Some Use Cases For Alexa In Healthcare – Part 2

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Since my last post about a use case for Alexa before an office visit, I had some additional ideas and I also received some feedback from a few sources.

I thought a measure of loneliness might be useful and with a little research, I found the De Jong Gierveld 6-Item Loneliness Survey. I’ve added it to my demo Alexa Skill I’ve called Office Visit Prepper.  See a sample of the EMR page below:

Sample EMR Page

Sample EMR Page

It shows the patient’s Goals, Barriers and Loneliness Survey responses requested by Office Visit Prepper.

There also were concerns from both patients and primary care physicians (PCP) regarding the lack of the physician’s access to specialist visit notes at the time the PCP office visit with the patient.  I believe Alexa could also help solve this issue but the process is quite a bit more complicated.  Let me suggest 2 approaches.  Each requires that Alexa has access to both the patient’s health insurance records and the PCP.s EMR.  Alexa could then determine what specialist visits occurred and whether the PCP’s EMR had those electronic records.  Then there could be a passive option to help solve this issue and an active one that would occur as part of the information gathering of a Skill like Office Visit Prepper:

  1. Passive – The patient gets informed that records from some specialists are missing and Alexa asks the patient to contact the specialist offices to have them forward the information to the PCP.  Ideally, these would be in an electronic format.
  2. Active – Alexa informs the patient of the missing records and asks the patient for permission to obtain them.  Once the patient approves, Alexa contacts the specialist offices to get the records sent to the PCP.

My plan is to post some more of my ideas for Alexa helping care delivery.  Next time I’ll talk about two use cases during the office visit.

I look forward to your comments about the uses cases I have posted and others you would like to see implemented in healthcare delivery.

To Your Health! – Dr. Bob

Some Use Cases For Alexa In Healthcare – Part 1

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There is no doubt that the introduction of the vocal interface with devices such as the Amazon Echo/Alexa and Google Home is revolutionizing many industries.   This trend also includes healthcare.  As you know, developing Alexa Skills is one of my hobbies in retirement.  A good number of them are focused on health.  I thought I’d state a few use cases over the next few posts, and invite readers of this blog to suggest others.

One use case I think worthwhile is using Alexa to gather some information from the patient at home before their visit to the doctor.  In addition to the usual information, I think it could include information about the patient’s support system as far as the closeness of friends and relatives, and their short-term and long-term goals.  I think such a conversation would be more conducive to gathering this kind of information rather by answering questions on a computer screen.  My rationale for including this information is that it would help build a personal relationship between physician and patient.  Given the pressure on physicians to see as many patients as possible, there is less time to probe for this kind of information during the office visit.  If they are already available for the physician to read in the electronic medical record, then they would be able to, at the very least, acknowledge them at the visit.  When I practiced medicine many years ago, I was able to take the time to find out more about my patients rather than just their physical findings.  I truly enjoyed that aspect of practicing medicine immensely.

I’ll be looking forward to your comments and suggestions for other use cases.

Thanks,

Dr. Bob

Alexa Skill Follow Up

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So, Alexa reads part of my post in a Flash Briefing, but only a small part of it, not even the first paragraph!  Welcome to programming of Alexa skills!

I want to see how much of this will be spoken.  If I understand it correctly,  This post should be read first, followed by the one I wrote earlier.

We’ll see!

Dr. Bob

Testing An Alexa Skill

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One of the reasons I haven’t posted on this blog since 2016 is that I have been learning how to build skills for Alexa.  So far I have had seven skills certified by Amazon.  Here is a list of them with a brief summary for each:

  • Blood Pressure Check – Compares a user’s BP readings to guidelines, considering the presence or absence of heart disease or diabetes. Other BP information is available to the user.
  • Healthy Snack Tips – Provides randomized tips on snacks.
  • Your Healthy Tips – Provides random tips on healthy nutrition or exercise, based on the user’s preference.
  • My Weight Loss Coach – Tracks the most recent weights and compares to the user’s goal. It also tracks cardio & resistance training.
  • Food Manager – Helps the user track the recommended expiration dates of their food items so they can either use them or donate them before those dates are reached.
  • State Explorer – A kid’s skill that gives information about each state and provides quizzes to help master that information.
  • Your Memory Challenge – A skill that tests the user’s short-term memory by presenting 5 brief scenarios and then asks questions about the content of those scenarios.

I’ll discuss these and more on developing voice technologies in health care going forward, but I’m being brief on this one so I can see if I can build an 8th skill where Alexa reads my blog posts.

Wish me luck!

Dr. Bob

Health Record Portability – Part 3 Problems Abound

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One of the challenges of managing your health information is that it comes in so many forms and formats.  It is not hard to find examples where the ball gets dropped.  Here are a few examples that I recently encountered that demonstrate this challenge.

Recently, my uncle who lives in a remote part of Pennsylvania had a heart attack.  Because the local hospital could not perform the required procedure, he was flown to a larger hospital.  There he had a cardiac catheterization and stents were placed in the arteries that supply blood to his heart (coronary arteries).  A day or two later when he was stable, he was taken by ambulance to the first hospital.  We had been told by the cardiologist who placed the stents that 2 were placed.  When we got to the first hospital after he was sent back there, the doctor who had reviewed his record from the second hospital said that he couldn’t find any documentation that any stents were placed.  The next day when my uncle’s local cardiologist looked at the record, he said that he found documentation of only 1 stent being placed.  It wasn’t until I was helping get things ready for his discharge home that I found 2 wallet cards, one for each stent, that were among the discharge papers from the second hospital mixed in the plastic bag that was sent with him.  These cards specify the kind of stent, its size & location in the arteries of the heart.  It would make better sense if this information would be in a more prominent place in the hospital chart so any doctor can easily find it!

Another example happened to me personally.  I recently saw an orthopedic surgeon about persistent pain in my knee for several months.  X-rays showed some arthritis but nothing very significant.  After another month, I noticed that one spot on the knee was especially tender.  Thinking that it could be a torn meniscus, the surgeon ordered an MRI.  A few days after the test, he called & told me, other than the arthritis, it was normal.  Well, because of continued pain that limited my activities, I saw a rheumatologist to whom I had the records from the orthopedic surgeon sent.  After a few minutes, the rheumatologist asked if I knew the result of the MRI.  After I told him that I was told it was normal, he showed me the report that indicated I had a small tear in the meniscus and some other abnormalities.  He assured me that surgical repair was unnecessary, but it left me wondering why the surgeon never mentioned it.  I believe he looked at the wrong report.   I wonder how often that happens?  In my case, it didn’t make a difference.  But how often does it?

So, how do you make sure all your important medical information stays “attached” to you and can be easily found?  The health care system should do this, but there are too many moving parts.  As I said in my previous post things are slowly moving in the right direction.  But the question is – What can we do now?

In my next post I’ll present some strategies that may help to ensure health record portability until the health care system catches up to the digital age.

Please share your experiences, ideas and comments.

For Your Health – Dr. Bob