The Optimized Doctor

Alexa


 


How many calories are there in a cheeseburger? (Yes, I too am looking forward to a svelter 2017). The answer, according to my new assistant, is 300 calories. She knows the dose of acetaminophen for a 10-year-old, 65-pound child is 325 mg every 4-6 hours. She also plays George Michael, reorders my Dentyne Ice gum, and turns off the lights. She is Alexa of Amazon’s Echo, the intelligent personal assistant.

Echo and Google Home are popular voice-assisted home appliances. Amazon has built a natural language processing system, so to use it, you simply say, “Alexa,” pause, then ask your question (What’s the weather in New York?) or deliver your command (Play Spotify). It’s hands free, so you can interface while typing, reading, or cooking dinner.

Dr. Jeffrey Benabio

Dr. Jeffrey Benabio

Alexa and her smart home device brethren have enormous potential for health and wellness applications. According to GeekWire, at last fall’s Vanity Fair New Establishment Summit, Amazon’s CEO Jeff Bezos, said, “I think health care is going to be one of those industries that is elevated and made better by machine learning and artificial intelligence. … And I actually think Echo and Alexa do have a role to play in that.”

Some medical centers, such as the Boston Children’s Hospital, are leading the way to make voice-assisted technology useful in health care. Their KidsMD app, for example, gives Alexa the “skill” to offer simple health advice regarding their children’s fever and medication dosing. I found this Alexa skill interesting but rudimentary. Most of the advice was reasonable; however, the scope is small and the responses glitchy. For example, when I asked Alexa what to do for a feverish 2-month-old, it advised me to contact my doctor then immediately followed this with recommended antipyretic medication dosing. Although we physicians understand the child must see a doctor, some parents might be confused and choose only to administer the medication. As with any new digital health technology, the team at Boston Children’s are continually iterating and improving based upon feedback.

I found Alexa currently has a few other skills for health care. For example, a skill called Marvee functions as a “care companion” to help aging family members and their caregivers. Another skill, Health Care Genius, helps patients decipher healthcare terminology by asking questions such as, “What is a deductible?”

The potential of voice-assisted technology in clinical and home health care settings is limitless, and I expect this segment to grow dramatically. Here are a few examples:

1. Physicians can ask for real-time help such as: What are treatment options for juvenile dermatomyositis? Order doxycycline 100 mg by mouth, twice daily, quantity sufficient 10 days.

2. Physicians might also use it to dictate notes intelligently, and even extract patient instructions directly from the notes to be emailed to the patient.

3. Surgeons could command an MRI to be viewed without having to scrub out.

4. Bedridden or chronically ill patients could use it to refill medications, make doctor appointments, or contact a caregiver in an emergency.

5. Patients could receive customized instructions, such as the answer to “How often do I change my surgical bandage?”

For all its potential, voice-assisted personal assistants have a long way to go. It would be a mistake to think these won’t be integrated into the entire health care chain from care to wellness, but it will be awhile before we get there.

Interestingly, when I asked my Apple Siri how many calories are in a cheeseburger, she reported 500, which is much more than Alexa’s 300. Which is why, for now, devices like Alexa are ideal for ordering a pizza hands free from your recliner. Just don’t ask how many calories are in it.

Dr. Benabio is a partner physician in the department of dermatology of the Southern California Permanente Group in San Diego. Dr. Benabio is @Dermdoc on Twitter. Write to him at dermnews@frontlinemedcom.com. He has no disclosures related to this column.

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