AI voice assistants are beginning to play a pivotal role in the healthcare experience. Estimates claim that in 2018 U.S households had 118.5 million smart speakers with AI assistants, with a quarter of all households having at least one device with such technology. AI voice assistance reimagines the way we engage with knowledge-seeking in everyday life and some companies are set on using voice assistants—like Amazon’s Alexa—to disrupt the more complex healthcare market. While Alexa works towards creating a more informed patient experience, it does little to improve the transparency of cost-information.
Alexa is Amazon’s best-selling AI voice assistant, competing alongside Google’s Google Assistant and Apple’s Siri. It is also a part of the company’s recent attempt to break into the healthcare industry. Characteristic of Alexa’s position in the healthcare space are strategic collaborations.
The Amazon and the U.K. National Health Service (NHS) collaboration made headlines with the announcement that Alexa will be used within their care-delivery pathway. Care-delivery is a tiered process, and Alexa will represent the first point of contact for many patients in the U.K. by addressing basic health questions. It will also allow the user to gauge whether more advanced tiers of care-delivery are required—such as a visit to a general practitioner (GP). The NHS will certify Alexa’s responses. Though unconventional, the collaboration has efficiency benefits across multiple levels of healthcare delivery.
Firstly, patients will have access to immediate, convenient and personalized information about their health concerns. While the internet search is immediate, obtaining information through voice request is natural and arguably more personal. Secondly, Alexa will function as a triage agent for the NHS—a filter of sorts—to reduce the number of minor cases that unnecessarily escalate to the level general practitioner (GP) consultation. Reducing the demand for GPs is especially important for the NHS, as it is facing GP shortages and increased GP patient-load. While still in its early stages, Alexa has the potential to increase access to and reduce the costs of the U.K. healthcare system.
Several U.S healthcare players are pursuing their very own collaborations with Alexa. In a recent press release, Cigna and Express Scripts announced their collaboration with Amazon’s Alexa. Cigna members can ask their Alexa devices about their health benefits in detail and receive personalized wellness incentives. Furthermore, Alexa can provide Cigna members definitions and explanations for confusing health terms—premiums, deductibles, formulary, etc.
Express Scripts clients can leverage Alexa to obtain updates on their prescriptions and set notifications for their recent orders. The firm hopes to reduce medication nonadherence by strengthening the connection between patients and their medications. Cigna and Express Scripts appear to use Alexa as a means of increasing their member awareness about plan benefits and healthcare technicalities. This is especially important at a time when consumers are in poor financial standing due to either misrepresented health insurance benefits or a lack of complete understanding of them.
Cigna and Express scripts are not the only early adopters of Alexa in their healthcare services. In April of this year, the Boston Children’s Hospital, Providence St. Joseph Health, Atrium Health and Livongo all announced unique collaboration with Amazon Alexa. Each leverages Alexa’s capabilities in unique ways. For example, the Boston Children’s Hospital is using Alexa to improve communication between different care teams and to effectively deliver information about post-op appointments. Atrium Health allows its customers to use Alexa to determine the nearest urgent care center and to schedule same-day appointments. Interestingly, Livongo incorporates Alexa into its care-delivery process so that customers can link their Alexa devices to glucose monitoring systems and obtain information through Alexa about their blood sugar measurements.
While Alexa’s access to medical information is in accordance with the law—specifically HIPPA—questions of whether such patient data will be stored and used by Amazon are frequent. Does Amazon hope to profit off sensitive patient information by training its AI algorithms for its medical diagnostic services? Will Amazon sell such data to third-party firms and companies? And, more broadly, how will Amazon’s use of patient data affect (or potentially compromise) patient privacy?
Certain collaborations paint an optimistic picture. Amar Kendale, chief of product at Livongo, stated that Alexa will be confined to accessing patient information stored on Livongo’s cloud base without the opportunity to export to the Amazon cloud. Additionally, across all collaborations, Amazon must de-identify all the health information it processes on its platform. If these requirements remain consistent throughout the length of these collaborations, the exploitation of sensitive data seems unlikely.
In a fragmented industry dominated by information asymmetry, Alexa’s strategic collaborations with U.S healthcare players offer opportunities for a more informed and engaged patient. Yet, at least in the case of the U.S, these efforts have fallen short. A truly informed patient is one who knows about both their coverage and the costs of medical services. Any attempt to better engage and inform a patient—as many of these Alexa collaborations seek to do—must also provide better ways for patients to learn about the variable and obscure costs of medical care. Current collaborations do not allow a patient to ask simple cost questions such as, “Hey Alexa, how much will an office visit cost me?” or “Alexa, how much out-of-pocket will I have to pay for an MRI?” Only when cost information becomes more transparent can we commend such collaborations for truly succeeding at creating a more informative and accessible patient experience.