Adoption of AI Scribes in New Zealand Primary Care Raises Ethical and Legal Questions

Recent research from the University of Otago in Wellington has highlighted the increasing popularity of AI-powered transcription tools, known as AI scribes, among general practitioners (GPs) and other primary care providers across New Zealand. Despite the promising benefits, such as potential time savings and improved patient engagement, widespread adoption has raised significant ethical and legal concerns.

A survey conducted in early 2024 involving 197 healthcare professionals—including GPs, nurses, nurse practitioners, rural emergency care providers, and practice managers—found that approximately 40% of respondents were actively using AI scribes to document patient consultations. However, only 66% had read the respective terms and conditions of the software, and 59% had sought patient consent for its use.

Participants reported varied experiences with AI scribes. Many found them helpful, estimating that, with consistent use, these tools could save between 30 minutes to two hours daily. Conversely, some users experienced frustrations, primarily due to the time-consuming process of editing and verifying AI-generated notes. Concerns about accuracy were prominent; some clinicians noted the AI occasionally missed critical negative findings or misinterpreted accents and vocabulary, including Māori language, which impacted trust.

The study also revealed changes in the doctor-patient dynamic, with clinicians needing to verbalize examination findings and thought processes more openly—altering traditional consultation interactions. While some practitioners appreciated this increased transparency and better engagement, ethical questions around data security, patient consent, and the adequacy of AI-generated notes persist.

Professor Angela Ballantyne, a bioethicist leading the research, emphasized the importance of vigilance in verifying AI-produced documentation to meet professional standards. She stressed that most AI systems rely on cloud-based platforms, often overseas, raising concerns about data privacy and sovereignty, particularly regarding Māori data governance.

In July, New Zealand’s health authorities endorsed two AI-scribe tools, Heidi Health and iMedX, after evaluations considered privacy and ethical issues. Nevertheless, the future regulation of AI in healthcare remains under development, with expectations that the Medical Council of New Zealand will publish guidance later this year. This guidance is anticipated to require explicit patient consent when utilizing AI transcription.

Professor Ballantyne advocates that patients should have the option to opt out of AI use in their care without compromising access. Additionally, she highlights the need for healthcare providers to be trained appropriately and to adhere to legal responsibilities to ensure accurate documentation.

Ultimately, while AI scribes hold significant promise for transforming primary care by increasing efficiency and enhancing patient interaction, they also necessitate careful oversight—balancing technological benefits with ethical, legal, and data security considerations. Future advancements and regulations aim to ensure these tools support safe, effective, and respectful healthcare delivery.