What shadow AI is
Shadow AI is the AI version of shadow IT. Staff adopt tools on their own because they help with the work, without security review, a contract, or a BAA. Examples include drafting patient letters in a free chatbot or summarizing a payer report in a personal account. Another is a browser extension that reads every page.
It is common in healthcare. Wolters Kluwer surveyed 518 providers and administrators, releasing results in January 2026. 40% had encountered unauthorized AI tools at work, and 17% had used them. In a Black Book survey released December 2025, 58% of frontline health-system staff used generic AI tools for work in the past 30 days. Of those users, 17% sometimes or often included identifiable patient information.
Shadow AI usually signals unmet demand, not bad intent. In Elsevier's 2025 Clinician of the Future survey, only 32% of clinicians said their institution provided adequate AI access. Bans alone tend to push use further out of sight. The fix is an approved tool with a BAA, plus a clear AI acceptable use policy. Rivvi is built to be the AI a healthcare team is allowed to use at work.