The Power of Voice in Health Care

The Voice of Health Summit, held at Harvard University Medical School on August 7, 2018, was full of exciting discussion on the future of voice technology in health care. The event was mostly consumer-focused, particularly on the elderly and disabled populations, because of speech technology’s ability to be hands-free and home-based. The second most discussed target demographic was clinicians. Voice is attractive to clinicians because it is able to tie into various sources of data, is flexible and easy to develop, is on-demand, hands-free, and extends into the home.

Some voice uses for caregiver and care recipients discussed at the conference included:

  • Quickly recorded data
  • Concierge services in assisted living centers
  • Medication management
  • Fall detection
  • Home and inactivity monitoring
  • Clinical assignments
  • Access to on-call and capacity information
  • Personalized data collected daily at home

There was a shared sentiment that voice technology has been transformative for many people. Michael Cullen, CEO of Novalte, has witnessed people with disabilities who can now do things they previously could have only imagined: “I can’t over stress the impact on patients, who are literally crying because they can turn on their own lights.”

According to keynote speaker Rowena Track, global vice president of Cigna, her company has found that many people don’t know medical or health insurance terms. In response, it developed the Alexa skill: Answers by Cigna, providing users with definitions for common terms.

Another point stressed at the conference was how voice technology can alleviate isolation. Isolation has been linked to cognitive decline and, according to Nate Treloar, COO of Orbita, costs Medicare $6.7 billion a year.

To make voice assisted healthcare work, devices and programs have to be integrated. A patient falling repeatedly must wear a device that detects the falls and relays that information to the voice assistant who passes it to the caregiver. Stuart Patterson, CEO of LifePod, described the company as this type of service— an online portal to deliver personal check-ins, reminders, and virtual companionship.

The subject of privacy and HIPAA compliance loomed greatly. Nobody seemed clear on a solution. The follow up question was usually, “Is convenience more important than privacy?” Laurie Orlov, principal analyst at Aging in Place Technology Watch, said seniors are concerned about privacy. Trust has to be developed.

Devin Nadar, partnerships manager and innovation and digital health manager at Boston Children’s Hospital (BCH), which has a robust voice pilot program, said the source is what matters. “If voice is coming from a known brand, you see it differently." But there are limits. Voice assistants like Alexa are trusted to inform, assist, assign risk probabilities, establish conditions. Not so much to diagnose, recommend treatment, dispense medications, or manage therapy.

Another sticking point is liability. What if your voice assistant gave you terrible medical advice? Nobody had a clear answer.

According to some estimates, the connected-home market will grow at an annual rate of 67% over the next five years. As Orlov put it, “Voice makes the pace of mobile adoption look slow.” With that in mind, large health organizations are developing voice programs: Mayo Clinic, Cigna, Beth Israel Deaconess Medical Center, Optum Care, WebMD, and others.

As for which device to use, Google assistant and Amazon Alexa are largest in market share with Google growing fastest. Other players are: IBM, Hound, Nuance, Microsoft’s Cortana, Marvee, and more.

Ilana Shalowitz, VUI design manager at Wolters Kluwer Health, showed attendees how the Emmi program is sophisticated enough to detect moods like depression and low confidence. Emmi’s Smart Series adjusts based on a person’s needs and progress. With this program, patients with conditions like CHF, COPD, and pneumonia, have greatly reduced their readmission rates.

As technology advances, AI and voice will work together to continue to improve outcomes and efficiency for everyone involved in the healthcare system.

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