This article explores the ethical issues associated with AI scribes, including consent, data security, and confidentiality, and explains how CareWay complies with Quebec standards to ensure ethical and secure use.
The Ethical Issues of AI Scribes
The growing use of AI scribes in the medical field raises significant ethical, legal, and cybersecurity concerns. As a family physician and ambassador for CareWay, I will address these crucial issues and explain how CareWay ensures compliance with all regulations and legal standards in Quebec.
Concerns from the Collège des Médecins du Québec
The Collège des Médecins du Québec (CMQ) has identified three key aspects to consider when using AI scribes:
- Patient consent
- Data confidentiality and security
- Compliance with medical record-keeping regulations
The CMQ does not prohibit the use of virtual scribes. However, it does not evaluate the security of each platform individually. The responsibility falls on the physician to ensure that patient confidentiality and data security are maintained, as the data must inevitably be processed somewhere.
Patient Consent
Explicit patient consent is essential and can be obtained verbally or in writing. Important factors to consider include:
- Where the data is processed (locally or internationally)
- How long the data is stored
- Whether personal information is retained (e.g., name, age, RAMQ number)
A documented verbal consent in the patient’s file may be sufficient if data is deleted quickly (within 24 to 48 hours) and remains within Quebec. However, written consent is recommended if data leaves the country or if personal information is retained.
Data Storage Location
The CMQ strongly recommends that medical data be stored and processed within Quebec or Canada for security and regulatory compliance reasons.
The CMQ discourages the use of services that transfer data to the United States and instead promotes solutions that keep all data within Canada.
Dr. Poirier mentioned during our discussion that in the event of a data breach, the CMQ may question physicians about their choice to use a platform that transfers data outside of Quebec or Canada when equivalent local options are available.
Data Security & Confidentiality
It is essential to verify the following details with any AI scribe provider:
- Which countries the data passes through
- The security standards in those countries
- What security certifications have been obtained
It is important to note that security standards in other Canadian provinces or in the United States do not necessarily align with Quebec’s regulations, which are stricter in terms of cybersecurity.
Physician Responsibility
Despite the automation provided by AI scribes, the physician remains responsible for the final content of medical documents.
- All notes and information generated by the AI scribe must be reviewed and corrected if necessary.
- Physicians must be cautious of potential "AI hallucinations," where the AI may generate inaccurate or misleading information.
How CareWay Ensures Compliance
CareWay is committed to full compliance with Quebec’s legal and regulatory standards through the following measures:
- Quebec-based company: CareWay prioritizes compliance with Quebec’s healthcare laws.
- TGV Certification: CareWay has obtained TGV certification, which will allow direct integration with EMRs (Electronic Medical Records) and ensure compliance with the strictest security standards in Quebec. CareWay is the only AI scribe company to have obtained this certification.
- Local Data Hosting: All data is stored in a Quebec-based data center.
- Rapid Data Deletion: Personal information is automatically deleted after 48 hours.
Conclusion
The use of AI scribes in medicine raises significant ethical and regulatory challenges that healthcare professionals must take seriously.
As a Quebec-based company, CareWay is fully committed to complying with Quebec’s strict data security and legal standards.
By choosing CareWay, physicians can benefit from an AI-powered tool designed specifically for Quebec’s healthcare system, while ensuring they meet their ethical and professional obligations. This enables the safe and responsible integration of AI technology into medical practice in Quebec.
Article written by:
Dr. Samuel Gareau-Lajoie, CareWay Ambassador