Bringing voice technology to healthcare: Hacking with Amazon’s Alexa

voice technology healthcare
Kate Donovan, clinical advisor to IDHA, conducts a simulated inpatient demo of Alexa.

Earlier this spring, Boston Children’s Hospital’s Innovation and Digital Health Accelerator (IDHA) released KidsMD for Amazon’s Alexa, the voice technology system’s first healthcare “skill.” It offers simple health advice for parents inquiring about their child’s fever and medication doses at home. But fever is just the beginning. Where else in a patient’s journey could voice be leveraged?

In collaboration with Boston Children’s Hospital’s Simulator Program (SIMPeds), IDHA brought Alexa to a two-part mini-hackathon on May 25. Patients and their families, clinicians, developers and researchers were invited to watch and join demonstrations of voice technology across the hospital. In the breakout hack sessions that followed, participants brainstormed future applications for voice at Boston Children’s.

Demos were conducted in four different settings, beginning in the Simulation Center’s waiting room, where voice technology could assist patients and families in initial paperwork and intake forms. Voice suggested the potential to streamline what both care providers and patients often view as a hurdle.

The next demo, in a simulated inpatient room, showed how nurses could utilize voice technology to aid in blood collection from patients — guiding them in how much to draw and which colored vials corresponded with each measurement. An IV therapy nurse at Boston Children’s who attended the demo noted that such a tool could potentially save her up to 30 minutes per patient.

The third setting was a simulated operating room where gastroenterologist Michael Docktor, MD, demonstrated the use of voice technology in medical procedures. He showed how voice could assist in video recordings during surgical procedures — in this case, annotating his (simulated) real-time observations during a colonoscopy.

voice technology healthcare
Michael Docktor, MD, clinical director of IDHA, demonstrating voice annotation with Alexa during a simulated colonoscopy.

At the fourth demo station, a home nursery setting, Jared Hawkins, director of Informatics at IDHA, showed off the KidsMD fever skill and introduced another skill for parents caring for their child’s PICC line — an IV catheter delivering drugs and nutrition. The skill would walk parents through dosing guidelines, infusion instructions and how to maintain and manage the line.

Hackathon demonstrations also included the Ask My Buddy skill, which could allow patients and their families to get directly in touch with their clinician via phone call, text message and e-mail, simultaneously — from the hospital or at home.

In the breakout group sessions, doctors, nurses, educators, parents and others walked through various acute and chronic care scenarios and discovered that voice technology can be part of almost every step of a patient’s journey. The exercises brought to light a variety of opportunities for voice technology: from providing updates to families waiting in the emergency room to guiding real-time post-discharge care at home to allowing inpatients, with their voice, to dim the lights or turn up the temperature.

voice technology healthcare hackathon
Primary care pediatrician Claire McCarthy, MD, adds her ideas at a breakout session.

Triaging opportunities for voice

With seemingly limitless applications, one of the challenges at the moment is how to “triage” the plethora of ideas. Building out even a single skill takes concerted effort and time, so choices have to be made.

“Patient and clinician need — what is most important to them — must be weighed against security considerations and risk, making sure protected health information is delivered to the right person and only to them,” says Hawkins. “Alexa isn’t HIPAA-compliant at the moment. One of the reasons is that voice and text have to go through Amazon servers. Another reason is that there isn’t a very good way to lock content to a specific user, particularly with voice. One potential way around that is a verbal passcode, but it remains unclear if that is secure enough. We need to focus on healthcare interactions in which voice brings real value and minimal risk to the patient.”

From voice-activated video to language translation at the bedside, voice technology can assist. For clinicians, this may allow for more freedom of movement, easier medical documentation and a larger focus on the patient. For patients, voice systems could provide higher-quality, timelier care and easier healthcare decision-making.

With all of its versatility and potential, it is not a matter of if, but when voice technology will be used across all healthcare settings. Smart phones are already linked to smart homes and perhaps in the future, your smart hospital, too.

Read more on last month’s hack in the Boston Globe’s STAT.