Why Alexa could be listening in at your next hospital visit

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Why Alexa could be listening in at your next hospital visit

Voice-activated personal assistants like Amazon Alexa and Google Home are becoming fixtures in people's homes. This could be the year voice makes its way into health care, said Nate Treloar, president and chief operating officer for Orbita, a voice technology company focused on health care. Treloar said he recently attended a health conference where three-quarters of the attendees said they were interested in using voice technology in 2018.

The company partnered with Libertana Home Health, a home health care company in California, to create an application for Alexa that helps residents report their weight, blood pressure and sugar levels, get reminders for medication and exercise, call for help from home care workers and hear about activities. It's one of many ways voice assistants could find use in health care.

Voice technology & health care

One of the most promising uses for voice is in coaching patients, Treloar said. A voice assistant could help someone with diabetes manage their care by reminding them to take insulin, for example.

Voice technology could also help in collecting data for clinical trials, Treloar said. Rather than researchers having to call patients to record health data, a voice assistant could ask patients for information instead. For example, patients in a trial for a drug that treats rheumatoid arthritis might be asked to answer questions daily about how easy they find it to perform activities like buttoning their shirt or picking up a glass of water. Rather than having to coordinate a call, a patient could report that information to a voice assistant on their own time — and even be reminded to do so.

Emily Kagan-Trenchard, vice president of digital and innovation strategy for Northwell Health, a health care provider with 22 hospitals, mostly in New York, can even see voice technology being used in patient rooms. Patients could use a voice assistant to summon a nurse on duty or check what the next step is in their treatment. Voice technology could eliminate the all-too-common experience of having to watch your doctor or nurse type your health information into a computer during an appointment. A voice assistant could just listen instead.

"As voice technology improves, there's nothing to say it couldn't be writing directly into the medical record," Kagan-Trenchard said.

Why use a voice assistant?

When the team at Northwell designed its own Alexa application — known as a "skill" — they considered when someone might want to use voice: When their hands are busy and they're not in front of a screen. For example, if you're cooking dinner and you accidentally cut your finger, it could be difficult for you to use a touch screen to look up the nearest urgent care center, Kagan-Trenchard said.

Voice comes naturally to people, Treloar said. It's more accessible for people with physical ailments or impaired vision.

"Hands-free devices that are always available reduce the barrier to access and engagement," Treloar said.

Many older people are comfortable using voice technology, as Orbita found when it introduced it to patients receiving home health care, Treloar said.

Northwell Health & Alexa

Northwell Health built its Alexa skill in-house, Kagan-Trenchard said. Users can use it to ask Alexa for wait times at nearby Northwell emergency rooms and urgent care centers. They can also ask for information on specific Northwell locations.

This is useful for people in densely populated areas like New York City, where many Northwell hospitals and urgent care centers are located. Knowing wait times at multiple locations helps patients make the best choice in case of an emergency, Kagan-Trenchard said.

"Depending on the traffic, as every good New Yorker knows, it could be 15 minutes or 45 minutes depending on the time of day and which way you're headed," she said.

Northwell is exploring other uses for voice technology, Kagan-Trenchard said. It's one of only a few health care systems that have designed a skill in-house. Boston Children's Hospital created a skill to help parents decide whether a symptom like fever or cough merits a call to the doctor. Mayo Clinic has a skill that delivers daily health tips and another that answers questions on non-life-threatening health problems like burns or cuts.

What about privacy?

Voice assistants like Alexa and Google Home represent yet another way for giant technology companies to collect your private data. That might be creepy enough, but having your data in the world also potentially exposes it to hackers. Imagine throwing your health information into that mix.

The privacy of your health information is protected under the federal law known as the Health Insurance Portability and Accountability Act. Commercially available in-home voice assistants like Alexa aren't compliant with the 1996 law, making their use in a hospital setting unlikely, at least for the near future. (Amazon did not return a request for comment.)

"There's just a lot of specialized requirements in that setting," Kagan-Trenchard said.

For voice applications to work in patient rooms, hospitals need the ability to wipe the devices once patients leave. The devices need to have the ability to make sure patients are in a secure area when they're recording sensitive information, Kagan-Trenchard said.

Hotels are grappling with these issues too. A Marriott official told Travel Weekly the hotel was working with Amazon to address privacy concerns with putting Alexa in hotel rooms.

Northwell is pressing ahead, as well. Aside from the Alexa skill it created, the health system is experimenting with voice applications in its Center for Learning and Innovation, where it test drives new technologies in simulations without patients. If those tests are successful, then it's possible voice apps could make it to an actual hospital floor, Kagan-Trenchard said. But between the testing process and privacy concerns, it could be at least a year before patients see them in hospitals, she said.

Image: JohnnyGreig