Alexa, Can You Fix Healthcare?

Last week I went to an event focused on the Amazon Alexa and applications for the management of diabetes that were developed in response to the Alexa Diabetes Challenge.  This event, produced by Luminary Labs and sponsored by Merck, was an interesting milepost in the evolving quest to make voice a de facto user interface in the healthcare world – interesting both because there is clear progress and because we are definitely not there yet. As with all things healthcare, nothing happens overnight.

Two years ago I wrote a post on this idea called The Next Voice You Hear May Be Your Own (or Dr. Alexa’s), noting that voice as user-interface in healthcare might well be the next 200,000 year old overnight sensation. Make that 200,002 years and counting. The applications shown at the event were very interesting, but I am not sure they were really giant breakthroughs. Rather they were, for the most part, versions of existing products that had voice as a key user interface, though not even the only one in most cases.  In a few of the products voice was nice, but not necessary. Given that Alexa still is not HIPAA compliant (although rumor has it this is fast approaching), there are also still other issues needing attention.

Coincidentally, last week my iPhone served me up this story about a woman who could not figure out where in the hell all of the Amazon purchases were coming from until she realized her parrot was ordering them. And if a parrot can mimic well enough to order from Amazon, imagine what a decently skilled human impersonator could do if they really wanted to. This may well be the full employment act for Ursula from the Little Mermaid if we are not careful.

Security and privacy are essential for this user interface to make it to actual prime time, as it is generally recognized that Minimum Viable Products (MVPs) are not particularly acceptable in healthcare. Yes, Amazon may make it’s way to being a full service pharmacy including delivery, but if Alexa hears Aricept instead of Aciphex, the consumer is going to have more than just a bad taste in their mouth.  Though I will note that as I sat there watching the diabetes product demos, I looked up whether you could buy glucose strips at Amazon.  Answer: yes.  Full service product, here you come.

These issues will ultimately be figured out and we will find voice applications in our everyday healthcare lives before the end of the decade. I just don’t think this is really going to start with consumers. Most think about Alexa and similar products as consumer-facing technologies but I have a feeling that the enterprise will be the first place where the product finds true adoption. Imagine physicians being able to speak to the EMR instead of working all night inputting notes (or hiring scribes – sorry scribes, you are going to be replaced by a robot after all). Voice technologies would be extremely useful in the operating room to get medical information on demand: Alexa, what is the patient’s ejection fraction? Alexa, please show me the last MRI scan. Alexa, what can we bill for that we haven’t thought of yet?

I was, in part, attending the Alexa event to get a better understanding of the investment opportunity in voice. Unfortunately, I came away thinking there isn’t really one, at least not now. Rather, it is going to be a technology that becomes integral to many healthcare products but isn’t one in and of itself. The product is the Echo or the Google home (notably nearly no one in the audience used the latter while many in the audience use the former) or whatever other gizmo is hot at the time. There won’t likely be an Echo for healthcare, as “regular” devices are winning the day even in healthcare. If security and privacy and sensitivity and specificity can be as good as human interaction, we may as well use the devices we can now buy at Whole Foods. No really. My local Whole Foods has a display of Echo devices right next to the organic broccoli. Alexa, can you make broccoli taste like ice cream?

I suspect that the people who make money off of voice as user interface will be design firms that help healthcare companies, often tone deaf about user interface, learn to use voice effectively. Since by and large those are consulting companies, they are generally not considered great venture investing opportunities, but the opportunity to prosper here could be significant for those in the consulting business. I can only imagine how some of our best-known healthcare companies would integrate voice left to their own devices. I’m guessing the most used question would rapidly become: Alexa, what in the hell are you talking about? Or actually, Alexa, I don’t know my PIN code to access my record – if I did I would have looked it up on my damn iPhone.  Alexa, where is my damn iPhone?

Most of the applicable voice interfaces are or already have come to the phone so that may be yet another reason why we may as well have our phones implanted in our appendages so they can’t so easily fall in the toilet. Alexa, please dry out my phone. And watch out, Ursula may be down there in the water.

If you are interested in the panel discussion that Luminary Labs hosted about voice in healthcare, you can watch it HERE. Besides me, John Brownstein, Chief Innovation Officer at Boston Childrens Hospital, and Ifeoma Ajunwa, a lawyer, sociologist and Felow at the Berkman Klein Center at Harvard, were on the panel, moderated by Sara Holoubek, CEO of Luminary Labs. FYI, the winner of the Alexa Diabetes Challenge has yet to be announced but the announcement is coming soon. See this space if you are interested. Or hear it if you are at Whole Foods.