts 965 and 649 take effect August 1, 2026.
Act 965 takes aim at wearable eyeglass recording devices, barring a participant in a direct conversation from recording or transcribing it unless all other participants are first notified. We will explore recording medical encounters from the patient perspective in a future article.
Act 649 on the other hand, directly addresses healthcare professionals who use recording technology to create AI-generated transcriptions by requiring a verbal disclosure prior to recording the encounter. The first part of the Act reads: “A healthcare professional licensed by this Title shall verbally disclose the use of any recording device, software, or service to a patient before recording any part of an appointment or treatment to be transcribed by artificial intelligence.”
This disclosure requirement reflects the growing use of AI-powered documentation tools by providers and patients. Understanding these tools and their benefits and risks can help explain why the legislature settled with a disclosure (and not consent) requirement. Before we review key takeaways for compliance with the law, let’s explore some of the issues present with ambient scribes.
Ambient Scribes
Ambient scribes are AI documentation tools generally acquired by a healthcare organization that capture the clinician–patient conversation and use speech recognition and generative AI to produce a transcript and prepare a draft clinical note that can be reviewed and signed. The time saved from typing, in theory, should translate to more quality engagement with the patient. This technology has spread quickly, promising to alleviate documentation burden and burnout.
Yet, these tools and systems remain tools and systems. They require a different level of attention that can add time elsewhere to a provider’s workflow. They do not relieve the treating professional of responsibility for reviewing the note, correcting errors, supporting medical necessity, and reviewing and signing an accurate, comprehensive, final record.
Parallel to clinical grade tools is the expanding market of consumer recording devices. Personal AI recorders, discrete microphones, and camera-equipped smart glasses may transmit audio, photographs, or video to cloud services outside the organization’s approved technology environment. A clinician using one for convenience may unintentionally bypass the organization’s privacy, security, contracting, and retention controls and policies. Because they are widely available, these consumer recording devices oftentimes operate without a Business Associate Agreement, without encryption guarantees, and without audit logs.
Risk Management Mitigations
Act 649 requires a healthcare professional to verbally disclose the use of a recording device, software, or service before recording any portion of an appointment or treatment that will be transcribed by artificial intelligence. A healthcare professional who violates the disclosure requirement may face disciplinary action by the applicable professional licensing board. The law generally limits civil liability unless the conduct amounts to gross negligence or willful misconduct.
The enacted law requires disclosure rather than affirmative patient consent. That distinction is important because a provider may legally record a patient visit after disclosure even when the patient objects to the use of an AI recording device. But, the physician may also choose not to record. Each organization should decide in advance what will happen when a patient objects.
Below are some considerations prior to recording the encounter:
- Use only approved technology. Personal recorders, smart glasses, consumer transcription applications, and similar devices should not be used during clinical encounters unless the organization has evaluated and authorized them.
- Give verbal disclosure before activating the tool. A sign, intake form, or written acknowledgment may supplement the disclosure, but it should not replace the verbal statement required by Act 649.
- Audio retention policy. Organizations should establish and consistently follow retention and deletion policies for recordings. Because these recordings are generally only used to assist in documentation, purging the recordings after the note is finalized can be the best option.
- Use plain language. The disclosure should tell the patient that technology will listen to the conversation and use AI to assist with documentation. Staff should also be prepared to answer basic questions about whether audio is retained and, if so, for how long; who processes the information; whether the data is used to train a model; and the fact that the information is not part of the medical record. Document the disclosure. A brief entry such as “Use of AI-assisted documentation verbally disclosed before recording; patient acknowledged” creates a useful audit trail after the healthcare provider makes the disclosure. While documentation is not required under the law, it can aid in proving that verbal disclosure occurred.
- Prepare for objections. A patient may ask for the recording to be stopped or may decline to proceed while the tool is active. The organization should provide its physicians and healthcare providers with acceptable mitigation steps. Does the visit end? Can the tool be turned off? Will more education on the tool help assuage a patient’s concern?
- Consider every participant. Family members, caregivers, interpreters, trainees, and others may also be captured. The practice should determine what notice or authorization is required for those participants.
- Review every note before signing. Ambient tools may omit important context, assign a statement to the wrong speaker, introduce unsupported language, or convert uncertainty into a definitive statement. An AI-generated draft should not be filed automatically in the medical record.
- Exercise additional care in sensitive encounters. Substance-use-disorder treatment, confidential adolescent services, behavioral health visits, reproductive care, and conversations involving sensitive family or social information may require additional or different considerations.
Ambient documentation can reduce administrative burden and allow clinicians to focus more fully on their patients, but it doesn’t eliminate the need for institutional oversight. Healthcare organizations should know which technologies are being used, prohibit unapproved recording devices, evaluate vendors before deployment, establish a consistent disclosure process, prepare for patient objections, and require clinician review of every generated note.
LAMMICO has created AI resources to provide insureds and their practice staff with current information related to the risk mitigation and use of AI in healthcare settings. These complimentary resources include an online education course, “Artificial Intelligence for Providers: A Risk Management Perspective,” to address the complex risks that accompany AI integration and present risk management strategies tailored to providers in the practice setting. We also offer a guide and sample form for our insureds to utilize to provide formal notification to patients regarding the routine use of ambient scribe technology and clinical support systems during medical encounters. This suite of online resources includes a detailed glossary of terminology and curated links to professional organizations.
To access, log in as a Member at lammico.com/login, and click "Artificial Intelligence (AI) Resources" under Additional Resources on your Member Dashboard.
For more information, contact the LAMMICO Risk Management and Patient Safety Department at 504.841.5211.
