Who is responsible if an AI scribe makes a mistake?

Whatever share of the blame a vendor carries, responsibility starts in one place. The Texas Medical Liability Trust tells clinicians they “remain fully responsible for the content of all medical documentation, regardless of how it was generated”. It adds that automatic signatures on AI-generated content are discouraged. Sign it and you own it: in a payer audit, a records request, or a dispute, the signature on the note is the answer to “who said so”.

That puts all the weight on the review step, and on how the tool fails. Every scribe misses sometimes. A miss that is obvious in the draft gets caught; a plausible sentence with the wrong side, wrong grade, or a dropped precaution is the one that ends up signed. Judge any scribe by how visible its mistakes are and how fast a therapist can fix them. Then hold the review habit even when the drafts have been clean for a month.

Orion treats review as the workflow rather than a disclaimer. Aurora’s draft appears inside the visit it belongs to; the therapist edits and signs; nothing enters the chart on its own. There is no auto-sign to turn off, because it was never there.