Minutes matter when medical care is needed quickly. With this in mind, Northwell Health in 2014 began posting wait times for its hospital emergency departments and GoHealth Urgent Care centers online. Recently, Northwell, based in Great Neck, N.Y, rolled out a futuristic version of this function via Amazon’s Alexa voice recognition service. Anyone with an Alexa-enabled device in their home or car can use the virtual assistant to check wait times by saying, for example, “Alexa, ask Northwell for the shortest urgent care wait time.”

“We have a strong commitment to transparency,” says Emily Kagan Trenchard, associate vice president of digital and innovation strategy at Northwell. “Whenever we can demystify the health care process for our patients, we do that to make it easier for them to partner with us as we provide their care.”

Transparency around wait times is particularly useful in the New York metropolitan area, where patients can choose from numerous nearby health care options. “Letting people know which urgent care centers and EDs are busy helps them make the best decisions on where to go for care,” Trenchard says.

The potential of voice recognition

Northwell’s digital innovation team is using lessons learned from its Alexa app to explore other voice interaction tools. “I think voice is going to be the way that we control more and more interfaces,” Trenchard says. “I can envision a world where doctors and nurses don't have to do chart entry with their backs turned to patients. If they had a computer that is smart enough to listen, then they could dictate their notes.”

Voice agents might also interact with patients in the hospital or clinic. For instance, patients might ask a digital assistant for the name of a medication or to record a physician’s bedside visit to share with family members.

From idea to implementation

While the technology is still evolving, voice recognition and natural language processing capabilities are rapidly becoming more accurate, Trenchard says. It’s also becoming easier for hospitals to experiment with the technology. Northwell staff followed the instructions and tools provided in the Amazon Alexa Skills Kit.

The most time-consuming part was thinking of how people might pose questions to Alexa, as well as developing appropriate responses. The app is designed so patients can ask for the wait time at every Northwell ED and GoHealth Urgent Care center, as well as for the shortest wait time within a ZIP code. Alexa also provides each facility’s address.

A beta version was tested on employees and patients to identify different ways people might phrase questions. In addition, staff had to proactively think of how Alexa might unintentionally mislead patients. For instance, when the shortest wait time is at Northwell’s pediatric ED, Cohen Children’s Medical Center, Alexa was programmed to alert the user that “this location only sees pediatric patients” and then provide the shortest wait time for adult patients at a nearby ED.

Currently, the Alexa app has more than 1,500 utterances. All of these responses are stored in a content management system, which interfaces with a data warehouse that holds the wait times for all of Northwell’s ED and urgent care facilities. When a user tells Alexa to “ask Northwell” a wait-time question, she rapidly finds the necessary information and relevant response before answering.

Wait times are updated every 15 minutes for more than 50 facilities. Each Northwell ED and GoHealth Urgent Care center electronically tracks when every walk-in patient checks in and how quickly they get to see a medical professional.

The limitations

Hundreds of users have downloaded the Alexa app since it launched in October. Eventually, Trenchard hopes the app will provide other health services information in addition to ED and urgent care wait times.

Determining the best type of information to exchange via the app requires recognizing the limits of voice recognition. “Alexa’s really wonderful if you’re asking one, maybe two quick questions,” Trenchard says. “But once you get into asking three, four or more questions, it’s usually easier to get answers with a visual interface.”

Security and privacy is also a challenge. Since Alexa and similar devices are sometimes used in communal settings, such as dinner parties, hospitals need to be careful about privacy breaches. 

The ultimate goal is to help people keep themselves and their loved ones healthy. “All our innovation is spurring new ways to help patients get to the care they need by giving them as much information as we can,” says Trenchard.