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Alexa, diagnose my cough

Tags: public health

About a year ago, my wife and I got a Sonos Beam for our house. With built-in Amazon Alexa, I thought this would be a pretty awesome way to interact with the TV, and would allow me to live out my dream of being on the USS Enterprise, asking Alexa to make me coffee, order groceries, and at the very least, start playing A State of Trance on Spotify.

After a year, I’ve realized a few things. One, Alexa can do a lot of things. Timers while you cook? Check. Turn the volume up and down? Check. Link to your thermostat? You got it. However, there are other tasks it can’t do so well. Do you want it to play music by Ricky Martin? It might read out the Wikipedia entry for the name “Martin” instead (true story).

Which made me very interested in this recent article in HBR, discussing the use of smart speakers in healthcare. See, smart speakers are very good at “discrete” tasks, where they can look up an answer in a database. Questions like “what is the weather tomorrow” works really well, because it can 1) check your current location, 2) pull up the weather for tomorrow, 3) read the weather for tomorrow. Very straightforward, and very simple steps. However, how does a voice assistant deal with complex data from health records?

Smart speakers can help you in your personal life – but how can they help improve the healthcare experience? (Photo by Caio Resende from Pexels)


That’s where the Innovation and Digital Health Accelerator (IDHA) at Boston Children’s Hospital comes into play. As a healthcare incubator, IDHA is well positioned to bring together key stakeholders to identify important questions, and then develop and test answers to those practical and applied healthcare questions. The article provides an example of 3 pilots that IDHA has rolled out – the ICU, organ transplant, and home health decisions. Each of these uses voice assistants to their strengths, helping enhance patient care. The example for the ICU is below:

The intensive care unit. In the health care setting, where sterile operating fields and infection control are priorities, hands-free, immediate access to information has big advantages in terms of safety and efficiency. IDHA’s voice deployment in the Boston Children’s ICU allows nurses to ask for key administrative information: “Who is the charge nurse on 7 South?” “How many beds are available on 8 East?” Clinicians are finding voice most useful for getting information that would otherwise involve picking up the phone, searching through documents, or walking down the hall. (Source)

What is perhaps the most striking is that physicians seem to be quite receptive to the idea of voice assistants in their practice. Of the paediatricians surveyed, 48% were willing to use voice assistants in their clinics, while only 16% were against it. However, there were concerns raised about how to roll this out – it would need to be done in a way that, if physicians were using the software, they could do it privately, without patients being able to hear them. The reasoning for this is twofold – the first is that they will use the responses to inform their clinical decision making, but ultimately they will make the decision themselves. The second is around patient privacy. Not only do they not want others to be able to overhear their conversation, they also want to know where the information is being uploaded, how it is being stored and secured, and how it can be accessed and by whom. While EMR’s and similar systems are being built with those in mind, voice assistants would need to follow the same privacy legislation laid out to ensure patients are adequately protected.

While I enjoy having a smart speaker in the house for personal use, the technology is still quite young and needs refinement before it can be used in professional settings, especially medical settings. However, with the speed of advancement that these products are making, this is the time to be thinking and planning how these devices can further enhance patient care and empower the patient experience.

Note: I’ve used “smart speaker” and “voice assistant” synonymously here, but there are nuances. A smart speaker is the hardware – which can be improved through better microphones, noise cancelling, beam forming, and other hardware upgrades. On the other hand, a voice assistant is like Amazon’s Alexa, Google’s Ok Google, or Apple’s Siri. This is a software agent that parses language and processes instructions, which is why sometimes Alexa can do something while Siri struggles, or vice versa.

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