# Transcription Options Guide

## Overview

Pediatric AI Scribe v2+ offers **three transcription methods**, allowing you to choose between **privacy**, **speed**, and **real-time feedback**.

---

## 📊 Comparison Table

| Feature | Browser Whisper | Server Transcription | Web Speech API |
|---------|----------------|---------------------|----------------|
| **Privacy** | ⭐⭐⭐⭐⭐ 100% offline | ⭐⭐⭐⭐ (with BAA) | ⭐ Sends to cloud |
| **Accuracy** | ⭐⭐⭐⭐⭐ Whisper | ⭐⭐⭐⭐⭐ Gemini/AWS | ⭐⭐⭐ Browser-dependent |
| **Speed** | ⭐⭐⭐ 2-10s | ⭐⭐⭐⭐⭐ ~1s | ⭐⭐⭐⭐⭐ Instant |
| **Real-time** | ❌ Batch mode | ❌ Batch mode | ✅ Live streaming |
| **HIPAA** | ✅ Yes | ✅ (Vertex/AWS) | ❌ No |
| **Cost** | Free | ~$0.005/min | Free |
| **Internet** | ❌ Not required | ✅ Required | ✅ Required |
| **Setup** | None (bundled) | API keys | None (built-in) |

---

## Option 1: Browser Whisper (Offline, Private) ⭐ RECOMMENDED

### What It Is
- Runs **OpenAI Whisper** entirely in your browser using WebAssembly
- Audio **never leaves your device** - 100% offline after initial page load
- Models bundled in Docker image (self-hosted, no CDN)

### When to Use
- ✅ Clinical documentation (HIPAA-compliant)
- ✅ Maximum privacy required
- ✅ Offline/air-gapped environments
- ✅ No API costs
- ✅ Zero vendor dependency

### How to Enable
1. Settings → Browser Transcription
2. Toggle "Enable browser transcription" ON
3. (Optional) Click "Pre-download model" if you want to cache it first
4. Start recording - transcription happens automatically after recording

### Models Available
- **Tiny** (~39MB) - Fast, good for short clips (2-3 seconds)
- **Base** (~74MB) - Balanced accuracy and speed (3-5 seconds)
- **Small** (~244MB) - Best quality, slower (6-10 seconds)

### Performance
- Transcribes ~30-second clip in 2-10 seconds (depending on model)
- First run may be slower (model loading)
- Subsequent runs are instant (cached)

### Privacy
- ✅ Audio never transmitted
- ✅ Models run locally in WASM
- ✅ No network calls during transcription
- ✅ HIPAA-compliant

---

## Option 2: Server Transcription (Cloud, Fast)

### What It Is
- Sends audio to your configured AI provider
- Uses Google Gemini, AWS Transcribe, OpenAI Whisper, or LiteLLM

### When to Use
- ✅ Maximum speed (~1 second for 30-second clip)
- ✅ Best accuracy (cloud models)
- ✅ Long recordings (Browser Whisper can be slow for 5+ minutes)
- ✅ HIPAA-compliant with BAA providers

### HIPAA-Eligible Providers
- **Google Vertex AI** (with BAA) ✅
- **AWS Transcribe** (with BAA) ✅
- **Azure OpenAI** (with BAA) ✅
- **OpenAI Whisper Direct** ❌ Not HIPAA-eligible

### How to Enable
- Configured via environment variables (`.env`)
- No user action needed - just works if API keys present
- Falls back automatically if Browser Whisper fails

### Cost
- Google Gemini: ~$0.005/minute
- AWS Transcribe: ~$0.024/minute
- OpenAI: $0.006/minute

---

## Option 3: Web Speech API (Real-Time, Experimental) ⚠️

### What It Is
- Uses your browser's built-in speech recognition
- Shows transcription **in real-time** as you speak (streaming)
- Chrome/Edge → Google Cloud Speech
- Safari → Apple Speech Recognition

### ⚠️ PRIVACY WARNING
- **Audio IS sent to cloud servers** (Google, Apple, etc.)
- **NOT HIPAA-compliant**
- Only use for non-clinical, personal use

### When to Use
- ✅ Personal notes (non-clinical)
- ✅ Want real-time feedback while speaking
- ✅ Demonstration/testing
- ❌ **NEVER for patient data**

### How to Enable
1. Settings → Real-Time Streaming Transcription
2. Read privacy warning carefully
3. Toggle "Enable real-time streaming" ON
4. Confirm warning dialog
5. Grants microphone permission
6. Start recording - see words appear live

### Limitations
- Not available in all browsers (requires Web Speech API)
- Accuracy varies by browser
- Requires internet connection
- May have usage limits

