In 2024, Kaiser Permanente introduced Abridge, an AI-powered ambient listening tool intended to assist clinicians, including mental health providers, by capturing clinical notes during patient visits. The technology records entire medical appointments, encompassing sensitive mental health sessions, which has raised concerns among some clinicians and patients about privacy and consent.

Mental health professionals using the platform are required to obtain patient consent before employing Abridge. However, multiple providers report that the consent process often lacks transparency regarding data handling, including information about storage duration, access, and security protocols. Providers have also expressed frustration over being unable to obtain details from Kaiser about these aspects despite repeated requests.

Ilana Marcucci-Morris, a licensed clinical social worker and union committee member at Kaiser’s psychiatry department in Oakland, has declined to use the platform with her patients. She criticized Kaiser leadership for offering what she described as vague assurances about privacy and compliance, without providing evidence or details. “If you have nothing to hide and you’re doing it ethically, then you would show us, prove it,” she said, noting that management has repeatedly declined to do so.

Similarly, Ligia Pacheco, a psychiatric social worker offering remote therapy to Kaiser patients in Southern California, recalled attempts to raise privacy concerns that were dismissed as unprofessional. She described an environment where clinicians felt unable to advocate for vulnerable patients. “We’re supposed to be the voice of patients who are coming in their most vulnerable state. And we can’t even be that voice for them,” Pacheco said.

The push to use Abridge coincides with growing pressures on providers to manage increasing caseloads and documentation demands. Marcucci-Morris noted that failure to meet these expectations can lead to disciplinary action, with management often encouraging the use of Abridge as a solution to reduce administrative burdens. She described this dynamic as coercive, placing clinicians in a position where using the tool feels necessary to avoid job jeopardy.

Kaiser Permanente’s chief information officer, Brian Hoberman, defended the implementation of Abridge, highlighting the technology’s role in alleviating documentation workloads. He said the tool was introduced after thorough evaluation and had been well received by both patients and clinicians. A Kaiser representative reiterated that patient consent is mandatory before recording and assured that recordings are stored no longer than 14 days, with data handling complying with HIPAA regulations and the organization’s own privacy standards.

Despite these assurances, some patients have expressed unease about the confidentiality of their mental health information. One patient, speaking anonymously, noted fears that recorded sessions could be accessed by unintended parties including employers or family members. Adriana Webb, a social worker at Kaiser Panorama City, added that many patients with highly sensitive conditions prefer not to have certain information included in their medical records.

Experts in technology policy emphasize that mental health data warrants particular caution due to stigma and potential negative consequences in employment, legal, and immigration contexts. Nicole Alvarez, senior analyst at the Center for American Progress, noted that use and retention of such data vary significantly across health systems and AI providers. She stressed the importance of clear, meaningful patient consent—beyond mere notification—that explains how data may be stored, shared or used, warning that opaque consent processes can undermine patients’ control over their information.

Some clinicians also reported that the consent process can feel coercive to patients. Pacheco shared an experience where her therapist did not ask permission to use the app but rather informed her it would be used; after declining, she sensed discomfort from the therapist and subsequently changed providers. Marcucci-Morris said Kaiser’s approach to obtaining consent often frames the tool as a means to reduce clinician burnout and allow more patient time, which can pressure patients to agree in order to avoid guilt or discomfort.

Abridge is currently deployed in 40 hospitals and over 600 medical offices across eight states and the District of Columbia, supporting over 14 languages. Kaiser’s spokesperson affirmed that no one is recorded without their knowledge or consent and emphasized the technology’s intended role in improving clinical efficiency.

The company behind Abridge did not respond to requests for comment. According to its website, the vendor classifies itself as a “Business Associate” to healthcare providers, with patient privacy protections outlined in providers’ policies rather than directly by the company.

For some mental health professionals, the presence of AI recording tools alters the therapeutic dynamic. Marcucci-Morris concluded, “Therapy is most effective in privacy and when trust is achieved through two human beings,” adding, “Recording a therapy session changes human behavior. It changes the patient’s demeanor.”