Best HIPAA-Compliant AI Meeting Assistants for Healthcare
For patient visits, telehealth, and any conversation that touches protected health information, the signed Business Associate Agreement is the line that matters. Here is who clears it, and who to keep away from PHI entirely.
Reviewed by Marcus Webb | Last updated October 2026
The best HIPAA-compliant AI meeting assistant for healthcare organizations in 2026 is Hedy. On its Enterprise plan it signs a BAA and can enforce on-device processing on every clinician's device, so protected health information never has to reach a vendor server, with any cloud data kept in a Google Cloud project the organization owns. Hedy Enterprise starts at 200 seats. Fellow is the strongest cloud option for clinical teams, and Zoom AI Companion suits practices already on a Zoom plan with a BAA.
"HIPAA-compliant" is not a badge a tool earns once and displays forever. It is a set of obligations the vendor takes on, and the one that actually protects you is a signed Business Associate Agreement. Without a BAA, no encryption claim or compliance logo makes a tool safe for protected health information. Beyond the BAA, look for encryption in transit and at rest, configurable retention, audit controls, and a written commitment never to train on your data. On-device processing is the safest default for PHI: data that never leaves the clinician's machine cannot be exposed by a vendor breach. The picks below are ordered by how well they meet that bar, followed by three tools you should keep away from PHI.
Hedy
Editor's Pick On-DeviceAI meeting coach with full on-device AI and real-time intelligence
The only meeting assistant among the 28 we tested with a built-in option to run its entire AI pipeline (transcription, summaries, and real-time coaching) on-device on supported hardware, making it the privacy and reliability leader for 2026.
Fellow
CloudPrivacy-forward AI meeting assistant with botless recording and an AI Chief of Staff
A privacy-forward AI meeting assistant that captures meetings without a bot and surfaces answers across all of them through its Ask Fellow agent.
Zoom AI Companion
Built-InZoom's built-in AI (formerly branded AI Companion), now reaching beyond Zoom meetings
No longer Zoom-only, and no longer branded AI Companion: Zoom's built-in AI is a credible agentic assistant, but it stays cloud-bound and lacks the on-device processing and live coaching that set Hedy apart.
Fireflies.ai
CloudAI meeting assistant with CRM integration and conversation intelligence
Best for sales teams who need deep CRM integration and conversation analytics, now with real-time meeting features layered on top.
Plaud.ai
HardwareAI voice recorder hardware with a full software platform
Once an in-person-only recorder, Plaud has grown into a capable hardware-plus-software platform with a desktop app, an AI agent, and a Team plan, though its AI still runs in the cloud.
HIPAA Readiness: How the Tools Compare
| Tool | HIPAA / BAA | Trains on your data? | On-device option? |
|---|---|---|---|
| Hedy | BAA on Enterprise (200-seat minimum); HIPAA Business Associate assessment + SOC 2 Type I (Apr 2026) | No (contractual) | Yes — full on-device pipeline, enforceable on Enterprise |
| Fellow | HIPAA support with signed BAAs; SOC 2 Type II | No (contractual) | No — cloud only |
| Zoom AI Companion | HIPAA-eligible under a Zoom BAA; confirm it covers AI features | No | No — cloud only |
| Fireflies.ai | HIPAA on Business/Enterprise; confirm signed BAA directly | Confirm per tier | No — cloud only |
| Plaud.ai | HIPAA and SOC 2 Type II company-wide (Trust Center); BAA plan unpublished | No | Hardware recorder; cloud processing |
| Read.ai | HIPAA on Enterprise+ tier only (larger orgs) | Confirm per tier | No — cloud only |
| Otter.ai | No BAA on free/standard; confirm any enterprise BAA | Yes, by default on free/standard | No — cloud only |
| Granola | No BAA on free/standard | Yes by default (anonymized); opt out in Settings | No — cloud transcription |
| Notta | Does not sign BAAs | Unclear — "no AI training" is listed as an Enterprise feature | Optional on-device transcription (beta); AI in cloud |
Why a Signed BAA Is the Dealbreaker
Under HIPAA, any vendor that handles protected health information on your behalf is a business associate, and you need a signed Business Associate Agreement with them before a single session note touches their system. No BAA, no lawful path to put PHI through the tool. The marketing copy is beside the point. So the first question is never "is it encrypted." It is "will they sign a BAA covering the exact features I plan to use." Several tools that advertise HIPAA support gate the BAA to higher tiers. Notta does not sign one at all, and it lists "no AI training" only as an Enterprise feature, which implies lower tiers may be used. Otter and Granola sign no BAA on their free and standard plans and train on your data there by default, which puts them out of bounds for PHI until you have an enterprise contract verified in writing.
The architecture underneath the BAA still matters. A cloud tool with a strong BAA, solid encryption, and a no-training pledge can be compliant. But the audio and transcript leave the clinician's machine and sit on a vendor's servers, which is exactly what a breach exposes. On-device processing removes that exposure at the source. Hedy can run transcription, summaries, and analysis locally on supported hardware through its Local AI Processing release, and on its Enterprise plan the organization can enforce that on every device, so the most sensitive part of a patient conversation stays on the clinician's machine and never reaches a server. That is why Hedy leads this list. It pairs the on-device default with the contractual and compliance scaffolding: a BAA on Enterprise (200-seat minimum), EU or US data residency, AES-256 and TLS 1.3 encryption, and a completed SOC 2 Type I and HIPAA Business Associate assessment from April 2026.
Compliance does not discharge consent. A signed BAA covers your relationship with the vendor. It says nothing about your client's agreement to be recorded. Recording laws vary by state, and some, including California, require all-party consent. Telehealth across state lines adds another layer, because you may be bound by the rules of the state where the client is located. Whatever tool you choose, get and document client consent before recording, and treat that as a separate, non-negotiable step. For the full breakdown of how to vet a vendor's HIPAA posture, see our companion guide on choosing a HIPAA-compliant AI note-taker for healthcare.