{"id":"https://openalex.org/W7147040546","doi":"https://doi.org/10.1016/j.ijmedinf.2026.106419","title":"Socio-technical risks of clinical speech-to-text systems: Transparency, privacy, and reliability challenges in AI-driven documentation","display_name":"Socio-technical risks of clinical speech-to-text systems: Transparency, privacy, and reliability challenges in AI-driven documentation","publication_year":2026,"publication_date":"2026-03-31","ids":{"openalex":"https://openalex.org/W7147040546","doi":"https://doi.org/10.1016/j.ijmedinf.2026.106419","pmid":"https://pubmed.ncbi.nlm.nih.gov/41936257"},"language":"en","primary_location":{"id":"doi:10.1016/j.ijmedinf.2026.106419","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.ijmedinf.2026.106419","pdf_url":null,"source":{"id":"https://openalex.org/S53142634","display_name":"International Journal of Medical Informatics","issn_l":"1386-5056","issn":["1386-5056","1872-8243"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Medical Informatics","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://doi.org/10.1016/j.ijmedinf.2026.106419","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5108005607","display_name":"Nelly Elsayed","orcid":"https://orcid.org/0000-0003-0082-1450"},"institutions":[{"id":"https://openalex.org/I63135867","display_name":"University of Cincinnati","ror":"https://ror.org/01e3m7079","country_code":"US","type":"education","lineage":["https://openalex.org/I63135867"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Nelly Elsayed","raw_affiliation_strings":["School of Information Technology, University of Cincinnati, Cincinnati, OH, United States. Electronic address: elsayeny@ucmail.uc.edu"],"raw_orcid":"https://orcid.org/0000-0003-0082-1450","affiliations":[{"raw_affiliation_string":"School of Information Technology, University of Cincinnati, Cincinnati, OH, United States. Electronic address: elsayeny@ucmail.uc.edu","institution_ids":["https://openalex.org/I63135867"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5108005607"],"corresponding_institution_ids":["https://openalex.org/I63135867"],"apc_list":{"value":3210,"currency":"USD","value_usd":3210},"apc_paid":{"value":3210,"currency":"USD","value_usd":3210},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.30936909,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"214","issue":null,"first_page":"106419","last_page":"106419"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.3968000113964081,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.3968000113964081,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.28940001130104065,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13248","display_name":"Healthcare Technology and Patient Monitoring","score":0.05730000138282776,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/documentation","display_name":"Documentation","score":0.8555999994277954},{"id":"https://openalex.org/keywords/workflow","display_name":"Workflow","score":0.8220000267028809},{"id":"https://openalex.org/keywords/accountability","display_name":"Accountability","score":0.5623999834060669},{"id":"https://openalex.org/keywords/clinical-governance","display_name":"Clinical governance","score":0.4828000068664551},{"id":"https://openalex.org/keywords/corporate-governance","display_name":"Corporate governance","score":0.48030000925064087},{"id":"https://openalex.org/keywords/patient-safety","display_name":"Patient safety","score":0.4505999982357025},{"id":"https://openalex.org/keywords/reliability","display_name":"Reliability (semiconductor)","score":0.40779998898506165},{"id":"https://openalex.org/keywords/conceptual-framework","display_name":"Conceptual framework","score":0.3718000054359436}],"concepts":[{"id":"https://openalex.org/C56666940","wikidata":"https://www.wikidata.org/wiki/Q788790","display_name":"Documentation","level":2,"score":0.8555999994277954},{"id":"https://openalex.org/C177212765","wikidata":"https://www.wikidata.org/wiki/Q627335","display_name":"Workflow","level":2,"score":0.8220000267028809},{"id":"https://openalex.org/C2776007630","wikidata":"https://www.wikidata.org/wiki/Q2798912","display_name":"Accountability","level":2,"score":0.5623999834060669},{"id":"https://openalex.org/C195094911","wikidata":"https://www.wikidata.org/wiki/Q14167904","display_name":"Process management","level":1,"score":0.5217000246047974},{"id":"https://openalex.org/C2777896688","wikidata":"https://www.wikidata.org/wiki/Q3773715","display_name":"Clinical governance","level":3,"score":0.4828000068664551},{"id":"https://openalex.org/C39389867","wikidata":"https://www.wikidata.org/wiki/Q380767","display_name":"Corporate governance","level":2,"score":0.48030000925064087},{"id":"https://openalex.org/C56739046","wikidata":"https://www.wikidata.org/wiki/Q192060","display_name":"Knowledge