Lowell General Hospital Turns Amazon’s Alexa Into an mHealth Coach

December 23, 2019 - Lowell General Hospital is turning Amazon’s Alexa into an mHealth assistant for patients headed home after undergoing knee replacement surgery.

The Massachusetts-based hospital is in the midst of a second pilot program with the Amazon Echo voice assistant and an mHealth platform developed by Frontive. The connected health service is designed to help patients before and after their hospital stay, giving them a digital health resource for education and care management questions.

“Our patients often get pages and pages of discharge instructions that we’re not even sure they read,” says Barbara Viens, the hospital’s Director of Orthopedic Services. “There’s a lot of information there that we go over with them while they’re in the hospital, but once they leave that connection with them is gone.”

With mHealth technology like that developed by Frontive, hospitals are now turning to Alexa and other voice assistants to make the transition from the home to the hospital and back home again as seamless as possible, so that those connections aren’t lost.

Prior to a trip to the hospital, the service is loaded with information helping patients prepare for their stay; after discharge, it helps them manage their recovery, offering information on medications, exercise, diet, sleep and upcoming appointments. In some cases the platform can integrate with the patient’s medical record, synching medication histories and other data that might affect post-discharge instructions.

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"When patients are heading home after surgery or were just prescribed their tenth daily medication, expecting them to fully grasp and recall the details around all of these instructions is unrealistic and sets them up for failure," Anthony Jones, Frontive’s co-founder and CEO, said in a September press release announcing the launch of the company’s telehealth platform. "Today, too much patient information is organized and presented to reduce liability instead of supporting patients the way they actually experience recovery and health management. We're aiming to change this so that patients always feel supported and in control."

Lowell General has been rolling out the service in phases, focusing first on knee replacement cases because hospital officials saw that population as an ideal test case. With knee replacements, post-discharge care plans are very specific and detailed, not only outlining the steps that patients must take to recover mobility but leaving opportunities for that recovery process to go awry if that care plan isn’t followed.

And if that care plan isn’t followed, a patient could wind up returning to the hospital – an expensive and unnecessary outcome that affects the patient’s outcome and the hospital’s bottom line.

Viens says the mHealth service loaded into an Echo device gives patients a chance to check in every day on their care plan, while also giving the hospital an opportunity to tweak that care plan on the fly if so needed. A real-time messaging service isn’t included with this particular platform, but it does give patients the opportunity to connect by phone.

“We’re giving these patients the opportunity to take control of their care at home,” she says.

Platforms like Alexa are popular in consumer circles, but they’ve been slow to adapt to healthcare uses. They’re being tested out in a number of homecare and senior living programs, and Lowell General is one of a few dozen health systems to use them in the remote patient monitoring arena.

Viens sees the day when the technology is used to connect with chronic care patients and others who could use a health assistant at home. And she cautions providers to test out the platform before sending an app home with every patient.

“I think this will help fill in the gaps in care that lead to hospital readmissions,” she says. “It’s personal to the patient. It can be their coach. But you have to be clear about what you expect from the technology and what you’re going to get. The patient wants to know what the patient wants to know.”

For now, Lowell General is looking to chart how often the platform is accessed at home, and to compare those uses against measurable clinical outcomes, including rehospitalizations.

“This technology is going to help our most vulnerable patients stay well, or at least stay as well as they can be, and stay in their communities,” Viens says.