AI for medical practices · POPIA

POPIA, patient confidentiality and an AI receptionist.

Health information is special personal information under POPIA, and a patient's health status is confidential under the National Health Act before any software comes into it. This page covers what that means for a South African practice putting an AI receptionist in front of its patients: the notice, consent, where the records are hosted, how long they are kept and what an erasure can and cannot do.

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Nothing on this page is legal advice. It is a plain summary for a practice manager, so the questions put to any supplier, us included, are better ones. The general POPIA picture for any business, including operator agreements and cross-border transfers, is on POPIA and AI chatbots; this page keeps to what is different for a practice.

The category that changes things

Health data is special personal information: what changes.

POPIA's special personal information is a short, defined list, and health is on it. Section 26 prohibits processing it unless a ground lifts the prohibition. Section 27 holds the general grounds, consent among them, and section 32 carries the grounds specific to health, which let medical professionals and healthcare institutions process it for a patient's proper treatment and care, or for running the practice, under a duty of confidentiality. The moment an assistant asks a patient why they want to be seen, the practice is in this territory.

Collect less in the chat

A message typed into a chat does not stay in one place: it is in the conversation record, on the dashboard, and in the model's context for the rest of that conversation. So the assistant does not collect ID numbers, medical aid numbers or medical history a message at a time. Those go on the practice's own form, which comes back as one PDF against the booking.

The one switch that differs

A practice that needs to find a returning patient's file can switch on one message asking for name and surname plus an ID number or date of birth. It is off unless the practice turns it on, the server stores the ID on the patient record and never writes it into the assistant's instructions, and it is masked in the system's logs.

The privacy page says so

An instance set up as a health practice publishes its own privacy notice with a section on health information as special personal information, naming the ground it processes on, and a section on what the assistant does and does not do in a practice.

Before anything is asked

Consent and the notice patients see first.

POPIA section 18 wants a person told who is collecting their information and why, at the point it is collected. For a practice using an AI receptionist there is a second thing to say at that point: that the patient is talking to an AI.

The first message says it is an AI

On a health instance the server puts the disclosure on the first reply, before anything asks for information: an AI assistant, no medical advice, and a person on request. It is said in English or Afrikaans to match the patient, and above the practice's own notice rather than instead of it.

The policies on the message that asks

Where the practice asks patients to accept its privacy notice and payment policy, the links are on the message that asks, and the server records which version of each policy the patient accepted and when. Where the notice says that carrying on is acceptance, the practice can have the first reply of any kind recorded the same way as a tap on Agree.

A record that answers a request

That acceptance record is what answers a later access request under POPIA or PAIA, and a patient who would rather not answer a question in the chat can ask for a person instead.

Hosting and access

Where the data lives, and who can see it.

Each practice runs on its own isolated instance with its own database, not a row in a table shared with other businesses. The instance is hosted in Johannesburg; the AI model that composes replies runs outside South Africa, so the text of a conversation crosses the border for each reply. We do not claim your patients' data never leaves the country.

The offshore leg, stated

POPIA has no data-localisation rule, and section 72 governs transfers across the border. We do not train models on patient conversations. On our provider account, its API terms provide that content sent through the API is not used to train their models; on a client's own AI key, that provider's terms apply instead.

People at the practice

Each person at the practice can sign in by name, the diary records who changed each appointment, and the owner decides who sees the practice's figures. A leaver is disabled rather than deleted, so the record of what they did stays.

People at our end

We are the operator. We can reach an instance to support it, and the container logs are kept free of patients' personal details by design. Ask us, in writing, who that is and how it is controlled.

Health data going offshore can raise one more question, prior authorisation under section 57, which the general page covers: POPIA and AI chatbots.

How long

How long records are kept: the six-year floor.

HPCSA guidance expects a practice to keep patient records for at least six years after they become dormant, and POPIA section 14 keeps a record for as long as another law requires it. So on a health instance the deletion clock has a floor. Patient chats, appointments, records and forms are kept for at least six years, and a shorter period typed into the settings is raised to the floor rather than obeyed. There is deliberately no switch that shortens it.

What the floor does not know

Age. For a minor, the period runs from majority rather than from the visit. The software does not read anybody's age, so a practice treating children sets its own longer period, and every retention report reminds the owner of that.

It reports before it deletes

The deletion clock is off until the practice switches it on, and its first run only reports what it would remove. Nothing is deleted until somebody has seen that list.

