Healthcare Institutions Are Recording Psychotherapy Sessions with Artificial Intelligence: Privacy Concerns Are Rising

Today, healthcare providers are increasingly turning to artificial intelligence (AI) technologies to record their interviews with patients and automatically generate clinical notes. Professionals operating especially in the mental health field are encouraged to use these tools to reduce their heavy workload and speed up paperwork. However, the use of this technology causes serious concerns among both patients and therapists in the context of patient privacy and data security. Recording highly personal psychotherapy sessions, where people share their most vulnerable moments, raises many ethical and legal questions. Because it remains unclear how these recordings are processed, how long they are kept, and who exactly has access to the data.

In 2024, the US-based large healthcare company Kaiser Permanente announced that it will launch an artificial intelligence-powered software named Abridge. In official statements, this technology was referred to as 'ambient listening technology' that helps clinicians securely generate clinical notes during patient visits. However, this nice-sounding technical definition ignores the fact that the tool actually records medical appointments in their entirety from start to finish, even if they are deep and intimate psychological therapy sessions. During the moments when the application is used, mental health professionals are asked to obtain consent from their patients. However, this consent process remains extremely superficial and does not contain any detailed information about the fate of the recorded data.

One of the biggest problems experienced is the lack of transparency regarding how the data is managed and the failure to inform healthcare workers on this issue. Ilana Marcucci-Morris, a licensed clinical social worker working at the Oakland, Kaliforniya branch of Kaiser Permanente, states that in meetings with the company management, they asked about the impact of this technology on patient privacy and data security, but could not get a clear answer. Managers, saying only that the technology meets the necessary security standards, find it unnecessary for employees to question this issue and close the subject. Marcucci-Morris argues that if the company is doing everything ethically and legally, in accordance with the rules, it should share the necessary documents and guarantees with its employees to prove it. Similarly, Ligia Pacheco, who provides remote therapy services in Güney Kaliforniya, states that when she expressed her concerns about artificial intelligence recordings, expressing these thoughts was described as 'unprofessional' behavior by her management.

Another important factor behind the spread of the technology is the excessively increased patient and workload of healthcare workers in recent years. Marcucci-Morris, as a union representative, reports that her colleagues face workplace investigations because they cannot keep up with the increasing patient volume or fill out documents on time. During such crisis moments and disciplinary processes, the management 'recommends' that healthcare workers use the Abridge software to save them time and get their work done. However, Marcucci-Morris emphasizes that her colleagues are forced to use this not because of the trust they have in the technology, but because of the fear of losing their jobs and corporate pressures. This situation is considered by critics as a 'coercive' practice that puts individuals under pressure, forcing them to make a choice between their job or using the software.

On the other hand, Kaiser Permanente senior executives claim that thanks to this technology, the daily practical documentation burden of doctors has been significantly reduced, thus increasing clinician welfare. Company officials argue that the software was subjected to a meticulous review and testing processes before being released to the market, and that it is extremely reliable in terms of data security and privacy. In addition, the management claims that the artificial intelligence assistant only makes doctors' jobs easier, giving them more time to focus on their patients. Nevertheless, mental health professionals working in the field state that ethical concerns and demands for data transparency have still not been resolved and they continue their concerns. Voice recording patients during their most defenseless and vulnerable moments continues to ignite new privacy debates in the medical world and society.