Healthcare is Ready for Alexa, as Soon as HIPAA Issue Resolved

Xconomy Seattle — 

[Corrected 10/10/17, 12:51 p.m. See below.] A voice-enabled bathroom scale that can scan for diabetic foot ulcers uses Amazon’s voice service, Alexa, to instruct patients to step on when they’re ready to begin. In one test, a patient responded to Alexa’s prompt by declaring, “Ready when you are.”

Anne Weiler, co-founder and CEO of Wellpepper, a Seattle company that developed the prototype scale as part of its entry in the Alexa Diabetes Challenge, might say the same thing to Amazon (NASDAQ: AMZN) itself.

She’s among those healthcare IT entrepreneurs convinced that the future of healthcare will include human-computer voice interactions—just as soon as Amazon makes its voice services compliant with healthcare privacy laws.

Wellpepper designed Sugarpod, which combines the scale, voice technologies, and a mobile app, to help new patients with type 2 diabetes manage their disease. The team was one of five finalists in the $250,000 challenge run by Luminary Labs, sponsored by Merck, and supported by Amazon Web Services; a winner is expected to be announced sometime this month. [An earlier version of this paragraph said Amazon Web Services sponsored the event, based on information provided by Amazon. A Luminary Labs representative clarified that Merck is the only sponsor of the event.]

Win or lose, Weiler says Wellpepper intends to move forward not just with Sugarpod, but with voice integration for many of its offerings. The company specializes in digital tools to help patients follow care plans prescribed by their doctors—such as the steps to take for optimal recovery from a knee surgery.

[Hear from Wellpepper co-founder and CTO Mike Van Snellenberg at Xconomy’s upcoming Seattle event Healthcare + A.I. Northwest on Nov. 9. See our event page for tickets and information.]

In anonymous testing of the Sugarpod system at a Kaiser Permanente wound care clinic, “people really did engage with voice and really talked to Alexa as though she was a person, so that emotional connection that we see with our mobile devices is even stronger with voice,” Weiler says. “We think there’s a great opportunity there and we’re really looking at voice as another modality in delivering any type of treatment plan.”


But Weiler, along with anyone else who would build a service connecting patients and healthcare providers via Amazon’s voice technologies, will have to wait.

Neither Alexa, the conversational interface that runs on Amazon’s own devices, nor Lex, a white-label conversational interface that can be incorporated into third-party apps, is currently compliant with the U.S. federal law governing how doctors, insurers, and other covered groups handle patient healthcare data—the Health Insurance Portability and Accountability Act (HIPAA).

AWS has made many other services HIPAA-eligible as it has grown its business in the healthcare and insurance industries. Among these is AWS Lambda, the serverless compute architecture that is called upon to execute code in response to Alexa and Lex voice interactions.

“Lambda was a prerequisite for Alexa and Lex” to be HIPAA eligible, Weiler says. “Amazon just never pre-announces or promises anything, so we’re just waiting.” She adds, “No one has confirmed anything to us, but yet they didn’t discourage us from building a solution that might connect patients and providers.”

A spokesman for Amazon Alexa declined to speculate on future plans for Alexa and Lex.

Since its founding in 2012, Wellpepper has designed its care plans to use the appropriate mode of communication—SMS or e-mail or a mobile care plan interaction—depending on what a patient is being told to do, and where they are.

Weiler says voice is a natural fit for healthcare technology in clinical settings, such as the voice-enabled scale. “You are used to having somebody ask you things, and so to answer is pretty natural,” she says.

Voice is useful outside the clinic, too, as voice-enabled devices proliferate in homes, allowing people to more efficiently enter data, such as their latest blood sugar reading in the Sugarpod application, or a list of what they recently ate in food diaries. “We always look at, what’s the easiest way you can get some information that a human can deal with, and then start to then look at how do you scale that with machine learning,” she says.

Apart from the HIPAA issue, Weiler says there’s more the company could do to make the Alexa and Lex voice services more useful for healthcare applications. For example, the company does not provide access to telemetry data. “We want to know what utterances people are making and which ones are failing,” Weiler says.

That would be important for fine-tuning healthcare dialogues, such as when a patient tells Alexa, “ready when you are.”

“I’m not sure [Alexa is] going to know how to deal with that,” Weiler says. But she’s ready to find out.