- Voice-enabled digital assistants like Alexa are all the rage in the consumer market these days, but connected health experts are expecting providers to be cautious in developing mHealth applications for clinical use.
Still, the interest is high – there’s even a “50 States of Alexa” conference scheduled for January 2019 in Chattanooga, Tenn. With one of four tracks devoted to healthcare uses. Imagine Alexa in the doctor’s office, helping a physician access a patient’s records or pulling up common diagnoses for a list of symptoms. How about Alexa in the emergency room or the operating room, pulling up X-rays and other patient data for the clinician with his or her hands full?
That’s not the same as, say, the living room or kitchen.
“It’s still really very new,” says Erin Benson, director of market planning for LexisNexis Health Care. “We’re still kind of early on the authentication side.”
To date, Alexa and her kind have proven their value in helping people with simple tasks, like ordering a pizza, calling a cab or buying something online (from Amazon, of course). In healthcare, the platform is gaining favor in chronic care, senior care and assisted living, where Alexa can act as a kind of home companion, giving out appointment and medication reminders and connecting with the care team.
“People are getting comfortable with this technology at home,” says Benson. “In that setting, it’s OK for the patient to be kind of anonymous. But it’s different in a doctor’s office.”
Amazon is fully invested in Alexa’s future in healthcare. The company created a healthcare IT unit earlier this year, called 1492, and has a “health and wellness” team, headed by Amazon veteran Rachel Jiang and including mHealth security expert Missy Krasner, Larry Ockene and Yvonne Chou, working specifically on Alexa’s platform. With its healthcare partnership with Berkshire Hathaway and J.P. Morgan on the books, Alexa may play a bigger role.
In Massachusetts and Rhode Island, the Brewster Ambulance Service has been testing Alexa as a voice-activated reference for ambulance personnel during transport. The application enables access to the Emergency Medical Services Statewide Treatment Protocols.
“It’s essentially a sheet of music for emergency responders and providers,” Chris DiBona, the 250-vehicle private ambulance service’s clinical director, told the Quincy Patriot Ledger. “The sheet of music we work off of is about a 300-page document.”
For instance, a paramedic might say, “Tell me about congestive heart failure,” and the device would recite the protocol for treating CHF.
Other potential uses, DiBona said, might include identifying the nearest hospital with the necessary facilities for treating a certain condition, such as severe burns, the bends or a mental health crisis.
Health systems have also been taking a look at the technology. Boston Children’s Hospital is using an app tailor-made for Alexa, called KidsMD, that allows users to ask general health and wellness and medication dosing questions. And that’s just the first step.
“There are some massive voice applications that will be built for health enterprises,” John Brownstein, chief innovation officer at Boston Children’s, told CNBC.
Boston’s Beth Israel Deaconess Medical Center, New York’s Northwell Health, Ochsner Health in New Orleans Atrium Health (formerly Carolinas HealthCare) are also working on applications for Alexa and other voice-based personal assistants, mainly built around patient queries. Even some insurers, like Cigna, are developing uses for their members.
“Right now they’re working on interactive conversations with structured responses,” says Chris Edwards, chief marketing and experience officer for Conversa, one of dozens of digital health companies jockeying for position in the market. “They’re automated and can be personalized, and they make patients feel more engaged in their healthcare.”
Edwards says Alexa will more likely be adapted to the doctor’s office first, with applications built around population health messaging.
“It’s not too far away,” he says. “It could allow them to scale and coordinate outreach.”
One of the biggest challenges in fitting Alexa and her digital colleagues into the hospital or doctor’s office will likely be privacy and security. Any applications that access patient information have to be compliant with the Health Insurance Portability and Accountability Act (HIPAA), so there has to be a framework in places to not only verify the user’s identity, but ensure that he/she has the authority to call up a patient’s data.
“That’s not going to be easy,” says Benson.
Benson says much of the innovation surrounding voice-activated digital assistants is coming from small but ambitious mHealth companies “who are trying to make the technology fit specific uses,” much in the same fashion that startups are driving the smartglasses field. They’ll be the ones, she says, to develop clinical uses for the technology.
“Patients are getting very comfortable with this technology at home,” she points out. “So providers are going to want to start using it as well.”