management","level":1,"score":0.4514999985694885},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.4505999982357025},{"id":"https://openalex.org/C43214815","wikidata":"https://www.wikidata.org/wiki/Q7310987","display_name":"Reliability (semiconductor)","level":3,"score":0.40779998898506165},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.4041999876499176},{"id":"https://openalex.org/C14224292","wikidata":"https://www.wikidata.org/wiki/Q13600188","display_name":"Conceptual framework","level":2,"score":0.3718000054359436},{"id":"https://openalex.org/C105339364","wikidata":"https://www.wikidata.org/wiki/Q2297740","display_name":"Software deployment","level":2,"score":0.3709999918937683},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.3702000081539154},{"id":"https://openalex.org/C68122502","wikidata":"https://www.wikidata.org/wiki/Q764527","display_name":"Informed consent","level":3,"score":0.33709999918937683},{"id":"https://openalex.org/C145642194","wikidata":"https://www.wikidata.org/wiki/Q870895","display_name":"Health informatics","level":3,"score":0.33550000190734863},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3276999890804291},{"id":"https://openalex.org/C112930515","wikidata":"https://www.wikidata.org/wiki/Q4389547","display_name":"Risk analysis (engineering)","level":1,"score":0.31850001215934753},{"id":"https://openalex.org/C32896092","wikidata":"https://www.wikidata.org/wiki/Q189447","display_name":"Risk management","level":2,"score":0.28940001130104065},{"id":"https://openalex.org/C139807058","wikidata":"https://www.wikidata.org/wiki/Q352374","display_name":"Adaptation (eye)","level":2,"score":0.2888999879360199},{"id":"https://openalex.org/C115901376","wikidata":"https://www.wikidata.org/wiki/Q184199","display_name":"Automation","level":2,"score":0.2874999940395355},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.27459999918937683},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.257099986076355},{"id":"https://openalex.org/C189922023","wikidata":"https://www.wikidata.org/wiki/Q17056348","display_name":"Information governance","level":4,"score":0.2565999925136566},{"id":"https://openalex.org/C26517878","wikidata":"https://www.wikidata.org/wiki/Q228039","display_name":"Key (lock)","level":2,"score":0.2540000081062317},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.25189998745918274}],"mesh":[{"descriptor_ui":"D000098403","descriptor_name":"Intelligent Systems","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001185","descriptor_name":"Artificial Intelligence","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D001185","descriptor_name":"Artificial Intelligence","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D001185","descriptor_name":"Artificial Intelligence","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D003219","descriptor_name":"Confidentiality","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D003219","descriptor_name":"Confidentiality","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D003219","descriptor_name":"Confidentiality","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D015203","descriptor_name":"Reproducibility of Results","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D015203","descriptor_name":"Reproducibility of Results","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D015203","descriptor_name":"Reproducibility of Results","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D018907","descriptor_name":"Privacy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D018907","descriptor_name":"Privacy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D018907","descriptor_name":"Privacy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D049250","descriptor_name":"Speech Recognition Software","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D049250","descriptor_name":"Speech Recognition Software","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D049250","descriptor_name":"Speech Recognition Software","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057188","descriptor_name":"Workflow","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.1016/j.ijmedinf.2026.106419","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.ijmedinf.2026.106419","pdf_url":null,"source":{"id":"https://openalex.org/S53142634","display_name":"International Journal of Medical Informatics","issn_l":"1386-5056","issn":["1386-5056","1872-8243"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Medical Informatics","raw_type":"journal-article"},{"id":"pmid:41936257","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41936257","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International journal of medical informatics","raw_type":null}],"best_oa_location":{"id":"doi:10.1016/j.ijmedinf.2026.106419","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.ijmedinf.2026.106419","pdf_url":null,"source":{"id":"https://openalex.org/S53142634","display_name":"International