Amazon’s Echo, second from right, can have powerful healthcare applications Amazon Echo’s Alexa, the cloud-based personal assistant, senses chronically ill patient Bob, 75, enter the room. Alexa: Good morning, Bob. It’s time for you take your 10 mg of Coumadin. Bob: Thank you, Alexa. If the above scenario sounds a little far fetched – how in the world can Amazon’s Echo device sense a person’s presence as well as know to say which medication to to take and how much – it’s time to put a little faith in the internet of things. “That technology exists now and it’s a matter of time before Amazon decides to creates a version of the device that either interfaces with another sensor device that is a motion sensor or has a motion sensor built in,” said Nathan Treloar, president and chief operating officer at Orbita, a software company that builds digital services for home health and is based in Boston, Massachusetts. Treolar says that there could be several use cases for how Amazon’s technology can be leveraged but the biggest potential is for this device to become a digital care agent for people, young or old, with complex care regimes. Orbita is working with a New England area care provider/payer to create a program that intends to leverage the voice interface of the Amazon’s Echo into something that home health care agents could use to streamline their work when caring for people with those difficult conditions, said Treloar. But in the interview, he declined to name the organization because the formal launch is not until Oct. 7. However, he will be demo-ing what is possible and what he is working on with the Echo at MedCity’s patient engagement conference ENGAGE, Oct. 18 in San Diego. “Care agents are so consumed when they are visiting the patient with caring for (the patients’) needs, they want to be able to record their activity — when they arrive and when they leave — and one of the things that Echo can do … is that the care providers can record medications on behalf of the patients,” Treloar said. Orbita is building the platform that will power future interactions such as these but clarified that the software company is beginning with lower risk applications. In other words, for Amazon Echo to know and confirm that the patient has taken their medication and it was the right dosage, will not be possible immediately. “The use cases that we are focused on are the ones with relatively low risk. I mention the medication adherence app, that is one of the more higher risk ones that we would take on.” he said. For now, Orbita is looking at two things: to facilitate the home visit of a care agent and to manage the transportation needs of a patient who needs to go to the clinic or even to the grocery store. The patient would simply say, “I need a ride to my clinic” and Amazon Echo would manage the conversation and get third party transportation services, even Uber, at the patient’s door step, he said. Other than the regional care provider/payer, Orbita is also working with “early adopters” to see how the device can be best used for patients. “What we are contemplating with a few early adopters is trying to use the Amazon Echo as a form factor for essentially a care agent (so that they) can do 20, 30 to 50 percent of the common home care Q&A, content delivery and support and coordination and in many ways serve as a digital triage for other more serious needs that require clinical intervention or other kinds of human intervention,” he explained. But why use Echo when smartphone apps can perform some of these chores also? It’s a matter of convenience for the care agents, but for some patients it can also be a much better alternative. For instance, those who find the smartphone screens to be too small to see or they have physical impediments that prevent the use of those devices. “What we love about voice is that it’s the ultimate universal remote control…,” Treloar declared. But, not surprisingly, there are limitations to the technology. The Echo is confounded by loud noise. Treloar said he had invited some friends over for poker one night and they were trying to play some background music, but the device failed to understand commands until someone came right next to it, essentially blocking off the ambient noise. This impairment notwithstanding, the Echo became a valuable companion to an elderly neighbor of Treloar’s parents to whom he had loaned the device for two weeks. The 81-year-old man said that simple things like checking the weather and calling up some music became so easy with the Echo. He found an extension that Treloar’s firm had built on to the Echo to allow voice recording also valuable to leave messages for his wife like, “I am taking the dog out for a walk.” The man told him that the device had changed his life. “When he said that, I thought well isn’t this the ultimate statement of patient engagement,” Treloar recalled. Photo: Amazon Correction: A previous version of the story misspelled Nathan Treloar’s name.
Orbita will launch an add-on for New England to enable it to act as a personal assistant for people with chronic conditions and streamline the work of healthcare agents. To be released on Oct. 18 , the company will begin operating “lower risk applications” third , meaning that monitoring and confirmation of medication dosages will not be immediately available. A spokesperson for Alexa has said the company aims to develop its programme to handle 30 to 50 percent of common home care tasks, as well as content deliveries, support and coordination for patients.