---

## Choosing the Right Option

### For Clinical Use (HIPAA Required)
**Use:** Browser Whisper (offline) OR Server (Vertex AI/AWS with BAA)
- Browser Whisper: Maximum privacy, no costs
- Server: Faster, better for long recordings

### For Personal Use (Non-HIPAA)
**Use:** Any option
- Browser Whisper: Best balance of privacy and accuracy
- Server: Fastest
- Web Speech: Real-time feedback

### Decision Tree

```
Is this clinical/patient data?
├─ YES → Use Browser Whisper or Server (Vertex/AWS)
│   ├─ Need offline? → Browser Whisper
│   ├─ Need speed? → Server (Vertex AI)
│   └─ Want free? → Browser Whisper
│
└─ NO → Any option
    ├─ Want real-time? → Web Speech API
    ├─ Want privacy? → Browser Whisper
    └─ Want speed? → Server
```

---

## Configuration

### Browser Whisper
```bash
# No configuration needed - bundled in Docker image
# Models at: /app/public/models/Xenova/whisper-tiny.en/
```

### Server Transcription
```bash
# .env file
TRANSCRIBE_PROVIDER=google  # google, aws, openai, litellm

# Google Vertex AI
GOOGLE_VERTEX_PROJECT=your-project-id
GOOGLE_APPLICATION_CREDENTIALS=/path/to/key.json

# AWS Transcribe
AWS_BEDROCK_REGION=us-east-1
AWS_ACCESS_KEY_ID=your-key
AWS_SECRET_ACCESS_KEY=your-secret

# OpenAI
OPENAI_API_KEY=sk-...

# LiteLLM (proxy)
LITELLM_API_BASE=http://localhost:4000
LITELLM_API_KEY=optional
```

### Web Speech API
```bash
# No configuration - uses browser built-in
# Privacy warning shown in Settings UI
```

---

## FAQ

### Q: Which is most accurate?
**A:** Browser Whisper and Server (Gemini/Whisper) are equally accurate. Web Speech is slightly less accurate.

### Q: Which is fastest?
**A:** Server transcription (~1s) > Web Speech (real-time) > Browser Whisper (2-10s)

### Q: Which is most private?
**A:** Browser Whisper (100% offline) > Server (with BAA) > Web Speech (not private)

### Q: Can I use multiple at once?
**A:** No. Priority: Web Speech > Browser Whisper > Server (whichever is enabled first)

### Q: What if transcription fails?
**A:** Automatic fallback chain:
1. Browser Whisper (if enabled)
2. Falls back to Server (if configured)
3. Falls back to live transcript (if available)

### Q: Is Browser Whisper really offline?
**A:** Yes! Models are bundled in the Docker image. After the page loads once, transcription works with zero network access.

### Q: Does Web Speech work offline?
**A:** No. It requires internet to send audio to cloud servers.

### Q: Can I train/customize the models?
**A:** No. Browser Whisper uses pre-trained models. Server transcription uses cloud models. No custom training available.

---

## Troubleshooting

### Browser Whisper stuck at "Initializing"
- **Cause:** Models not loaded or network blocked during initial download
- **Fix:** See [browser-whisper-troubleshooting.md](browser-whisper-troubleshooting.md)

### Server transcription returns "No provider"
- **Cause:** API keys not configured
- **Fix:** Set environment variables in `.env`

### Web Speech says "Not supported"
- **Cause:** Browser doesn't support Web Speech API
- **Fix:** Use Chrome, Edge, or Safari

### Transcription is slow
- **Browser Whisper:** Try switching to "Tiny" model
- **Server:** Check API provider status
- **Web Speech:** Check internet connection

---

## Best Practices

### Clinical Documentation
1. Use Browser Whisper for all patient data
2. Enable audio backups (automatic in v2)
3. Keep recordings under 5 minutes for faster processing
4. Use "Tiny" model for quick notes, "Base" for detailed documentation

### Personal Use
1. Web Speech for quick, informal notes
2. Browser Whisper for anything you want private
3. Server for long recordings

### Performance Optimization
1. Pre-download Browser Whisper model before first use
2. Use shorter clips (30-60 seconds) for fastest results
3. Clear browser cache if models seem corrupted

---

## Summary

| Need | Recommendation |
|------|---------------|
| Clinical/HIPAA | Browser Whisper (offline) |
| Fast transcription | Server (Vertex AI) |
| Real-time feedback | Web Speech (non-clinical only) |
| Maximum privacy | Browser Whisper |
| Zero cost | Browser Whisper |
| Long recordings | Server (faster for 5+ min clips) |
| Offline use | Browser Whisper |

**Default recommendation:** Browser Whisper for 95% of use cases. It's private, accurate, free, and offline. Only use alternatives when you have specific needs for speed or real-time feedback.
