What Happens to Visit Audio? AI Scribe Retention Compared

Does an AI scribe store recordings of your patients? It depends entirely on the vendor. Published policies run the full spectrum: never stored, deleted at note generation, kept 30 days, or kept indefinitely on a setting your front desk might not know exists. Below is each major vendor's policy, quoted from their own pages, with the date we checked.

Nobody else publishes this table. Vendors describe their own policy (sometimes carefully, sometimes not) and stay quiet about everyone else's. So we fetched the pages ourselves.

Key takeaways

• Of 8 vendors we checked on June 12, 2026: 4 say audio is never stored or deleted at note generation, 1 keeps audio 30 days, 1 lets clinics keep it indefinitely, and 1 publishes no number at all.
• Audio and transcripts are separate artifacts. Two vendors that don't store audio keep transcripts for 2 years, or forever by default.
• Two policies hinge on the word "successful." Ask every vendor what happens to audio when note generation fails.
• Deleting audio fast does not remove the consent requirement, not in any US state, and not under India's DPDP Act.

Does your AI scribe store recordings? Eight vendors, quoted

Every quote below comes from the vendor's own public page, fetched on June 12, 2026. Policies change, which is why each row carries its source. Check the link before you rely on the row.

Four patterns hide in that table, and they're worth naming.

Never-stored vs deleted-after. "We don't store audio" (Doximity, Patient Square) and "we delete audio after the note generates" (Freed, Jane's default) sound identical and aren't. In the first model there's no stored artifact at any point, because audio is processed in memory and gone. In the second, a recording exists as a file until a pipeline step succeeds. Usually a distinction without much practical difference. Until the pipeline has a bad day.

The word "successfully" is doing quiet work. Freed deletes audio "upon successful note generation." Jane's default deletes "immediately after successfully generating a chart entry." Neither page says what happens to the recording when generation fails. Maybe nothing interesting. But a policy that only describes the happy path has only answered half the question. Ask the other half.

Transcripts outlive audio. Healthie discards audio and keeps transcripts for 2 years. Heidi doesn't store audio and defaults to keeping transcripts forever. A transcript is the same conversation in a different format. If your privacy question was "does a record of everything said in my exam room persist," the audio answer alone hasn't answered it.

Enterprise vendors delegate the answer. Abridge publishes no retention number; the health system deploying it sets one. That's a defensible model for a hospital with an information-governance office. If you're a 3-physician practice, it means the policy is whatever your contract says, so read the contract, not the website.

One honest concession: stored audio is sometimes what you want. Jane's configurable retention is the better fit if your clinic deliberately keeps recordings. Some practitioners re-listen while finalizing charts, and Jane lets a Full Access user set the window the clinic actually intends. Heidi's never-delete transcript default is the better fit if you want a permanent searchable record of every consultation beyond the note. Those are legitimate choices. Our argument is only that they should be choices someone made on purpose, not defaults nobody read.

If you'd rather the answer be "there is nothing to configure because nothing is kept," that's our model. Read the security page, then book a short demo and ask us the failure-path question live. We like that question.

Why is visit audio more sensitive than the note?

The note is a summary you reviewed and signed. The audio is everything else.

A recording of a 20-minute visit contains the depression screen the patient answered honestly, the "while I'm here" question about an STI, the daughter in the room arguing about her father's drinking, your own thinking out loud before you settled on an assessment. The note you signed contains none of that phrasing. The recording contains all of it, verbatim, in the patient's own voice.

That asymmetry has teeth:

• It's a second record you didn't author. You control what enters the chart. You don't control what a microphone heard. If a stored recording and your signed note ever diverge, you'll be asked about the gap.
• It's a bigger breach surface. A leaked note is a clinical summary. A leaked recording is a patient's voice describing their lowest moment. Same incident-response process, very different patient harm.
• It can be requested. Anything retained can, in principle, be sought in a dispute by either side. Penn Medicine's patient FAQ is blunt about who controls this: recordings are kept (de-identified) "for a short time," and patients cannot request that previous recordings be deleted. Even careful health systems end up with retention rules the person in the room can't override.

None of this means stored audio is reckless. It means audio deserves its own line of questioning, separate from "is the note secure," and most vendor security pages answer the second question while hoping it covers the first.

What should you ask a vendor before the first recorded visit?

Six questions. A good vendor answers each in one sentence, in writing.

