How to ask for consent to record in under 20 seconds

Most patients agree to recording when the request is short and specific. The clinics in our pilot settled on three sentences: "I use a tool that records our conversation to draft my notes. The recording is deleted after I sign. Is that OK with you?" Said at a normal pace, that takes less than 20 seconds, and it works best when it sounds the same at every visit.

Why each sentence is there

The first sentence says what the tool does, and "draft my notes" tells the patient the notes are still yours. The second answers the privacy question before anyone asks it. Both points come up when patients are asked about AI scribes. In a survey at UC Davis Health before its rollout, 39% of the comments about concerns were about documentation accuracy and 15% were about privacy. The third sentence is a real question, with room for a yes or a no.

If your clinic keeps audio for a review window, change the second sentence to match. Admins can keep recordings for up to 30 days, and patients should hear the real timing.

Use the same words every time, so the patient hears a routine and no one on your team has to improvise. Ask before the recording starts. Charted shows the patient a consent prompt, or you read it aloud, and the note records whether they agreed and when. The three sentences work as the spoken version.

If a parent, family member or interpreter is in the room, ask them too. In the Stanford Health Care program studied by Shah and colleagues, clinicians had to tell patients and anyone else in the room that the visit would be recorded before turning the scribe on.

What to expect

Expect a yes from most patients. Shah and colleagues surveyed 2,202 Stanford patients after visits with an ambient AI scribe: 70.1% found it helpful and 73.6% wanted it used at future visits. In the UC Davis survey, taken before patients had used one, 48% expected to react favorably, 33% were neutral and 19% were unfavorable.

Both studies have limits. Most of the Stanford respondents were 70 or older, and the authors note that responders may have been more positive about technology. The UC Davis survey had a 20% response rate, and its respondents didn't match the clinic population.

In our pilot, about 4% of patients declined, most often at a first visit or when the visit turned to something sensitive.

When a patient says no

If the recording is already running, pause it. Thank them and carry on as usual. Don't ask again in the same visit, and don't try to change their mind. The UC Davis authors recommend explicit verbal permission, so we treat an unsure "I guess" as a no for that visit.

A no costs you one note. You write it the way you did before Charted, and the patient's care doesn't change. Patients can also ask you to stop partway through. Pause with one tap, and the note records that the recording was paused.

Before the patient reaches the exam room

Front-desk staff can help by mentioning recording at check-in, and many clinics post a QR code to our For Patients page in the waiting room. The UC Davis patients rated education before the visit and being asked for permission as very important. The authors suggest signs in the clinic, notices through the EHR or a conversation beforehand.

Patients who read the page before the visit rarely have questions in the room. When someone does ask, these are the answers it gives:

• Is someone listening? No person listens during the visit. A computer turns the recording into text for your clinician, who reviews the draft and signs the note.

• Is my visit used to train AI? No. Recordings, transcripts and notes are never used for training.

• Who can see it? The clinician and the care team at the clinic. People at Charted can't open it unless the clinic allows it for support.

• Can I see my note? Yes. Patients can ask the clinic for a copy or look for it in their patient portal, if the clinic has one.