Professional guidelines regarding artificial intelligence (AI) scribes in clinical care

Approved

December 12, 2025

Preamble

The College supports the use of AI scribe technology, recognizing its potential to support and improve charting, to alleviate physician administrative burden and to allow more time for patient care.

When using AI scribes, registrants are required to comply with the College’s Professional Standards and Guidelines Regarding Charting and with the Personal Health Information Act.

Standard

When using an AI scribe physician must:

  1. Ensure the accuracy of medical records;
  2. Take all reasonable steps to ensure the AI scribe is secure and private;
  3. Obtain expressed consent to maintain a recording of a patient encounter; and
  4. Obtain knowledgeable implied consent to use an AI scribe if no recording is maintained.

The College endorses the guidance provided in the policy Artificial Intelligence (AI) Scribe for Health.

Artificial intelligence (AI) scribe policy Nova Scotia [PDF, 237 KB]

5.4 Knowledgeable implied consent is required for a streaming AI scribe.

5.4.1 The Nova Scotia Health Authority and IWK must provide information describing the purpose of AI scribes and how the AI scribe will be used with the individual prior to the appointment. Some examples to meet this standard include, but are not limited to:

  • Printed materials such as signs, posters, brochures displaying the use of AI scribe information in a waiting area.
  • Digital signage or screens showing AI scribe information.
  • Brochures that explain how AI scribe will be used during the appointment.
  • Adding information within patient onboarding process or during appointment check in.
  • Sharing news release(s) from Nova Scotia Government or the NSHA or IWK on the AI Scribe program.

5.5 Express consent is required for a recording AI scribe.

5.5.1 Consent of the patient, whether given orally or in writing, must be documented.
5.5.2 Audio must be deleted following completion of charting and cannot be stored on personal devices.
5.5.3 Patients must be informed of their right to withdraw consent at any time, with assurance that such a decision will not impact the quality of care or access to care.
5.5.4 The withdrawal of consent must be recorded in the patient’s health record and the previous approval must be kept for record purposes but stricken from use.

Physicians’ obligation to protect their patients’ personal health information is no different when using AI scribes than in any other circumstance.

Guidelines

When using an AI scribe in practice, physicians should:

  1. Review all information summarized by the AI scribe for accuracy and completeness;
  2. Be aware of potential inaccuracies that may be generated by AI scribes; and
  3. Advise patients about how the AI scribe will be used for the purposes of documentation.

Definitions

The following definition was provided by the College of Physicians and Surgeons of Alberta’s Advice to the Profession: Artificial Intelligence in Generated Patient Record Content.

Artificial Intelligence (AI): the ability of a digital computer or computer-controlled robot to perform tasks commonly associated with intelligent beings.

Background information

Artificial intelligence (AI) is being integrated into health care, with the potential to improve and accelerate care.

The use of large language model (LLM) generative artificial intelligence (AI) has exploded since the introduction of ChatGPT (Chat Generative Pre-Trained Transformer) in November 2022. Generative AI tools are being used in the provision of health services, largely in advance of studies to assess their impact on the quality of patient care. Third party tools that generate chart notes from text input or from recorded conversations are rapidly entering the market and being advertised to members.

The impact of LLM generative AI on the quality of health programs and services is rapidly evolving and because of the speed of change, there is currently limited research-based evidence to guide an approach to AI use by regulated members. The College will monitor developments in this field and make every effort to communicate them to members and update this Standard as more information becomes available.

An AI scribe is an AI-powered tool that captures and summarizes (and, in some cases, records) clinical encounters between a physician and a patient into detailed medical notes for the physician’s review in real-time.

AI scribes differ from dictation software. Dictation software converts voice to text. AI scribes extract content from an encounter, summarizing it into text, and applying it to appropriate fields of the patient’s medical record. This technology can analyze and isolate relevant medical information from the conversation between a physician and patient and create a more concise medical note for the physician’s review. Physicians are responsible for ensuring that the AI scribe used is secure and private.

Resources

College of Physicians and Surgeons of Nova Scotia

Canadian Medical Protective Association

Department of Health and Wellness

Government of Nova Scotia

Acknowledgements

This standard was informed by the College of Physicians and Surgeons of Ontario’s Advice to the Profession: AI Scribes in Clinical Practice and the College of Physicians and Surgeons of Alberta’s Advice to the Profession: Artificial Intelligence in Generated Patient Record Content.

Document history

Approved by Council:December 12, 2025
Approved by Executive Committee:February 27, 2025, May 28, 2025
Review date:Annually
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The College acknowledges that we are in Mi’kma’ki, the ancestral and unceded territory of the Mi’kmaq people. This territory is covered by the Treaties of Peace and Friendship. We also acknowledge that people of African descent have been in Nova Scotia for over 400 years, and we honour and offer gratitude to those ancestors.