Making Visible, Making Invisible: How an AI Scribe Reshapes Documentation Authority in Social Work
Eunki Joung ⋅ Hong Chul Nam ⋅ Geonhwi Hwang ⋅ Moohyun Lee ⋅ Hyun Kwon
Abstract
AI scribes have shown promise in reducing clinical documentation burden and are now extending into social work. Social work documentation, however, serves a distinct function: it mediates between individual clients and the welfare regime, determining eligibility and shaping whose needs are recognized. We designed and deployed $\textit{Care Fish}$, an AI scribe technology probe for in-home older adult care in South Korea, with four social workers over two weeks. Participants reported that Care Fish improved documentation efficiency by surfacing information missed during client interviews, and they identified and corrected its errors during a re-entry step into their existing systems. The deployment also surfaced shifts in documentation practice. The recording and AI-generated citations acquired a form of authority that workers compared against their own observations, reinforcing an existing epistemological hierarchy in which institutional ways of knowing outrank both worker observation and client speech. The expectation of being recorded changed how both clients and workers spoke during case interviews. We discuss how these shifts bear on workers' professional discretion and clients' self-presentation and consider design directions that make the AI scribe's own perspective visible to the workers who use it.
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