It’s not quite the same as Hollywood, but digital healthcare is experiencing a trend that relates to movies moving from silent films to the talkies.

An estimated 10 million consumers now own an Alexa-powered device from Amazon.com, according to market research firm Consumer Intelligence Research Partners, and eMarketer estimates that up to 37 million consumers are now using a voice-activated assistant device for such tasks as listening to music, getting the news, shopping and controlling home lighting and garage doors.

With consumers becoming accustomed to interacting with voice-activated devices such as Echo from Amazon and Google Home, a number of hospitals and health systems also are developing voice-activated tools for patients.

Alexa, Amazon’s virtual personal assistant that responds to voice commands, has been around for about two years and is getting smarter and more sophisticated in responding to health-related requests, says Ashraf Shehata, a partner in the Global Healthcare Center of Excellence at KPMG US.

For example, hospitals including Massachusetts General Hospital and Boston Children’s Hospital are experimenting with ways to use Alexa to help surgeons in the operating room comply with a safety checklist before a procedure, or to offer Alexa apps that will provide instructions patients can use at home.

In March, healthcare content provider WebMD and Amazon announced a technology and marketing program that enables users of Amazon Echo, Echo Dot and Amazon Fire TV to access WebMD’s library of healthcare content, and get answers to questions about conditions, treatments, drugs and other topics such as symptoms. Those answers also can be sent to a user via an Alexa app.

Other big health systems such as the Mayo Clinic in Rochester, Minn., Northwell Health in New York and Carolinas HealthCare System in Charlotte, NC, also are rolling out voice-activated patient tools. In September, Mayo introduced an Echo tool, Ask Mayo First Aid, that enables a user to access common topics related to first aid.  In October, Northwell Health introduced a free service that lets patients use Alexa to find the shortest wait times and the locations for the nearest Northwell emergency room.

A similar tool also was introduced last month for patients at Carolinas HealthCare. It enables patients with an Alexa-enabled device to ask for the location of the nearest urgent care center and emergency department and get current wait times at each facility. Once the patient enables the Carolinas HealthCare functionality on Alexa, he just needs to say, “Alexa, use Carolinas HealthCare to find the closest urgent care or hospital.” Alexa responds with the closest Carolinas HealthCare location and estimated wait time. Patients can then reserve their spot at one of 28 urgent care locations, via the Carolinas app on their tablet or smart phone or at CarolinasHealthCare.org/UrgentCare.

Craig Richardville

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But it’s still early days for voice-activated tools in healthcare. For now hospitals mainly are focusing on relatively simple patient tasks, such as checking wait times or looking up medical advice.

But voice-activated tools have the potential to become a major way patients deal with doctors and hospitals. They could become a common way for patients to schedule appointments, access and update personal medical records, and refill prescriptions. They can also be used to help providers more closely monitor patients at home such as by voice activation tools being used for medication reminders.

“Voice-activated search and devices move patient engagement even more from a passive to an active mode,” says Carolinas HealthCare senior vice president and chief information officer Craig Richardville.

It took Carolinas Healthcare about two months to build the internal programs for its Alexa tools and a month or two of testing before the voice-activated feature went live, Richardville says. Carolinas Healthcare didn’t say how much it cost to build its Alexa application and the health system doesn’t have any early statistics on patient use. But by the end of the year or early in the first quarter, Carolinas Healthcare will roll out a similar tool for Google Home and plans to aggressively develop more sophisticated features, although the health system didn’t provide details of those future programs.

Some health systems may take a slower approach by building a single voice-activated tool and testing it for patient acceptance. For example, Northwell web developers created the Alexa tool by integrating its emergency and urgent care wait times portal, which analyzes check-ins at Northwell emergency departments and updates them every 15 minutes. Northwell has more than 50 urgent care centers and emergency rooms throughout the New York metropolitan area, the health system says. “We’re looking at new ways to solve old problems,” says Northwell senior vice president and chief marketing and communications officer Ramon Sotol. “Connecting with our patients where they live and interact is a core value.”

Northwell says more tasks will be added to the Alexa tool, though the first task is assessing how often—or not—patients use their Echo device to check for wait times. “There will be a version 2.0,” a Northwell spokesman says.

Voice recognition systems, whether for communicating with patients online or for internal use in hospitals, can save time and money, but the upfront software installation and training costs can be pricey. Premier Health, a medical network of five hospitals and two major health centers in the Dayton, Ohio, recently spent as much as $1.6 million, or about $2,700 per physician, to implement voice recognition software integrated with an electronic medical records system from Epic Systems Corp.

Premier installed the voice recognition software to improve physician productivity and eliminate “clicking fatigue” by freeing up to 90 minutes per day of the time doctors were entering new or updating electronic patient records.

“The system brings efficiency by using speech to automate repetitive functions,” says Dr. Brian Zimmer, a physician with Premier Health and co-founder of Physician Technology Partners.

First-year savings from the voice recognition software were about $1.3 million based on better workflow procedures and doctor productivity. “Speech recognition improves productivity and physician satisfaction,” Zimmer says.

The mainstream use of voice recognition tools is just now getting underway, says Dan Housman, a director with Deloitte in Boston and chief technology officer at ConvergeHEALTH by Deloitte, which applies new technologies such as mobile, geospatial, wearable/sensors, cognitive computing and predictive modeling applications  to healthcare. “Hospitals are starting with the low-hanging fruit mainly because of patient privacy laws,” Housman says. “They are taking baby steps because there are some significant privacy hurdles to overcome.”

At Carolinas HealthCare the health system is working on a blueprint for more advanced use of Alexa and Google Home tools that may eventually give patients secure voice access to medical records, or to use voice-activated tools for better monitoring patients between office visits. Richardville didn’t get into specifics but says Carolinas HealthCare information technology staff are looked at internally developed or commercial voice activation authentication log-ins that can comply with HIPAA. “Our road map is laid out and we will mature this thing as quickly as we can,” he says.

Carolinas HealthCare wants to fast track voice recognition tools for Alexa and Google Home because such use of digital healthcare gives the system a competitive edge as healthcare becomes more consumer-driven and Carolinas HealthCare works to become a national rather than a regional healthcare system. “Consumers are using voice recognition to do more of their banking and shopping so why can’t they do the same with healthcare?” Richardville says.

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