An Ontario clinic that lets software answer the phone still owns the privacy duty. This guide shows what an AI medical receptionist may say, which calls it must hand to a person, ten questions to put to any vendor before signing, and the cases that trigger a breach report.
By Aniket Gandhi, founder, AGNT/01, Ottawa · Last verified October 2026
An AI medical receptionist can be used in an Ontario practice if the custodian stays accountable under PHIPA: it collects only what booking needs, gives no clinical advice, runs under a written vendor agreement and is disclosed to patients. Ontario's privacy commissioner says custodians should do a privacy impact assessment before introducing an AI system.
The clinic. The College of Physiotherapists of Ontario puts it simply: a health information custodian is responsible for the personal health information in its control, and for its agents' actions [5]. The commissioner's January 2026 guidance on AI scribes says the custodian remains accountable when it buys an AI system and should have a robust service agreement with the vendor [2]. That guidance is about scribes, not receptionists, so read it as a standard to borrow rather than a rule written for phone assistants. The statute itself is on the e-Laws site [1].
| Call | The AI may | The AI must not | Hand-off |
|---|---|---|---|
| Book, move or cancel a visit | Offers open slots, confirms by text | Choose a slot for medical urgency | Staff for any exception |
| Hours, address, parking, fees | Answers from the clinic's approved sheet | Quote prices that are not on the sheet | Staff |
| "Are my results in?" | Says it cannot access results and takes a message | Read or summarise any result | Clinician or staff, same day |
| Prescription refill | Takes name, number and pharmacy and passes it on | Approve or refuse a refill | Staff |
| Caller describes symptoms | Says it cannot assess symptoms; gives the 911 line for emergencies | Triage or reassure | Staff alert |
| Family member, employer or insurer | Takes name and number; does not confirm the person is a patient | Share any detail | Staff, with consent checks |
| Another provider or pharmacy | Takes name, number and message | Share chart details | Staff |
| # | Question for the vendor | Source | Why |
|---|---|---|---|
| 1 | Has a privacy impact assessment been done, and will you help us with ours? | [2] | The commissioner says custodians should conduct one before introducing an AI system |
| 2 | Does the service agreement bar you from using our patient information without authorization? | [2] | Guidance on vendor agreements |
| 3 | What breach support do you provide, and how fast do you tell us? | [2] [3] | Custodian must notify at the first reasonable opportunity in listed cases |
| 4 | Where are call audio and transcripts stored, and by whom? | AGNT/01 suggestion | Ask for subprocessors by name |
| 5 | How long are recordings and transcripts kept, and can we set it to zero? | [2] | Data minimization is a PHIPA concern |
| 6 | Can staff review every record the AI creates before it is relied on? | [2] | AI-created records should be independently reviewed |
| 7 | How do callers hear that an AI is answering and that a call may be recorded? | [6] | Disclosure before the first question |
| 8 | Can access be limited by role, and is it logged? | [5] | Role-based access is a College privacy example |
| 9 | What does the AI do with a caller who describes an emergency? | AGNT/01 suggestion | Scripted 911 line and a staff alert |
| 10 | What happens to our data if we end the contract? | AGNT/01 suggestion | Deletion confirmed in writing |
The commissioner also says custodians must be transparent about their information practices and that individuals' consent would generally be required for AI scribes, with express consent as best practice [2]. A receptionist is a different tool, so ask your lawyer how that applies to call handling.
Section 6.3(1) of Ontario Regulation 329/04 lists seven situations in which a custodian must tell the commissioner, and notice is due at the first reasonable opportunity [3]. The list applies whether the incident started with a person, a vendor or software.
| # | Situation (summary) |
|---|---|
| 1 | Information used or disclosed without authority, where the person knew or ought to have known they lacked it |
| 2 | Information that was stolen |
| 3 | After an initial loss or unauthorized use or disclosure, the information was or will be further misused |
| 4 | The incident is part of a pattern of similar incidents |
| 5 | The custodian must notify a College under section 17.1 of PHIPA |
| 6 | The custodian would have had to notify a College if an agent were a College member |
| 7 | The custodian considers the incident significant, based on sensitivity, volume, number of people and whether several custodians or agents were involved |
Consequences: administrative monetary penalties since January 1, 2024 of up to $50,000 for individuals and $500,000 for organizations; offence fines of up to $200,000 for individuals with imprisonment up to one year, and up to $1,000,000 for organizations [4].
| Rule | What it adds | Script consequence |
|---|---|---|
| PIPEDA [8] | Covers commercial customer data that is not personal health information | Opening line gives the purpose of each question |
| Recording guidance [6] | Callers should hear that recording is happening and why; see the call recording consent guide | Notice up front and a way to decline |
| CASL [7] | Consent, a named sender and a working unsubscribe for reminder texts | Texts carry logistics only |
Clinic types have their own regulators. See the physiotherapy clinic guide and the dental office guide.