Ontario auditor general: approved medical AI scribes hallucinated and misrecorded drugs
What happenedOntario's auditor general reported in May 2026 that most AI-powered medical transcription/scribe tools approved for the province's doctors produced inaccurate, incomplete, or fabricated clinical notes. Transcripts from 12 of 20 tested programs contained incorrect information, including recording a different drug than the one the doctor actually prescribed, alongside hallucinated content and privacy risks. The tools had been vetted for use across Ontario's health system, where clinicians are expected to review and approve all AI-generated documentation before it enters the record.
Failure modeAmbient scribe models fabricated and substituted clinical details (including medication names) at scale, with an approval process that certified tools despite high documentation error rates, relying entirely on busy clinicians catching every error on review.
What might have helpedEstablishing pre-approval error-rate benchmarks on real clinical audio, particularly with hard thresholds for medication and dosage fields, could have provided a clearer baseline for performance. Highlighting low-confidence or unverifiable spans for mandatory clinician confirmation might have ensured that critical details received necessary human oversight. Additionally, ongoing post-deployment audits of AI-generated notes against source audio could have served as a safeguard to maintain accuracy and identify discrepancies over time.
Partly mitigated Since thenOntario's Information and Privacy Commissioner issued guidance and a companion checklist for AI scribes on January 28, 2026, covering vendor assessment, contractual safeguards, ongoing monitoring and governance.
Still openThe guidance centres on privacy law and sets no accuracy threshold; the Auditor General's May 2026 report found that vetted scribes still produced wrong notes.
LessonProcurement vetting and privacy guidance did not stop approved scribes from writing wrong notes. The audit points to measuring accuracy in use and to clinician sign-off on each note.