Consultation notes and AI patient confidentiality: what clinical notes give away in ChatGPT or Claude.

A consultation note is written fast, for the record, and it says more than the patient would say to anyone else: how much they drink, what frightens them, what a parent died of. Doctors paste notes into ChatGPT or Claude to tidy the shorthand, to turn them into a summary for a colleague, or to draft the follow-up letter. This page marks every item in a routine GP consultation note that the Privacy Act, Good medical practice and the NSW health records law bear on, including a line recording an apology to the patient, and shows how the same note is written up on Ermos inside the practice.

The GP consultation note

Written by the treating doctor during or straight after a consultation. Good medical practice 10.5 asks for records made at the time of events or as soon as possible afterwards, accurate, up to date and held securely.

An invented consultation note. Hover or tap any highlighted item for the analysis; the full list is below.

What leaves the practice

1. 1
   Patient name and date of birth

   The key that ties the whole note to one person. Personal information held by a health service provider, and health information once it sits in the clinical record. Privacy Act guide.

2. 2
   Symptoms and a family cancer history

   A symptom history and a parent’s cancer. Health information is sensitive information under the Privacy Act, and the family detail bears on the patient’s own risk. Patient data guide.

3. 3
   Alcohol, smoking, work and a secret from a spouse

   Lifestyle facts the patient gave in confidence, including something his wife does not know. Good medical practice 4.4 asks doctors and their staff to hold patient information in confidence. Patient data guide.

4. 4
   Examination findings and pathology results

   Findings and laboratory values against a named patient. Health information, and the core of the clinical record under Good medical practice 10.5. Patient data guide.

5. 5
   The assessment

   The doctor’s reasoning about what this could be, including a possible cancer. Clinical judgement that a person must own, and sensitive to the patient before the investigations are done.

6. 6
   The plan and the safety net

   Referral, treatment and the advice given about when to seek emergency care. A record that protects the doctor and the patient, so it belongs to the practice.

7. 7
   A recorded apology and a complaint right

   That a result was communicated late, that the doctor apologised and that the patient was told he may complain. Sensitive to the patient and to the practice, and the start of a complaint file. Patient data guide.

8. 8
   The billing item and the recall

   An item number and a follow-up date. Low risk alone, but against a name it reveals the service delivered and when the patient will be back.

9. 9
   The signature and time stamp

   Records who wrote and signed the note and when. The doctor’s own act, which a draft cannot replace.

What happens in Frontier Models (ChatGPT, Claude)

• The whole document is transmitted to the provider’s servers. On personal plans the user cannot choose where it is stored or processed, and for the major providers that has generally meant outside Australia, under that country’s legal process. Some business plans offer storage in Australia, but the provider still receives the content.
• On consumer tiers, prompts can be retained and used to train future models.
• The provider’s staff and systems can reach the content under the provider’s own policies.
• Once sent, the practice no longer controls it. Retention and deletion happen on the provider’s terms.

The same document on Ermos

Part of AI data leakage in healthcare practices. See how this works in practice: Clinical documentation on Ermos.

Common questions