Patient-Centered Care

LeadingAge 2019: Weighing the Pros and Cons of Smart Speakers in Senior Living

The devices and other voice-first technology can boost autonomy and personal safety. But care centers must implement clear policies when adopting them.

Kevin Joy

Kevin Joy is the managing editor of HealthTech. He previously worked in content marketing for a major university health system and as a features reporter for the Columbus Dispatch.

As voice technologies become a vital resource for consumers, the option is increasingly finding a home among residents in senior care centers and the staff who serve them.

And it’s not just for basic tasks such as reciting news headlines or queueing up a favorite song, a group of panelists explained on Monday at the LeadingAge 2019 conference in San Diego. Smart speakers and other tools can help older adults communicate with loved ones, stay up to date on their surroundings and take more control over their care — all without navigating a touch screen or keyboard.

A recent rollout of 25 Amazon Echo Dot devices at The Birches at Trillium Woods, a rehabilitation center in Plymouth, Minn., was launched with those needs in mind. The 44-bed center worked with Soundmind, a New York company that designs customized, HIPAA-compliant tools for voice assistants in the senior care space.

As a result, “it gives residents the opportunity to questions: What time is bingo? What’s on the menu tonight? When is my therapy appointment?” said Katie Patzelt, an administrator at Life Care Services, which manages Trillium Woods.

By helping users quickly find answers to queries that otherwise would have required calling an employee, the practice, Patzelt noted, “gave them a little more of their independence back.”

Greater benefits also can result: A review of depression scores of older residents who used a smart speaker dropped by 44 percent over a six-month period, said Soundmind CEO and co-founder Erum Azeez Khan. Improved health, she added, can translate to reduced workflow costs that positively impact reimbursements and revenue.

Smart Speakers and Security: How to Prevent Trouble

Amazon made headlines in April after announcing new HIPAA-compliant features for its Alexa digital assistant. But concerns remain among senior care providers that the devices are vulnerable to hacking or could be misused by residents and staff — accidentally or intentionally — to record patient-identifying information without consent.

Care centers shouldn’t discard the idea of implementation but instead develop robust security policies that leverage the tools’ potential while keeping patient privacy and safety top of mind to avoid a breach or HIPAA violation, said John DiMaggio, co-founder and CEO of BlueOrange Compliance.

These steps can include network segmentation; using only center-owned devices that can be configured by IT staff; using a platform that limits available skill sets; and training employees on best practices, such as checking to ensure a device’s microphone is off when entering a room.

As with other Internet of Things devices in medicine, “hackers are trying to get into these things; the minute you put something on your network, it’s an issue,” DiMaggio said

Complicating things further, not all details are considered personal health information, such as a reminder to take medication, DiMaggio notes — and not all senior care settings are considered clinical ones that would mandate HIPAA compliance.

Which is why, regardless of particulars, general precautions for smart speakers are critical in any setting. This summer, BlueOrange Compliance and the LeadingAge Center for Aging Services Technologies published detailed recommendations for senior care providers looking to implement voice technology, with insights specific to various environments and populations.

Implementing Smart Speakers in Senior Living

Panelists suggested starting slowly, with small pilot programs to determine smart speaker scenarios that work best to address the needs of residents and staff. (A relatively low cost per device, they said, helps reduce the barrier to entry). This involves determining where devices should be placed; a shared patient room, for instance, might not be a feasible setting.

Connectivity is also important so devices are functional when users need them. “You need a resilient network,” said Nick Patel, president of the Asbury Group – Integrated Technologies, a consulting arm of Asbury Communities. “It is a resource that kind of hogs your bandwidth.”

Just as staff must be educated, residents need to learn how the tools operate, and they should be warned of vulnerabilities that could result from their use. The BlueOrange and LeadingAge recommendations advise obtaining a signed agreement with the resident (and possibly the device manufacturer) that covers security measures and shared responsibilities among everyone in a care community.

Although panelists acknowledged that the smart speaker landscape is still evolving — and that some risk is involved — the potential of voice technology in senior care is too great to ignore.

“It’s removing the friction that interfaces present,” DiMaggio said. “You can walk into a room and say: ‘lights.’”

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