Boston Children's taps Alexa—Amazon's virtual assistant—to rethink the patient experience

Hospital considering voice software at 'every stage of the patient's journey'

Boston Children's Hospital could soon have a new member of its care team, Melissa Bailey writes for STAT News: Alexa—Amazon's voice-recognition software program.

Medical facilities across the country are developing ways to integrate the company's virtual-assistant technology into the care continuum, from helping doctors take notes to reading patient charts, says an Amazon spokesperson. And Boston Children's "is leading the way when it comes to hands-free work in hospitals," she says.

Testing voice-assisted technology

In April, Boston Children's launched an app called KidsMD that uses Amazon's technology to provide parents with information and advice when their kids have a fever. The hospital is now taking its effort to the next level by integrating Alexa throughout the patient experience.

During a recent test in the hospital's simulation center, staff walked visitors through potential uses of Alexa-based apps in three scenarios: an OR, an ICU, and a kid's bedroom at home.

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In the simulated OR, Michael Docktor—a gastroenterologist and the clinical director of the Boston Children's innovation group—walked visitors through a potential use of Amazon's virtual assistant during colonoscopy procedures.

During a colonoscopy, Docktor uses an endoscope to take photos of a patient's intestinal tract. Then, typically one to three hours afterward, he reviews the photos to document the procedure. But that review process can be difficult because "every part basically looks the same," he says.

With the help of Alexa, Docktor could instead ask an app to save a photo and description into the patient's EHR during the initial procedure.

In the simulated ICU, Boston Children's staff demonstrated how Alexa also could lend a virtual hand to nurses.

When nurses draw blood, they must determine how much to take and which vials to store it in. Nurse Paula Lamagna says a voice-activated system that provides her with that information could save 15 to 30 minutes per patient.

And in the simulated children's bedroom, Jared Hawkins, director of informatics in the hospital's innovation group, showed parents how to use KidsMD to access medical guidance, such as the right dosage of acetaminophen for an infant with a fever. Alexa also helped troubleshoot issues with flushing a catheter.

Potential future uses

The demonstrations were just the first step, says John Brownstein, the hospital's chief innovation officer, noting that the hospital is "counting on" clinicians, patients, and software engineers "to think about where this can go, if anywhere."

"We're thinking about how these technologies come into play in every stage of the patient's journey," says Brownstein.

Physicians participating in the demonstrations offered additional ideas for using the voice recognition software.

Anjolie Laubach, an anesthesiologist, says Alexa could help her deal with patients in critical condition by reading aloud the heart rate every 30 seconds. Pediatrician Claire McCarthy suggests saving patients the hassle of having to repeat information about their condition by asking Alexa to record the details instead.

Alexa also could remind patients about their discharge instructions or answer questions that patients are too embarrassed to ask a human being, says Peter Warrington, a software developer.

Alexa wouldn't need to be limited to strictly medical uses either. For example, some participants suggested that the virtual assistant could help find and play music during surgeries or adjust the lights or temperature in a patient's room.

Barriers to use

Alexa's potential roles in the hospital are seemingly endless, but there are some barriers to adoption, STAT News reports.

First, there's miscommunication. The voice-recognition technology doesn't always interpret a user's words correctly, and poor Wi-Fi connections could exacerbate those problems.

Warrington says hospitals also need be concerned about patient privacy and security. As with other technology, Alexa could be susceptible to hackers.

Jim Gregoric, a software engineer at the hospital, notes, "Alexa better not give any information that causes any harm."

Gregoric also questions whether patients will be interested in interacting with a virtual assistant rather than a human care provider (Bailey, STAT News, 5/31).

From voice recognition to EHRs: Keep patient data secure

Patients often divulge sensitive information to clinicians, and providers must assume this responsibility of privacy protection with integrity or face reputational and financial consequences.

Read our cheat sheet to learn what you should know about HIPAA and how it affects providers.

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