Some Use Cases For Alexa In Healthcare – Part 4

It’s been quite a while since I last posted, but here it is!  This will be the last in my series about use cases for voice in healthcare delivery.  I presented these at the Project Voice Conference this past January.  At the end of this post, you’ll find a link to that presentation.

These last two use cases deal with follow-up care after a procedure and with a healthcare team that focuses on helping the patient follow their physician’s recommendations.

POST PROCEDURE USE CASE – PROTOTYPE MY FOLLOWUP CARE

Concept:

  • To provide a vocal interface for patients in addition to the usual printed post-procedure instructions.
  • Would allow for variations among Providers Instructions for each procedure will be grouped by common components/categories, such as:
    • Activity
    • Bathing
    • Diet
    • Medications
    • Wound Care
  • Instructions would be time specific as measured by days from procedure date

My Prototype Includes:

  • Web/EMR-based application to enter post-procedure instructions by or on behalf of the practice
  • MySQL database to host the necessary tables
  • Alexa Skill to allow Users/Patients to access their instructions

Example of All Instructions 3 Days Post LASIK Eye Surgery:

  1. Regarding Activity – DO NOT rub or squeeze your eyes.  Avoid eye make-up.  Avoid dusty and dirty environments.  No swimming or sports.  No driving until permitted by your doctor
  2. Regarding Diet – You may resume your usual diet
  3. Regarding Meds Post Procedure – Use Eye Drop One 4 times during the day.  Eye Drop Two 4 times during the day.  Eye Drop Three 2 times during the day.  Eye Drop Four every half hour while awake.  Use Eye Drop Five before sleeping. 
  4. Regarding Routine Meds – Take routine medications as usual
  5. Regarding Wound Care – Plastic eye shields are to be taped over your eyes anytime you sleep for one week.  Please use the medical tape provided by your physician

CHRONIC CARE COACH USE CASE

Concept:

  • Can be used in healthcare systems where team health coaching has been implemented to extend their reach to those with the highest risk of bad outcomes.  (Some Accountable Care Organizations use such multidisciplinary teams.)
  • To help the most vulnerable Patients manage their Chronic Conditions using Alexa as a Chronic Care coach
  • Patients identified through predictive modeling with approval of managing Physician to work with the Care Team
  • Issue identification & solution in care dimensions of:
    • Medication Adherence
    • Appointment Adherence
    • Self-Management
  • Patients invited to use the skill to serve as a bridge between active Care Coaching & self-care
  • Capability of reaching more patients by Care Team

IN CONCLUSION

These are some use cases that I think would be great opportunities to leverage the power of a voice assistant, such as, Alexa, in the delivery of healthcare. However, their complete implementation would require:

  • Access to EMR/EHR database
  • Development of EMR/EHR pages by vendors
  • Input from relevant practice
  • Implementation by medical practice

So, if you are a clinician or represent an Electronic Health Record vendor who wants to explore any of these, please let me know. I’ll be looking forward to your comments.

For Your Health – Dr. Bob

Here is a link to this presentation:




Some Use Cases For Alexa In Healthcare – Part 3

In my last post, I showed some of the information that the patient could provide before their office visit displayed on their physician’s Electronic Health Record (EHR) screen. The physician could use this information to better connect with their patient and identify patients that are being affected by loneliness. Here I’ll talk about two other use cases for Alexa, the Scribe and, the Zebra Finder.

The Scribe would enable the physician to carry on a conversation with the patient and speak the elements of his or her examination of that patient without needing to break their contact with the patient. No more turning from the patient to the computer keyboard. Ideally, the Scribe would present two versions of the encounter, one in the language of medicine that would become part of the EHR and the other that the patient could understand and suggest edits if needed.

While the Scribe would be used for every office visit, the Zebra Finder would only be used for the difficult cases with which the doctor gets confronted from time to time. In medical school, you are taught that when you assess a patient’s symptoms you should think that common things occur commonly. Or, in other words, when you hear hoofbeats, think horses, not zebras! However, sometimes a patient has a rare condition, a zebra.

An experience of mine in my early clinical years led me to propose Zebra Finder as another use case for Alexa in healthcare delivery. After I completed my Internal Medicine training, I joined a three-man Internal Medicine group outside Washington, D.C. One Friday evening when I was on-call, one of my associate’s patients was admitted to the hospital. He was a gentleman about 30 years old who had been having a fever for over 2 weeks without a diagnosis after undergoing extensive outpatient testing. Many tests, including chest x-ray, blood & urine cultures were all negative. Yet the patient was very ill and warranted hospitalization. While examining this patient, in addition to his fever of about 102 degrees, two things were abnormal:

  1. He had tender lymph nodes in his right armpit, and
  2. A small, circular, pale patch of skin on his right hand near his thumb that was anesthetic. In other words, he couldn’t feel me touch him there.

Years ago during my training, I had seen a patient who also had an anesthetic patch of skin which is indicative of Hansen’s Disease, better known as leprosy. So, based upon my exam and remembering this fact that was lodged somewhere in my brain, leprosy was my working diagnosis. Further testing confirmed the diagnosis. I recount this story not to boast, but to show how a small bit of information can be important in medicine. For some reason, that nugget of medical knowledge popped into my head. This is especially important since the amount of medical information a person going through medical training must absorb continues to explode.

So, Zebra Finder would have Alexa connect through artificial intelligence to a database of medical information. It would help the physician when they are faced with a challenging case. The physician would tell Alexa the patient’s problems and physical findings. Then Alexa would guide the physician in their examination & testing required. It would be especially useful in more remote areas of the country where access to specialists is limited.

Well, these were the use cases I have identified for Alexa during an office visit. Next time I’ll talk about some after the visit. Please feel free to leave your comments.

For Your Health – Dr. Bob