A perfect example of this is what happened near me. There was a picture taken for the newspaper of an ambo crew and inadvertently the patient they were carrying was identifiable in the pic. There was a complaint filed and it was determined it was a HIPAA violation.
If the wife is legally associated with the practice, I would not think it a problem. If she has no legal connection, I would think it is a problem. To determine the answer, you will have to determine if the wife is legally associated with the practice in a manner that would allow her access to patients' records.
If there is audio on the system, there is a problem. It has nothing to do with HIPAA but the eavesdropping laws.
I am not an attorney and any advice is not to be construed as legal advice. You might even want to ignore my advice. Actually, there are plenty of real attorneys that you might want to ignore as well.