The healthcare voice odyssey

Before Siri, voice-controlled assistants were being used in hospitals around the world 

Mobile voice-controlled assistants help us with everything from searching medical information on the web to selecting a restaurant. Regardless of whether we use an Android, iPhone, or Google Pixel, we expect these virtual voices to give us the right information instantly. At home, these voice-controlled assistants take the form of Cortana on the Kinect, Google Home, and Amazon Alexa, helping us manage everything from the thermostat to music with a simple command.

While this technology in the consumer market is still relatively new, with the home devices becoming commonplace only within the last couple years, voice-controlled assistants have had a foothold in the healthcare industry for a long time. In fact, wearable voice-controlled assistants have existed in hospitals for more than 15 years, long before Siri and Cortana were even imagined. Similar to consumer technology and trends, the use of voice-controlled assistants by healthcare workers has expanded significantly over the years as clinical workflows improve and the core technology evolves.

Hands-Free Voice Communication
In hospitals all over the world, voice-controlled assistants are used in the form of hands-free devices like the Vocera Communication Badge, or a mobile app on smartphones, tablets, Apple Watch, and other “smart” devices that have become more commonplace at the point of care. The foundational advantage of the technology is the same today as it was 15 years ago. Because nurses and doctors must use their hands to provide direct care to their patients, a voice-controlled device keeps their hands free so they can easily and quickly respond to an inquiry or ask for assistance, which during a crisis can make all the difference in the life of the patient.

If you’re a nurse, you know this is more important than it sounds. Your hands are being used to administer treatment, check and change lines, help patients in and out of bed, and otherwise provide them with the best possible care. Being able to simply touch a button, say a name or role, and be connected to the right care team member can save valuable time as opposed to remembering who is on call then dialing a number or texting a message. Having worked in the healthcare industry for many years, I’ve heard some amazing stories where hands-free, voice-controlled technology has made the difference between an adverse event and saving the day. One of those stories involved a nurse caring for a pregnant patient who unexpectedly went into labor. The baby was quickly on its way into the world, and the nurse needed help fast. With one hand on the patient and one hand free, she used the communication badge on her lanyard to call a code and get assistance.

Hospitals can be mission-critical environments. They are also sterile environments. Wearing gloves and promoting handwashing are essential to reducing risks of infection. So, being able to control a mobile device with our voice instead of our hands can make a significant impact on patient care, safety and experience.

Automated Voice Alerts
While we are heavily dependent on our communication devices, to be effective in today’s world we must figure out ways to prioritize all the interruptions from news alerts, text messages, phone calls, and app notifications we receive. If we try to multitask all these interruptions, it is unlikely we will be successful. So, we are forced to develop ways to manage this cognitive overload by doing things like turning off certain notifications, silencing ringtones during meetings, or limiting how often we check our e-mail or Twitter accounts.

The same holds true in healthcare, where nurses and doctors are inundated with notifications from multiple systems, including EHRs, patient monitors, ventilators, nurse call systems, and more. With the right workflow software, every type of alarm or alert generated from each system can be evaluated and a notification with patient information and situational context can be sent to the right care team members on their device of choice. An intelligent alarm management system can make a significant impact on improving patient care, safety and satisfaction, while reducing alarm fatigue and clinician burnout. The ideal software platform will have assignment and routing capabilities that triage alerts and alarms, sending voice or text notifications to certain clinicians based on urgency. Automated, actionable alerts or notifications improve a number of workflows that impact patient care and satisfaction by eliminating the need for staff to login and manually check the status of an order or lab results.

For example, when a physician enters a discharge order into the EHR, which is integrated with the care team’s communication solution, an automatic alert can go to the patient’s nurse via their hand-free badge indicating that “patient in room 707” is ready to be discharged. The nurse can immediately start the discharge process. A similar alert can be sent to the environmental services team, letting them know a room needs cleaning; and when the room is cleaned, the EVS personnel can send a voice notification back to the EHR indicating the room is ready for the next patient. It’s a fast and convenient way for highly mobile teams to communicate, plus the time stamps recorded in the system provides valuable transparency into processes.

Sometimes these alerts can be life-saving. For every hour that passes without treating sepsis, the likelihood of death increases by 8 percent. Halifax Health has set up a sepsis management and alert system, allowing treatment to occur more quickly. An integration between the hospital’s EHR, communication system, and a predictive analytics tool scours 250+ data points within a patient’s record, identifies early signs of an infection, and automatically sends a contextual voice alert or text message to the patient’s care team. The intelligent alert can ensure action is taken in a timely manner, and it eliminates the need for a nurse to log into another system to see if there is an issue.

Intelligent Software Platform
Technology that makes the most impact in our lives is intuitive. The more we use Siri, the better it understands us. It does so by learning about our accents and other characteristics of our voices. Siri uses voice recognition algorithms to categorize each person’s voice into one of the dialects or accents it understands. In healthcare, voice-controlled communication badges and smartphone apps are also able to learn users’ voices and preferences, even going so far as to route certain commands more quickly to certain groups based on patient room assignments and personalized rules and workflows set up in the communication software.

For example, once logged into the hospital’s intelligent communication system, all a doctor needs to do to find a patient’s nurse is push a button on the mobile device and say “call room 618 nurse.” The system will instantly route to the nurse assigned to the patient in that room, eliminating the need to pick up a phone, look up a number, find a name, or send a one-way or overhead page – which is still a common practice in hospitals that haven’t updated their clinical communication systems.

Better yet, if a nurse is constantly making calls to a particular department, the system can learn this tendency and route the conversation more easily. Much like how Siri learns from user patterns, voice-controlled assistants in healthcare are similar. The difference is, while it may be quite convenient to get local movie times more quickly, in healthcare timely and efficient voice communication means so much more as it impacts the lives of patients, families and care teams.

The Future of Caring
Over 15 years ago, voice-controlled assistants in healthcare became a reality. But, the technology is still relatively in its infancy. As more use cases develop and the technology improves, the list of benefits from voice-controlled experiences in healthcare will only continue to grow and help us.

It’s becoming hard to imagine our personal lives without Siri and Cortana, much as it’s becoming difficult for clinicians to imagine doing their work without voice-controlled technology. Without it, they would likely be spending valuable time tracking down people, information and supplies and less time at the patient bedside delivering care.

As we move forward, and as voice assistants continue making the lives of nurses and doctors more convenient, the advancements we’ve made over the last 15 years will seem like only the first steps on the path toward transforming care delivery.


By Brent Lang, President and CEO, Vocera Communications


The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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