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April 9, 2019

The 3 big questions about Alexa's future in health care. (No. 1: Will anyone actually use it?)

Daily Briefing

    Amazon's Alexa voice assistant was recently upgraded to support HIPAA-compliant voice skills, but experts say that big questions remain about the technology's future in health care—including whether patients even want to use the voice assistant for their health care needs.

    Advisory Board's take: What providers should know about Alexa

    About Alexa's HIPAA-compliant upgrade

    In the company's latest move into health care, Amazon last week announced an update to its Alexa Skills Kit that enables developers to build HIPAA-compliant skills for Alexa.

    Six health care companies already have launched tools developed using the new skills kit, including:

    • Atrium Health, which launched an Alexa skill that customers in North Carolina and South Carolina can use to schedule a same-day appointment at an urgent care center;
    • Boston Children's Hospital, which created a skill called My Children's Enhanced Recovery After Surgery (ERAS), which parents and caregivers can use to provide clinicians with information on a child's progress after surgery and to get information on post-operative appointments; and
    • The digital health company Livongo, which launched a skill that will allow users to ask for their last blood sugar reading and trends as well as receive insights and Health Nudges.

    3 big questions about Alexa's future in health care

    Health care executives had been eager for the ability to create HIPAA-compliant skills, saying the voice technology could offer patients and providers an alternative to typing or tapping screens, the Wall Street Journal reports.

    Richard Roth, head of strategic innovation for Chicago-based CommonSpirit Health, said, "We were waiting for" Alexa to become HIPAA-compliant because "this level of privacy and security" is "critical." According to Roth, CommonSpirit Health is developing its own Alexa tool for scheduling appointments.

    But despite health care companies' enthusiasm, experts say that several big questions remain unanswered about Alexa's future in health care.

    1. Is anyone actually using Alexa's health care skills?

      Some health systems that invested early in creating Alexa skills have seen limited returns. About two years ago, for example, Northwell Health launched a tool using Alexa's voice assistant to let patients look up wait times at local emergency departments. But Emily Kagan, Northwell's vice president of digital and innovation strategy, said patients aren't widely using the tool, in part because older patients aren't comfortable with technology.

      Further, several Alexa skills exist that are designed to help patients manage diabetes, but Gizmodo reports many of them have zero online reviews—suggesting that they're not being widely used by patients.  And that seems to be part of a wider trend with Alexa. A Voicebot analysis of existing Alexa skills, including those not related to health care, found just four skills have over 1,000 user reviews, while 62% have zero.

    2. Can Alexa be trusted to give accurate health information?

      Another concern is that, as reputable health care companies seek to develop and release Alexa skills, they may find themselves competing with existing skills that provide inaccurate or incomplete health information.

      An analysis by Quartz last year found that only 10 out of 16 Alexa tools provided any valid answers to a series of health-related questions. Quartz ultimately concluded that its findings "suggested Alexa health skills provide mediocre health advice in the best-case scenarios."

    3. Are Alexa's privacy protections strong enough for health care?

      Finally, patients may just not be willing to trust Alexa with their private health information—especially because Alexa's voice interface means that anyone who talks to the device can, at least potentially, gain access to a user's personal information.

      Amazon recommends that all of Alexa's health-related tools include features to verify a user's identity by either using a voice code or requiring users to log in into their existing health care accounts, the Journal reports. Five of the just-launched Alexa skills require users to confirm their identity before they use the technology, but Atrium's urgent care scheduling tool does not.

      Further, some patients may be uncomfortable with the idea of a voice assistant that could potentially listen in on their private lives. Last year, for instance, Alexa grabbed headlines when it misinterpreted a private conversation as voice commands and ended up recording and transmitting the conversation to a person on the user's contact last.

    So while Amazon's new HIPAA-compliant Alexa opens up new possibilities for providers, Kagan cautioned that the technology is still in its infancy. "Everybody feels like it is going to be really game-changing," but "[w]e're all still experimenting," Kagan said (Evans, Wall Street Journal, 4/7; Dellinger, Gizmodo, 5/10/18).

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