When a patient asks to be forgotten

Erasure requests and what cannot be erased.

The dashboard has an Erase this person control inside each conversation. On a medical practice only the owner's own sign-in can use it, not the front desk's, because it is the one action in the product that cannot be undone. It erases the person rather than one thread: every earlier conversation from the same number, and the entries the assistant put in the practice's calendar. It then says what it actually removed.

The erasure does not check the six-year floor, and it will delete on request. Whether a given request should be honoured in full, against the practice's own duty to keep a record, is the practice's decision, so make it before pressing the button. And some things are out of its reach:

Messages already sent

Reminders, alerts, emails and PDFs that have already left the server cannot be recalled, by us or by anybody.

Records kept for tax

Invoices and payment records are kept for the period tax law requires, which POPIA section 14 allows.

Backups and other systems

Encrypted backups hold the state as it was, so an erasure is re-run on any instance restored from one. Copies in the practice's own systems, and those held by Meta for WhatsApp, are outside the instance.

Confidentiality

HPCSA confidentiality and the doctor's own duties.

National Health Act section 14(1) makes information about a patient's health status, treatment or stay in a health establishment confidential. Disclosing it needs the patient's written consent, a court order, or a serious threat to public health. The HPCSA's ethical rules on confidentiality sit on top of that, and they bind the practitioner, not the software. No supplier's terms can vary any of it.

Under POPIA the practice is the responsible party and we are its operator. That means the practice decides what the assistant collects and what patients are told, and we process on its instructions. It also means an AI receptionist keeps the confidentiality question manageable only if it stays administrative. An assistant collecting a name, a slot and a form is doing administration. An assistant drawn into a conversation about symptoms is doing something else, which is why ours is designed never to give clinical advice, and why on a medical practice the server checks every reply for it before it is sent. More on that line is on WhatsApp AI for doctors and clinics.

Compliance is a property of how a practice operates, not of a product. No product is compliant on its own, ours included. What a product can do is make the honest answer easier to give.

Before you sign anything

Questions to ask any vendor.

Including us. If a supplier cannot answer these in writing, that is itself the answer.

Where is it hosted, and what crosses the border?

Which country holds the records, which country composes the replies, and what is written down about the transfer.

Does the patient know it is an AI?

Show me the first message a patient receives, in every language you support.

What happens when a patient describes a symptom?

Show me the actual reply, not a paragraph about model safety.

How long is it kept, and can we shorten it?

If the answer for patient records is "yes, to anything", ask how that squares with the six years.

Who at your company can read our conversations?

Names or roles, and how access is controlled.

What does an erasure really remove?

Ask for the list of what it cannot reach as well as what it can.

FAQ

Fair questions.

Is an AI receptionist POPIA compliant?

No product is, ours included. Compliance is a property of how a practice operates: what it collects, what it tells patients, what it has agreed with its suppliers and what it does when somebody asks for their information. A product can make that easier or harder, and we will tell you in writing what ours does and does not do, so that your own answer can be an honest one.

Do patients need to consent?

Health information may only be processed on a ground POPIA recognises. Consent under section 27 is one; section 32's health grounds for medical professionals and healthcare institutions are another. The privacy notice our health instances publish processes what a patient chooses to share in the chat on the basis of their consent, tells them they never have to answer in the chat, and records which version of the practice's policies they accepted. Which ground fits your practice is a question for your own advisor.

Can patient data leave South Africa?

POPIA has no data-localisation rule, and section 72 allows a transfer across the border under a binding agreement or adequate protection. Each practice's instance is hosted in Johannesburg, but the AI model that composes replies runs outside South Africa, so we do not claim the data never leaves the country. Health data going offshore can also raise prior authorisation under section 57, covered on the general POPIA page.

How long do you keep chats?

On a medical practice, at least six years. Patient chats, appointments, records and forms sit under a six-year floor that a shorter setting cannot lower, because HPCSA guidance expects patient records to be kept that long. A practice treating children sets a longer period itself, because the software does not know anybody's age. The deletion clock is off until the practice switches it on, and its first run only reports what it would delete.

Ask us the hard version, in writing.

Tell us about your practice and we will set out, in writing, what the assistant collects, where it is hosted and processed, who can see it, how long it is kept and what an erasure removes, so your own answer to a patient can be an honest one. Or try the live medical demo first and ask it about its own privacy.

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