Technology Corner

At this time of year, we try to find a few quiet moments to reflect on the previous year and to take stock of all that we experienced, both personally and professionally. We also share a sense of excitement — as you likely do — in the promise of a new year. This is also a popular time for resolutions and lists. We are not necessarily huge fans of resolutions, but we do enjoy a good list. A quick Google search for “popular tech gifts of 2016” returns a very large number of lists from a variety of authoritative sources. While we sometimes recommend tech newbies stay away from the bleeding edge items, there are a number of popular tech gifts that are ready for prime time usage by even the latest tech adopters.

We have a family member who uses a pill box but still has trouble remembering if that day’s medication was taken. It would be very powerful if patients could ask their virtual assistant if they took their medication that morning.

An item commonly found across virtually every list we read is the Amazon Echo. An alternative to the Echo, the Google Home, entered the market more recently, but it is also a virtual assistant. At the core, these devices include omnidirectional speakers and multiple microphones with noise cancellation and far-field voice recognition. They are, of course, wirelessly connected to home Wi-Fi networks. This means that you control the Echo and Home through spoken commands. These virtual assistants can also connect to home automation systems to control the temperature and lights. Other functions include alarms, traffic and weather reports, turning on the coffee machine, and requesting a ride from Uber. Oh, and we forgot to mention that they can play your favorite songs. The Home is more visually appealing than the Echo, but the Echo currently has more capabilities. We are excited to follow these two tech giants as they compete with each other in the virtual assistant space in 2017.

Speaking of Capabilities

We envision health- and wellness-related uses of these devices. While these capabilities are not currently available, we can see great potential in their development. Here are five desirable, health-related uses for virtual assistants, in no particular order.


Medication adherence.
Of course, we are going to start our list with a hugely important challenge to your patients and to society as a whole. Imagine the Echo (or Home) serving as an interactive reminder that it is time to take a scheduled medication. We know that patients also forget if they took their medications. In fact, we have a family member who uses a pill box but still has trouble remembering if that day’s medication was taken. It would be very powerful if patients could ask their virtual assistant if they took their medication that morning. We anticipate that this type of feature would be relatively easy to implement through modification of existing virtual assistant apps or accessing the patient’s currently preferred app, personal health record, or similar tool. Virtual assistants can transfer voice requests for things like prescription refills and medical supplies onto a smartphone shopping list that will be carried to the pharmacy.


General information and reminders.
Both the Echo and Home can currently provide up-to-date reports on the news, traffic conditions, and sports. We would like to extend this information provision function to focus on daily health tips. The tips would be specific to the user’s health status and chronic conditions. For example, general tips related to diabetes and diet — delivered at regular intervals — may help enable better decision-making at meal and snack time. This feature could be tied to a feature that is currently available — recipe suggestions. Again, for the patient with diabetes, the virtual assistant would automatically recommend health-conscious meal plans.


Health-related weather reports.
This idea is similar to the previous feature. Echo and Home can currently provide local weather reports. We envision weather reports that incorporate the patient’s conditions and medical history. This could be especially important for patients with asthma, for example. Prior to embarking on their day, patients could use the virtual assistant to obtain the weather and pollution forecasts and hopefully prevent the need to use a rescue inhaler. Or, for patients in high UV light areas, the virtual assistant can remind those who are listening about the importance of sunscreen usage.


Messaging between users.
Mobile phones have completely changed the way we communicate. First, we were able to stroll along the beach with our brick-size bag phone in hand. We thought we were so cool! We realized how uncool we were when phones that almost fit in our pockets were introduced. These were then followed by phones that actually fit in our pockets. We then went from PDAs with no phone capabilities to smartphones. This ushered in the era of text messages. We can debate the value and distractive nature of text-based communication, but it is difficult to argue the popularity of this form of communication. Now we can speak our text messages, which helps with the safety factor while driving.

It is exciting to envision the health-related potential of the latest consumer electronics devices, especially because of the accessibility of these devices.

But we would greatly value the ability to speak to our virtual assistant and have the message sent to someone else — either in our home or across the country. We would value even more being able to send a message to our forgetful relative regarding his medication usage. Yes, we can do this with a text message, but sometimes the message needs to be sent when we are not able to grab our phones. Or, another health-related messaging use would be to receive public health notifications from the CDC and other authoritative groups.


Convergence.
The ultimate value of virtual assistants is as a convergence portal for health-related uses. Imagine adding your genetic history to the weather example above. Not only would Echo report the UV level for the day, but your genetic predisposition to melanoma can also be included in developing a personalized risk assessment. This could be a powerful way to strengthen the message regarding sunscreen. Or, in the asthma example, not only are weather and pollution data useful inputs, but add in longitudinal data regarding rescue inhaler usage under similar conditions. And then include the individual’s daily schedule, which includes club soccer, an event that has previously induced an asthma attack. As a final example, for a patient with diabetes, the virtual assistant analyzes medication and diet information from a smartphone app, blood glucose readings from a Bluetooth glucometer, and longitudinal weight data from a wireless scale. A scan of the patient’s personal health record reveals his or her last check-up from the primary care doctor. All this data results in specific, targeted recommendations to improve the person’s diabetes management and overall health.

It is exciting to envision the health-related potential of the latest consumer electronics devices, especially because of the accessibility of these devices. Certainly, many of the features we describe are not available yet. We, however, focus on the fact that many readers would have given us a second glance if we had suggested as little as two years ago that you would be able to use spoken commands to receive a wide range of information and services in your home for under $200. We can’t wait to see what the future holds. We welcome your ideas. CT



Brent I. Fox, Pharm.D., Ph.D., is an associate professor, and Bill G. Felkey, M.S., is professor emeritus, in the Department of Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University. They can be reached at foxbren@auburn.edu and felkebg@auburn.edu.