Interior Alaska's tribal health system is recording patient visits with AI

Tanana Chiefs Conference has started using an artificial intelligence tool that records patient visits and drafts the clinical note from the recording. Patients can decline by telling their provider, can change their mind later, and TCC says refusing will not affect their care.

The reach is wide. TCC serves 42 member communities across 235,000 square miles of Interior Alaska, about 37 percent of the state, through the Chief Andrew Isaac Health Center in Fairbanks and nearly 40 clinics. In most member villages, it is the health system available.

TCC says a provider reviews, edits and approves every note before it goes in the chart, and that the tool does not diagnose, recommend treatment or make medical decisions. The audio is deleted after 90 days, according to TCC, while the approved note stays in the record. TCC also told patients the vendor may strip identifying details from portions of recordings and use them to improve the system.

The vendor, a California company operating as Sully.ai, says on its trust page that patient health information is never used to train its models. Stripped of identifiers, data is no longer protected health information under federal privacy law, which is how both statements can hold.

What is not public is the contract between TCC and the vendor, including the business associate agreement that would set the actual terms for handling and retaining recordings. The vendor's website privacy policy, which covers people using its website and platform rather than clinical audio, lists a six-year retention floor for HIPAA-covered data. Neither TCC nor the vendor has been asked publicly to explain how that relates to the 90-day figure.

Patients with privacy concerns can contact TCC's privacy officer in Fairbanks or the federal Office for Civil Rights, which enforces HIPAA.