1. "Where does audio live during processing?" In memory, or written to disk and queued? Either can be done securely; you want to know which it is.
2. "What exactly triggers deletion, and what's the window?" "When the note generates" and "within 30 days" are both real answers. "We take privacy seriously" is not.
3. "What happens to audio when note generation fails?" The happy-path question every published policy answers; this is the one some don't. Our answer: there is no audio archive for a failed draft to land in, full stop.
4. "How long do transcripts persist, separately from audio?" You now know why. Ask about each artifact by name: audio, transcript, note.
5. "Do backups keep copies after deletion?" Jane discloses about a week on secure backups, and that's the honest shape of a real answer. A vendor who says "deleted means deleted, instantly, everywhere" either built something unusual or hasn't checked.
6. "Who in my clinic can change the retention setting?" Jane's policy is clinic-wide and editable by any Full Access user. That's fine, if you know it. A privacy posture that one staff account can quietly flip is a process risk, not just a setting.

Vendors who handle these six without flinching will probably also survive the evaluation questions that go beyond audio.

What does US law actually require before you record?

Two separate obligations, often blurred together. This is orientation, not legal advice, so confirm specifics with your counsel or malpractice carrier.

The HIPAA side. Visit audio is PHI the moment it's captured. Any vendor processing it for you must sign a business associate agreement. No BAA, no deal, even if the audio is deleted in seconds. Patient Square signs a BAA for every US customer, on every plan, including the trial week. Ask any vendor whether BAA coverage extends to the subprocessors that touch audio (speech-to-text APIs included), and at which pricing tier the BAA actually becomes available.

The consent side. State law governs recording a conversation, and it doesn't care how briefly the file existed. Most states require one party's consent; roughly a dozen (California, Florida, Illinois, Pennsylvania, and Washington among them) expect every party in the room to consent. Fast deletion makes the disclosure easier to say; it does not make the disclosure optional. The line that works in practice is one sentence: "I use a tool that listens and drafts my note so I can pay attention to you, and the audio is deleted once the note is written. OK?" When retention is genuinely zero, that sentence has the advantage of being true.

What does India's DPDP Act expect when you record patients?

A Pune OPD at 8pm: forty patients deep, consultations running about two minutes each, a relative answering half the questions, Hindi and English switching mid-sentence. Now add a recorder. The Digital Personal Data Protection Act, 2023 sets the frame for that recorder: consent-first, purpose-limited handling of personal data, with reasonable security safeguards.

Applied to visit audio, the frame turns into three working questions for any vendor:

• Consent first. The patient should hear what's capturing the conversation and why, before it does. Keep the disclosure to one sentence that works aloud in Hindi as easily as English. At a 2-minute consultation pace, a paragraph of disclosure is a policy that won't survive Monday.
• Purpose limitation. The audio exists to produce the note. A recording retained long after the note is signed, for no purpose anyone can name, is exactly the kind of data the consent-first, purpose-limited frame tells you to question. "Why is it still there?" is a DPDP-shaped question. So ask it of every vendor, including us.
• Security safeguards. Encryption in transit and at rest, access controls, and a straight answer on where audio physically goes during processing. For low-connectivity clinics, ask how offline capture is protected; ours encrypts on-device (AES-256-GCM) and syncs when the network returns.

Patient Square handles clinical data to DPDP Act 2023 standards, consent-first and purpose-limited, and the shortest version of our audio answer works in any language: nothing is kept, so there's less to explain.

Where does AI Scribe by Patient Square sit on this table?

In the row with the least to say. AI Scribe by Patient Square is an ambient AI medical scribe that listens during the visit and hands back a structured SOAP note, ICD-10 suggestions, and a prescription draft, ready to review and sign about two minutes after the visit. The audio that produced the note is processed in memory and discarded once the note is drafted. No archive, no configurable window, no retention setting a staff account can flip. The security page states the full posture: TLS 1.2+ in transit, AES-256 at rest, role-scoped and logged access, BAAs for every US customer, DPDP-aligned handling in India, SOC 2 Type II audit underway.

We think zero retention is the right default for a tool that sits in an exam room, and we're saying that as the vendor whose table row it is. Weigh it accordingly, then check our claim the same way you check everyone else's: read the page, ask the questions, and make us answer the failure-path one.

What does persist is yours. Notes belong to the practice; export or delete any visit, anytime; we never sell or share clinical data. If a vendor's retention answer ever stops satisfying you, your exit shouldn't be held hostage by your own charts.

The fastest way to test all of this is not reading. It's a week of real visits. Book a short demo, bring this post's six questions, then run the 7-day free trial in your own clinic and watch where the audio goes. (Nowhere. That's the point.) For how retention fits into the wider buying decision, the honest comparison of the leading scribes is the next read.

7-day free trial · month-to-month available · audio never stored.