Can I use an AI scribe without sending audio to the cloud?

Yes, but most products do not work that way, and one practice owner in a psychiatry forum built their own setup to get it. The practice is cash-pay. The owner tried several commercial scribes, found they saved time once tuned, and stopped using them because the audio went to the cloud and privacy is part of what those patients pay for. The local version used off-the-shelf parts costing under a thousand dollars.

Why does it matter where the audio goes?

For some practices, privacy is the product. Cash-pay patients often choose to pay precisely so their care stays out of other systems. Therapy practices are starting to promise clients in writing that sessions are not recorded. Clinicians in several forums have said the quiet part out loud: once data leaves the room, it will be used for whatever earns someone money.

What does a typical tool do with the audio?

Usually it sends the recording to a server, transcribes it, and passes the transcript to a language model to write the note. Some delete the audio straight after transcription and keep the transcript for a set period. One psychiatrist described that period as about two weeks for the product they used. Every vendor is different, so ask.

What are the options for keeping it local?

Build your own, as that owner did, and become your own IT department. Dictate after the session into a tool that runs on your own machine. Or choose a product that offers an on-device mode, where the processing happens on your phone or computer and the note never goes to a server.

What is the trade-off?

Devices are smaller than data centres, so on-device processing has limits that cloud processing does not. For many practices the trade is worth it. For others, a cloud mode with a signed agreement is the right answer. The point is to choose it, rather than discover it.

The short version

You can, but you usually have to look for it or build it yourself. Solanto is being built with a Private Mode that keeps the note on your device, alongside a Cloud mode for when you want one, so therapy practices and cash-pay practices that sell privacy do not have to build their own.

Solanto has not shipped yet. The price is on the page rather than behind a call, and early access is open: solanto.ai/pricing

Ask your vendor one question in writing: does the audio of my visit ever leave my device?