Hospitals across the nation are piloting voice-enabled smart speakers in patients’ rooms, including Cedars-Sinai Medical Center in Los Angeles and Boston Children’s Hospital. These institutions are hoping that smart speakers will make patients more comfortable, help staff stay organized, and, in some cases, keep people out of hospitals and emergency rooms altogether.
Early results are promising, but health-care providers are still figuring how to protect privacy once smart speakers know our intimate medical details. Searching online for medical help, even for common ailments, already reveals much more than people realize. That data has proved valuable both to health officials and to big businesses.
The Cedars-Sinai pilot will send more than 100 Amazon Echos to patients’ rooms. The devices will perform skills typical of the technology, such as playing music or changing the TV channel, and specific to the hospital, such as alerting nurses or caretakers that a patient wants help to get up to use the bathroom. Boston Children’s is trying out a different method, using Alexa-enabled speakers to help staff stay on top of their work by asking Alexa for information on staffing and bed availability.
Boston Children’s has also come up with an in-home application for voice-enabled health care, targeted to parents of young children. The hospital created an Alexa skill called KidsMD, which lets parents ask their speaker what to do when their children are sick. BCH has also developed a similar skill called Flu Doctor. John Brownstein, the hospital’s chief innovation officer, explains that the skills can save parents time and money.
“Oftentimes, [emergency rooms] are flooded with cases where an individual could be treated at home or they could wait the next day to go to a physician’s office,” Brownstein says. “These tools are helping triage people.” Keeping some patients out of the ER when they don’t need to be there could in turn keep diseases from spreading, Brownstein says.
Parents can ask KidsMD for help with cold and flu symptoms such as fever or stomachache. Brownstein explains that the skill follows a similar format to Thermia, a tool on the BCH website that allows parents to enter a kid’s age, weight, and symptoms to find advice on how to respond to a fever. “We just took that framework that we use at the hospital and put it into a chatbot,” he says.
But because consumer voice assistants are not HIPAA compliant, they can make only simple health recommendations. Health-care providers are exploring how voice assistants might become fully integrated in a medical environment, but these are early days. Each prospective use comes with prospective drawbacks. Doctors placing medical orders via speaker risk accidentally ordering the incorrect medicine or dosage if they’re misheard. Directly speaking with devices might be faster than reviewing paperwork, but could slow things down if Wi-Fi is spotty. And the risk of storing health records, lab tests, or medical bills on a private company’s non-HIPAA-compliant servers is huge.
“Privacy is one of our top concerns as we’re building tools,” Brownstein says. “We kept privacy in mind as we were building our KidsMD skills.”
Privacy foregrounds the conversation as providers explore voice-enabled health care and balance legal concerns with giving sound medical advice. This isn’t true for traditional online searches, where, as far as advertisers are concerned, seeking advice for dealing with cold and flu symptoms is the same as shopping for shoes. Online, everything is caught up in the same search-engine dragnet. Mucinex, for example, used Google’s browser data to target users with YouTube ads based on recent searches or a Google-determined “affinity” for healthy living.
Smart devices are becoming part of this trend as well. Amazon has filed a patent for a voice assistant that would recommend cold and flu medicine if it overhears you coughing. The health-care start-up Kinsa drew sharp criticism from privacy experts last year for selling illness data. Kinsa makes a smart thermometer that takes a user’s temperature, then instantly uploads it to a server along with gender and location information.
Kinsa used this data to create real-time maps of where people were getting sick and to refine its flu predictions for the season, with accuracy levels matching those of the Centers for Disease Control and Prevention. But it also sold the information to Clorox, which beefed up its marketing of disinfecting wipes and similar products in zip codes where thermometers reported a spike in fevers.
Boston Children’s KidsMD skill is compatible with a different smart thermometer, Nokia’s Thermo, but Brownstein says the data isn’t shared for advertising purposes. Still, that doesn’t mean parents aren’t contributing to health-care data through all the other ways they try to find out what to do when their kids have a temperature.
Using smart devices or web searches to find quick advice can save time and money for patients, parents, and overburdened ERs alike. But doing so feeds into a far-reaching advertising network that turns those searches into lucrative data. No matter what you’re doing on the internet, it seems, someone, somewhere, is making money off of it.