Journal of Medical Informatics","issn_l":"1386-5056","issn":["1386-5056","1872-8243"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Medical Informatics","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.581240713596344,"id":"https://metadata.un.org/sdg/16","display_name":"Peace, Justice and strong institutions"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":34,"referenced_works":["https://openalex.org/W1994216910","https://openalex.org/W2046499381","https://openalex.org/W2131484877","https://openalex.org/W2137373451","https://openalex.org/W2163767758","https://openalex.org/W2407634150","https://openalex.org/W2512902140","https://openalex.org/W2515682654","https://openalex.org/W2754518417","https://openalex.org/W2797303992","https://openalex.org/W2829536104","https://openalex.org/W2942858056","https://openalex.org/W2966690051","https://openalex.org/W2978159570","https://openalex.org/W3046795846","https://openalex.org/W3119071838","https://openalex.org/W3157485606","https://openalex.org/W3199500316","https://openalex.org/W3200318528","https://openalex.org/W4210497435","https://openalex.org/W4220664218","https://openalex.org/W4291746033","https://openalex.org/W4386566940","https://openalex.org/W4390544746","https://openalex.org/W4393353064","https://openalex.org/W4402826865","https://openalex.org/W4407758839","https://openalex.org/W4411338003","https://openalex.org/W4411857731","https://openalex.org/W4412012638","https://openalex.org/W4412570388","https://openalex.org/W4414465746","https://openalex.org/W4416715849","https://openalex.org/W4416715916"],"related_works":[],"abstract_inverted_index":{"BACKGROUND:":[0],"AI-driven":[1],"speech-to-text":[2,56,124],"(STT)":[3],"documentation":[4,14,235,248],"systems":[5,132],"are":[6,154],"increasingly":[7],"adopted":[8],"in":[9],"clinical":[10,55,70,123,130,176,226],"settings":[11],"to":[12,31,103,113,220,240],"reduce":[13],"burden":[15],"and":[16,36,47,72,80,83,85,100,121,151,161,169,180,188,206,217,237,243],"improve":[17],"workflow":[18,71,149],"efficiency.":[19],"However,":[20],"adoption":[21,245],"has":[22],"outpaced":[23],"the":[24,52,222],"systematic":[25],"evaluation":[26],"of":[27,54,225,246],"socio-technical":[28,43,106,137,197,214],"risks":[29,49,157],"related":[30],"transparency,":[32,232],"reliability,":[33],"patient":[34,81,147,233],"autonomy,":[35,82,234],"organizational":[37,86],"accountability.":[38],"OBJECTIVE:":[39],"To":[40],"develop":[41,114],"a":[42,90,115,195,213],"framework":[44,118,216,230],"for":[45,119,166],"identifying":[46],"governing":[48,122],"associated":[50],"with":[51],"implementation":[53,218],"systems.":[57,125,228],"METHODS:":[58],"This":[59],"study":[60,211],"synthesizes":[61],"interdisciplinary":[62],"evidence":[63],"from":[64],"technical":[65],"automatic":[66],"speech":[67,168],"recognition":[68],"research,":[69],"human":[73],"factors":[74],"studies,":[75],"ethical":[76],"guidance":[77],"on":[78],"consent":[79,162],"regulatory":[84],"governance":[87,153,198,215,239],"sources.":[88],"Using":[89],"structured":[91],"narrative":[92],"synthesis":[93,110],"approach,":[94],"relevant":[95],"literature":[96],"was":[97,111],"iteratively":[98],"reviewed":[99],"thematically":[101],"analyzed":[102],"identify":[104],"recurring":[105],"risk":[107,192],"mechanisms.":[108],"The":[109,210,229],"used":[112],"layered":[116],"conceptual":[117],"evaluating":[120],"RESULTS:":[126],"Findings":[127],"show":[128],"that":[129],"STT":[131,227],"operate":[133],"within":[134],"tightly":[135],"coupled":[136],"environments":[138],"where":[139],"model":[140,199],"performance,":[141],"audio":[142],"capture":[143],"conditions,":[144],"clinician":[145,182],"oversight,":[146],"understanding,":[148],"design,":[150],"institutional":[152],"interdependent.":[155],"Key":[156],"include":[158],"inconsistent":[159],"disclosure":[160],"practices,":[163],"performance":[164],"disparities":[165],"accented":[167],"speech/voice":[170],"disorders,":[171],"accuracy":[172],"degradation":[173],"under":[174],"real":[175],"acoustics,":[177],"automation":[178],"complacency":[179],"variable":[181],"review,":[183],"unclear":[184],"accountability":[185],"across":[186],"vendors":[187],"healthcare":[189],"organizations.":[190],"These":[191],"domains":[193],"informed":[194],"six-layer":[196],"spanning":[200],"technical,":[201],"human/workflow,":[202],"ethical,":[203],"organizational,":[204],"regulatory,":[205],"sociocultural":[207],"dimensions.":[208],"CONCLUSION:":[209],"proposes":[212],"roadmap":[219],"support":[221],"responsible":[223],"deployment":[224],"emphasizes":[231],"integrity,":[236],"accountable":[238],"enable":[241],"safe":[242],"equitable":[244],"speech-based":[247],"technologies.":[249]},"counts_by_year":[],"updated_date":"2026-07-16T13:24:37.021932","created_date":"2026-04-02T00:00:00"}
