Some Straight Talk on Voice-Enabled Technology in Health Care

“Voice recognition is the next killer app.”

Toby Cosgrove, M.D., former CEO, Cleveland Clinic
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Voice technology has emerged as the next frontier for self-service in healthcare, promising a more “human” experience and enabling users to access information quickly without navigating a complicated interface. While the use cases are still developing, they promise myriad benefits to practitioners and patients alike – especially the elderly and disabled, those afflicted with chronic disease, or living in rural areas.

“Voice is the most obvious next step of user interface that is going to radically change the way we interact with technology.”

Dwight Raum, CTO of Johns Hopkins Medicine

In 2020, AI-powered chatbots and virtual assistants played a vital role in the fight against COVID-19. Chatbots helped screen and triage patients, and Apple’s Siri now walks users through CDC COVID-19 assessment questions and then recommends telehealth apps. Voice and conversational AI have made health services more accessible to everyone unable to leave their home during COVID-19 restrictions. Now that patients have a taste for what is possible with voice and healthcare, behaviors are not likely to go back to re-pandemic norms. Be prepared to see more investment in voice-tech integration in the healthcare industry in the years to come.

What are some potential use cases for voice-enabled technology in healthcare? – The most critical voice applications include disease management (system tracking, journaling, medication adherence), data collection, and cost reduction. In the future, the technology could evolve into a diagnostic tool using voice biomarkers like tone, inflection, breathing patterns, and more to detect abnormalities.

How do you justify the business case for voice-enabled technology? – Like any novel technology solution, voice must solve a business problem, such as engaging patients between doctor’s visits, improving access for patients in clinical trials, and removing friction in overall treatment.

“Think big from the outset and avoid framing a hyper-specific problem, otherwise you downplay the potential ROI and alienate stakeholders.”

Dan Solomon, professor of medicine at Harvard Medical School.

Are there practical examples of voice-enabled technology in use today? – As mentioned earlier, the COVID-19 pandemic accelerated the adoption of voice-enabled technologies like chatbots and virtual assistants. I like to segment the emerging use cases for voice-enabled technology into these categories:

Voice-enabled technologies for patient engagement – The most mission-critical use case for voice so far is symptom-tracking for patients with chronic illnesses. They may see their doctor episodically every two or three months, but in-between visits, voice assistants log and track their symptoms and adhere to medication by administering reminders or prompting the patient to schedule their next appointment.

Voice-enabled technologies for patient information services – These are platforms like Mayo Clinic’s First Aid skill on Alexa and WebMD’s symptom tracker. With voice assistants being essentially a “black box” lacking visual cues, they’re suitable for quick hits and guided interactions but not conveying lengthy or complicated information. Voice has also been shown to increase information retention when used to deliver medical advice versus reading a pamphlet.

Voice-enabled technologies for removing friction for healthcare providers – Health systems are using voice technology to administer assessment surveys on a daily or weekly basis to preemptively detect red flags and be up-to-date on the patient’s condition on their next visit.

Voice-enabled technologies in the examination room – Eric Schmidt from Google highlighted this use case in his keynote at the HIMSS 2018 conference. Whether it’s your Primary Care Physician, or a specialist practice, having a listening device in the room with your patient has a lot of potential for capturing clinical notes, identifying billing codes, or even providing clinical decision support during the encounter. It could also populate the physician’s visit notes into the EHR, potentially eliminating the burden of after-hours work.

Voice-enabled technologies in the operating room – There’s a lot to be said for interacting with devices in a sterile environment via voice. The most common concern is whether the surgical mask will muffle the sound too much, but so far this has not been an issue. If the environment is sufficient for you to hear and have a conversation with a human on the other side of the room, then speech recognition can be expected to work equally as well.

Voice-enabled technologies in the patient room or at home – Whether it’s staying in a hospital room or after discharging a patient to recover at home, voice interfaces represent a new opportunity to connect patients into their ecosystems, primarily when they have restricted mobility. Start with simple things like being able to dim lights, adjust the temperature of a room, control the audio levels. Voice can empower users to maintain control of their environment. Then, move to more integrated options, voice can also order food, request nursing assistance (and be able to articulate the reason for the aid so that nurses can prioritize appropriately), or find out more about their medical condition from trusted sources such as HealthWise and Health Navigator.

Voice-enabled technologies for Surveys, Feedback, and Clinical Trials – Surveys and clinical trials represent multiple opportunities to simplify user interaction and increase patient engagement. By providing a voice interface, we provide another touch point to gather information and allow users to do this while they’re completing other tasks.

Voice-enabled technologies for elder care – I participated in organizing and managing a trial use of Amazon Alexa devices in several assisted living facilities for tasks that ranged from reminders to home automation and personal or medical alert response systems. By the end of the trial, 100% of participants felt that Alexa overall made their life easier.

What are the challenges to the widespread adoption of voice-enabled technologies in health care? – Several obstacles remain for the widespread adoption of voice in a medical setting. They include:

  • HIPAA Compliance – While this limitation has slowed some organizations down, others are moving forward with the expectation that speech technologies will be compliant by the time their systems are complete.
  • Skills discovery – The Amazon Alexa marketplace has well-known challenges where the discoverability of new skills is problematic or unworkable.
  • Cumbersome Invocation Phrases – Having to say “Alexa, tell [My Skill] to do something,” or “Hey Siri” or “Hey Google” can be challenging to remember for skills you don’t use regularly, and more than a little repetitive when you’re using it often. Similarly, being able to interrupt a device once it’s started responding and chaining requests together so that we can ask for multiple things at once is critical – although we’re already beginning to see support for these functions.

It remains very early days for the use of voice assistants in healthcare. Consequently, provider organizations experimenting with the burgeoning technology do not have many hard results like return on investment to report. But these organizations are showing what the technology can do and have patients to back them up.

However, voice interaction is already becoming part of our everyday experience, and it’s natural that this will converge with our healthcare needs. There are currently pilot projects being tested today that utilize this technology in healthcare, many of which are still in a learning phase focused on establishing best practices for tomorrow’s medical devices. If you’re not using a voice interface already, start – it’s the best way to learn how they operate, and they’re not going away any time soon.

6 thoughts on “Some Straight Talk on Voice-Enabled Technology in Health Care

  1. These advanced technologies, like voice technology, first seem to enter the market in the non healthcare world and then evolve into our healthcare world. It will be interesting to watch this process.

    • Agree completely Tom. The recent purchase of Nuance by Microsoft will drive the adoption of voice-enabled technology, especially as they integrate it with Office 365 and Teams.

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