“It is, from a user's perspective, an enormous black box. You put things into it, and you don't really know what happens to those things…”
Cold Call · August 2026
HBS professor Susanna Gallani, discussing why physicians and patients hesitate to trust an AI scribe that records and transcribes clinical visits. Her point is that opacity, not the technology's usefulness, is what undermines adoption.
Transcript
…amount, did not pursue it. So they had the license, they just didn't do it. And in fact, there was a rule that if you didn't use it for three months, they would ask you why and potentially take it away. Because it has a cost. There is a monthly fee for this licenses, which is person by person.
…what if it breaks? Or what if I don't do it right? What would you say to people who are listening who are maybe going through the same kind of a process in their own organization? What are the sorts of things that you have to be thoughtful about as you're trying to scale up this kind of platform?
The first thing is trust, right? We talked about it. It's really difficult for people to just embrace this when this technology changes daily. It is, from a user's perspective, an enormous black box. You put things into it, and you don't really know what happens to those things, things being information, sometimes sensitive, sometimes personal. And so having this expectation that everybody will jump at the opportunity to use it is probably misguided. So understanding what do you need to do to make it so that people trust what you're going to do with that technology. Generally speaking, security of that technology, it is a black box for the leadership too. It's not that we understand this infinitely well. Remote learning,
yeah.
Yes, and it's changing so much that we tend to understand less and less instead of more and more in certain ways, right, of what it does and what it's capable of doing. So the first thing would be trust. The second thing would be use it to bring up the humanity of the workers and not to replace…
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