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I know some European "automatic scribe" projects of the government sector. Their IT buys a physical GPU server hosted locally. Pretty sure it wouldn't be accepted otherwise (or maybe I'm just naive, but it sure is a topic they care about). The software stack is mostly open source, I think. It sure as hell doesn't talk to a big American cloud provider. (Well, the transcription service doesn't. Who knows what they do with the automated transcript. Probably the same thing they did with the manual transcript.)

Physicians, like lawyers, may still understand enough Latin to know what "invidia" means, and therefore never touch that crap with a ten-foot-pole.

https://en.wiktionary.org/wiki/invidia#Latin

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It's not just transcribing text, there is also a post processing step to turn it from an interview transcript into an actionable summary.