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What the HIPAA-compliant Alexa skills mean for the future of voice in healthcare

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Yesterday the healthcare world was abuzz with news from Amazon: The tech giant announced that select skills for Alexa, its voice-activated personal assistant service, are HIPAA-compliant. The announcement came less than two months after MedCity speculated whether Amazon would release a HIPAA-compliant Echo device.

Six organizations — including providers, a payer, a pharmacy benefits manager and a chronic disease management company — have been invited to access the HIPAA-compliant capability to build skills.

Boston Children’s Hospital is one of the entities. The hospital already has a program called Enhanced Recovery After Surgery (ERAS), which helps parents and caregivers of kids who have undergone heart surgery. Its new Alexa skill allows individuals in the ERAS program to provide their care teams with updates on recovery progress and get information about post-op appointments.

Cardiac surgery is major surgery,” Boston Children’s chief innovation officer John Brownstein said in a phone interview. “Alexa’s a great opportunity to maintain engagement post-discharge.”

Another one of the six companies, Livongo, took things in a different direction by building an Alexa skill for individuals in its Livongo for Diabetes program. It lets them keep track of their blood sugar checks and get insights and personalized health nudges.

“In diabetes, one of the most common things people have questions about is how best to handle their nutrition,” Livongo chief product officer Amar Kendale said in a phone interview. In thinking about voice, the company started to wonder: “What would it look like if Livongo could offer members with diabetes information when they’re thinking about something to eat?”

That’s exactly what the skill seeks to enable. For instance, let’s say a Livongo user has an Amazon Alexa device in the kitchen. While standing in front of the fridge deciding what to eat, the person could ask Alexa what their last blood sugar reading was. The information can then help them choose the most appropriate snack.

Looking at the larger picture, the news from Amazon has implications on how voice will be leveraged in healthcare.

“Just as we’re hearing loud and clear concerns about privacy and security in the consumer part of our lives, we’re expecting there will and should be a similar level of scrutiny when it comes to healthcare data — in fact, more so,” Kendale said.

Brownstein said that more broadly speaking, this is where virtual care is headed. Alexa represents a solid opportunity for “more continuous engagement.”

Taha Jangda, a partner at HealthX Ventures, also noted that that voice can lower barriers to patient engagement. While the news marks the next step in making voice-powered virtual tools more common in digital health, there’s still work to do when it comes to bringing voice to healthcare, he said.

“HIPAA is a regulatory requirement in the U.S. healthcare market only,” Jangda said in an email. “It is an important start, but it does not, by itself, address all the data privacy and security concerns that exist with voice applications in healthcare.”

User authentication and privacy in shared settings are also topics that need to be addressed. “Also, most major healthcare organizations hold to privacy and security requirements that go well beyond the regulatory requirements of HIPAA,” he added.

Photo: lvcandy, Getty Images

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