Virtual Voice Assistants Do What Websites Can’t

by Marcia Simon, APR

(Note: A version of this article was first published in Strategic Health Care Marketing.)

“Alexa, what is rotator cuff tendinitis?”

“Alexa, where’s the nearest urgent care center?”

“Alexa, what’s my glucose level?”

Amazon’s voice assistant can now answer all these questions through the new HIPAA-compliant Alexa Skills Kit for developers. The new kit enables developers at medical organizations to build Alexa skills capable of transferring and receiving protected health information on an invitation-only basis. This opens the door for patients and caregivers to not just learn about their health concerns but manage them as well through virtual voice devices and smart speakers at home.

“Right now, voice is where it’s at,” says Charles Gaddy, director of mHealth at Atrium Health, with more than 40 hospitals and 900 care locations throughout North Carolina, South Carolina, and Georgia. “AI (artificial intelligence) tools on a website help with general information, but not with personal information,” he adds. While website chatbots are server-oriented, virtual assistants like Siri and Alexa are user-oriented, making it easier to quickly gain access to information.

“Website traffic dynamics have changed. Previously, 84 percent of website traffic was organically driven by people searching conditions and treatments. They would click to find a phone number or request an appointment. They searched content and watched videos to learn about diseases and treatments,” says William Gagnon, senior director of digital engagement at Boston Children’s Hospital, adding, “When a patient is newly diagnosed, that person’s caregiver is more likely to go to the website for relevant content, but patients in the middle of treatment for a disease or illness tend to want more than the website can offer. Now, third-party reputation websites, Google, and AI-based searches account for 20 percent of all search volume.”

In spring 2019 Boston Children’s Hospital became one of six health partners piloting Alexa’s HIPAA-compliant Skills Kit. The “My Children’s Enhanced Recovery After Surgery” (ERAS) program allows caregivers to share and obtain post-operative information and manage appointments. Patients invited by their health care provider to download the skill can book an appointment, access hospital post-discharge instructions, and check on the status of prescription deliveries. They can also receive personalized medication reminders and hear a summary of their personal progress or measurement trends, thanks to Alexa’s capability to provide HIPAA-compliant patient privacy.

It’s a game changer, with Big Pharma, payers, and providers embracing voice technology. Plus, doctors are willing to use it.

Convenience for Patients and Providers

“Using a voice assistant to get information to patients reduces the volume of calls to our call center and saves a lot of time. Users don’t have to wait on hold while someone finds the answer or transfers the call,” explains Gagnon. For parents, the ability to check in with the hospital while also doing other tasks gives busy caregivers time back in their day. Voice assistants also have the capability to get information to patients who have accessibility issues, vision difficulties, and people who just can’t find their reading glasses when they want to go online and search the internet.

Atrium Health developed an Alexa skill enabling people to find a network-affiliated urgent care location and schedule a same-day appointment.

“We had informational services that gave people hours and wait times, but we wanted to match users with the right provider,” says Gaddy about the Atrium Health pilot. “Does the patient care about the doctor’s gender? Do they have a language preference? We wanted the skill to be more conversational, being able to process more criteria in one sentence.”

Becoming Voice-Friendly

Preparing user-friendly content for a virtual voice assistant is different from writing for a website. Case in point: self-scheduling appointments. Websites usually display a calendar with available dates and times. Gaddy points out that it’s easy for the brain to process a large amount of information viewed on a screen; the user simply clicks on his or her choice. But with a voice assistant, the interaction is different. It’s more of a conversation:

“You said you’d like an appointment on January 23?”

“Yes.”

“I see an opening at 12:30. Will that work for you?”

Often, website language needs to be optimized for discoverability via voice search.

Do Patients Want This?

A survey conducted by Software Advice, a Gartner company, shortly after the launch of the HIPAA-compliant Alexa Skills Kit, showed mixed feelings about sharing and receiving private information via a voice assistant.

While 66 percent of patients responded that they are either “very” or “somewhat” comfortable using Alexa skills to find and schedule appointments at urgent care centers, when it comes to sharing post-surgery patient information, the patient comfort score drops to 43 percent. HIPAA-compliant skills are available by invitation only, so health care networks and providers need to get the word out to patients and their caregivers.

Alexa Dominates the Home Market

While Google and Siri dominate the voice assistant landscape on mobile devices, Amazon’s Alexa products (Echo and Dot) lead the way for home-based smart speakers. It’s estimated that as many as 16 percent of Americans now own an Amazon Alexa device. According to eMarketer, in January 2019 Amazon reported that 100 million devices with Amazon’s Alexa assistant preinstalled had been sold.

Common sense tells us that a voice assistant is not intended to take the place of a doctor. But the doors have been opened, and the boundaries are being tested as to how far consumers are willing to go with their personal health information when weighing the benefits of convenience and faster service against privacy of personal information and how much to trust third parties to protect that data.

With this in mind, and as early adopters of technology know, first-generation technology always has kinks. Even when privacy applications are 100 percent infallible, any individual who has access to the user’s Alexa-enabled device could potentially gain access to personal information as well. Amazon recommends that users concerned about HIPAA and protected health information (PHI) should enable the verification features, such as voice codes or logins, for all health-related voice command features.

Marcia Simon, APR, writes about health, digital health, and wellness. As principal of MSE Public Relations, she manages content, strategic communication, and media relations for hospitals and connected health clients. Connect at marcia@mseusa.com or linkedin.com/in/marciasimon.