Market Spotlight—Healthcare: Speech Aids in Patient Care

Doctors have been using speech technology to dictate patient notes for decades, but the technology is finding its way, albeit slowly, into other aspects of the healthcare market, specifically to provide patients with better care, to give a voice to those with speech impediments, and to ensure that all required government mandates are being followed in hospital and clinical settings. As the technology gets more pervasive, expectations are high that it will contribute even further to improved health care, experts say.

That has been the case already at Libertana Home Health, which provides medical and non-medical home healthcare in various California communities. Libertana this summer deployed a first-of-its-kind home care solution using Orbita Voice, an enterprise-grade software platform for creating and maintaining conversational voice applications running on Amazon Alexa-enabled devices, like the Amazon Echo and Echo Dot. The deployment followed months of testing Orbita-powered Amazon Echo Dots with a select group of residents. Using the devices, Libertana was able to engage patients in managing their daily activities and more effectively inform home care professionals in triaging care needs and aligning care delivery.

The home health care residents use the voice assistant to report vital data, such as weight, blood pressure, or blood sugar levels, to their healthcare providers; hear medication and exercise reminders; request help; coordinate transportation; and learn about social or recreational activities.

“We see great value in the capabilities of voice to address a full range of health and living needs for seniors and disabled individuals,” said Jonathan Istrin, Libertana’s executive director, in a statement.

Loneliness, he added, “is a huge variable impacting health. At a minimum, if a digital assistant can help break the loneliness cycle, we come out ahead. Beyond this, the possibilities seem nearly endless.”

Debra Harrison, a registered nurse who serves as Libertana’s public subsidized housing manager, agrees. “Voice assistants overcome challenges for individuals who, due to physical limitations, cannot use a keyboard or touchscreen. They also improve patient satisfaction with more natural, engaging experiences that eliminate the monitoring stigma of other connected devices, while still providing the data-driven insights that improve caregiver response in moments of need and intervention. Finally, they reduce costs by keeping patients at home and away from more costly clinical care settings,” she said.

Voice is the next big user interface, and home healthcare is arguably one of its most important frontiers, according to Orbita CEO Bill Rogers.

“It empowers the caregiver and the patient,” he says. “The caregivers need to record all of the things that they have done. Rather than go back home and record all of the care tasks, they can use Orbita to do it immediately. They can also use it to easily add tasks. This is a lot easier for the caregiver than trying to list everything on paper.”

Additionally, digital home assistants like Amazon Alexa or Google Assistant can also help the elderly remember when to take their medicines, and which pills to take at set intervals.

Rogers sees the Orbita application expanding to further automate healthcare applications, as in pilot programs some facilities are undertaking with other speech-enabled applications.

Doctors at Massachusetts General Hospital, for example, are examining how they can use text-to-speech applications to help ensure that physicians follow hospital procedures for surgical safety checklists.

Boston Children’s Hospital is following a similar path, developing and deploying an Alexa app, KidsMD, which can be used to obtain qualified health information for common illnesses and for medical dosages. Internally, the hospital is also using an app to ensure rules compliance in the operating room and with other procedures throughout the hospital.

Speech and mood analytics are also being put to use in a pilot program designed to help track calls with people with PTSD and other mental disorders, according to Ali Azarbayejani, chief technology officer at Cogito. Depending on what patients say on a call, they receive certain feedback. The program is designed to augment, not replace, aid provided by humans, the company said.

Helping Childhood Development

At Florida International University, speech pathologists are using the LENA Pro application, developed by Terrance and Judith Paul through a donation of assets of Infoture. The Pauls are also majority owners of Renaissance Learning.

The LENA System measures the early language environment of children, from birth to 48 months. It consists of a compact digital recorder with clothing so a child can wear it comfortably; software that turns the recording into data; and a cloud-based system for managing the data. Feedback from LENA helps parents and caregivers increase the quantity and quality of interactive talk.

LENA tracks a number of speech aspects. Words are important, but “conversational turns”—times when an adult says something and the child responds, or vice versa—are even more so. Turns measure interactions, and according to research, they’re a very powerful predictor of brain growth. LENA also generates a reliable measure of the child’s language development.

LENA captures all of the environmental sound around a child, says speech-language pathology professor Aliette Alfano. It calculates adult words, vocalizations the child is using, and the conversational turns. From there the application compares the vocalizations to what is expected for a child of a particular age.

Alfano uses the application to help bilingual children with hearing loss, a unique population without many dedicated resources to help with speech improvement.

“I’ve been working with children with hearing loss since 1998,” Alfano says. “Kids are getting cochlary implants younger and younger; we’re trying to see if their speech and language patterns are developing at a typical pace. We also don’t know what, if any, difficulties bilingualism presents.”

The current research with children with hearing loss is expected to last another 18 months. From there the plan is to expand the program.

“In another year or two, as we identify more children with hearing loss and fill in all of their [hearing and speech-related] characteristics, we will look to work with other Florida-based colleges and universities,” Alfano says. “Then we will look to create tailor-made interventions to help children with hearing loss.”