Patient Consent for AI Scribes in Australia

Patient consent is required before an AI scribe is used in a consultation. The requirement is consistent across Australian privacy law, TGA guidance on digital scribes, AHPRA expectations, and medical defence organisation positions, and it is not a point on which these sources meaningfully diverge.

The more practically useful question is what good consent looks like in day-to-day practice: how it is obtained, how it is documented, and how patients who decline are handled.

This guide consolidates the current Australian consent framework for AI scribes into a single reference and is kept current with regulatory and professional guidance as it develops.

The Four Sources of the Consent Requirement

Four independent authoritative sources converge on the consent requirement, and understanding them separately is useful when a patient, colleague, or auditor asks for specifics.

The Australian Privacy Principles. AI scribes process patients' personal and sensitive health information, and the APPs apply. Under APP 3, collection of sensitive information requires consent in most circumstances. Under APP 6, use of that information is bound by the purpose for which it was collected. Under APP 8, offshore processing requires specific disclosure. The OAIC has also published specific guidance on privacy and the use of commercially available AI products that applies to AI scribe deployment.

TGA guidance on digital scribes. The TGA's August 2025 guidance identifies informed consent as a key responsibility for the safe and appropriate use of digital scribes. This is one of the specific responsibilities the TGA has named alongside update review and safety reporting.

AHPRA and Medical Board expectations. The AHPRA shared Code of conduct and AHPRA guidance on AI in healthcare set the professional expectation that practitioners obtain informed consent before using AI tools that process patient information, and that they retain accountability for the record regardless of how it was generated. The Medical Board of Australia's Good medical practice code of conduct covers the underlying informed consent expectation for clinical practice generally.

Medical defence organisation guidance. Avant's AI scribes and patient consent resource sets out specific positions on consent workflow, and the broader Avant guidance on AI for medical documentation covers the practitioner's ongoing responsibilities. MDO positions treat documented consent before AI scribe use as comparable to any material change in how consultations are conducted and recorded.

Additional useful references include the RACGP guidance on AI scribes and the RACGP's patient consent guidance.

Verbal Consent, Written Consent, or Both

Either mode is acceptable under the sources above, and most Australian practices arrive at a combination that fits their patient mix and workflow.

Verbal consent is well-suited to established patients and to consultations where AI scribe use is intermittent. The clinician states, near the start of the consult, that an AI scribe will be used, what it does, where the data is processed, and that the patient can decline without affecting their care. The patient's response is documented in the record, and Lyrebird timestamps this in the consent log at the consult level.

Written consent at patient enrolment is well-suited to practices where AI scribe use is standard and where enrolment already includes a privacy document. This shifts the consent conversation out of the consultation itself, produces a persistent record, and simplifies consistency across different GPs within the same practice.

For new patients, a reasonable default is written consent at enrolment combined with a brief verbal reminder at the first consult. For established patients being introduced to AI scribe use for the first time, notification via letter, email, or SMS before the appointment gives them time to consider and ask questions, with verbal confirmation at the consult itself.

The Five Components of Adequate Consent Wording

Consent statements should cover five elements, at minimum. These are drawn from the consistent requirements across the four regulatory sources above and the practical guidance published by MDOs.

The nature of the tool. For example: "I use an AI tool called Lyrebird that listens to our consultation and helps me draft your clinical notes."

The handling of audio. For example: "The audio is processed to create a written note. It is not retained as a recording. It is deleted at the end of the consultation."

The location of data processing. For example: "All your data is processed and stored on Australian servers." This element matters because APP 8 specifically requires disclosure if data is processed offshore, and patients have a right to know where their health information is going.

The status of the resulting note. For example: "The note becomes part of your medical record, the same as if I had typed it myself."

The patient's right to decline. For example: "You can decline and I will document the consult in the usual way. It will not affect your care."

Handling Declines

Patients who decline are documented accordingly, and the consult proceeds without AI scribe use. The decision is not questioned, and the patient's choice is not flagged in any way that would affect their subsequent care.

Patients who decline mid-consult can have the scribe stopped without losing the consult record. Lyrebird supports mid-consult stop without disrupting the note structure for what has already been captured.

Published data from deployments suggests patient decline rates are low when the consent conversation is clear. Where clinicians have reported higher decline rates, the contributing factor has typically been consent wording that is rushed, vague, or technical rather than patient-facing.

Consultations Where Consent Warrants Additional Consideration

Some consultations warrant a more considered consent conversation, and in some of these the clinician may reasonably decide that an AI scribe is not appropriate for the consultation at all. Mental health consultations, paediatric consults with a parent or guardian present, consults involving disclosure of family violence, and consults covering highly sensitive clinical content are the most commonly cited.

The appropriate control is that the scribe can be turned off for an individual consult without changing the default for the remainder of the day. Lyrebird supports this directly. Using it selectively for sensitive consults is consistent with good clinical judgment.

Consent for Minors

The general approach to consent for minors applies. In most Australian jurisdictions, a mature minor may consent for themselves under the Gillick competence framework, and otherwise a parent or guardian consents on the patient's behalf. Documentation of who gave consent, and on what basis, is consistent with the practice's existing consent documentation standards. The RACGP's patient consent guidance covers the underlying consent framework.

Implications of the TGA's 2025 Position

The TGA's August 2025 guidance did not change the consent requirement, but it clarified the regulatory significance of the underlying product distinction. A scribe that generates diagnostic or treatment suggestions is a medical device. A scribe that only transcribes and structures clinical conversation is not. The use of a medical device in a consultation is reasonably of greater interest to a patient than the use of a transcription tool. Lyrebird is positioned as a documentation tool rather than a diagnostic one, and the consent conversation is correspondingly more straightforward.

Documentation and Auditability

An MDO query or audit following a complaint will typically request evidence that consent was obtained, and the quality of that evidence depends on how it was recorded. Verbal consent retained only in the clinician's memory is not retrievable. Verbal consent timestamped in a consent log, with the note associated with the relevant consult, is retrievable.

Lyrebird logs consent status per consult, and the log is retrievable and exportable for audit, MDO query, or internal review purposes. This directly supports the NSQHS Clinical Governance Standard's expectation of effective patient safety and quality systems, which includes documented consent as part of the quality system.

Template Consent Language

Verbal, beginning of consult:

"I use an AI tool called Lyrebird that listens to our consultation and helps me draft your clinical notes. The audio is not retained, all your data stays in Australia, and the note becomes part of your medical record the same as if I typed it. Are you comfortable with that? You can decline and I will document the consult the usual way."

Written, patient enrolment form:

"This practice uses an AI medical scribe (Lyrebird) to assist with clinical documentation. The tool listens to your consultation and drafts a clinical note. Audio is not retained. All data is processed and stored on Australian servers. The note becomes part of your medical record. You may decline the use of the scribe at any time without affecting your care. I consent / I do not consent."

Next Steps

To trial Lyrebird directly, book a demo. Lyrebird Free is available for free to Best Practice clinics.