Using our voice is fundamental to communicating. I notice that lately my teenager, a focus group of one, has replaced texting with exchanging voice memos with friends (even though, being as it’s a phone, they could just talk). She does this because she wants to effectively communicate her inflections and personality.
The primacy of voice communication could be a key to a new advance with one of the fundamental issues in healthcare: chronic diseases. As we live longer, we are seeing the doctor more, getting more surgeries, and taking more medications than previous generations, putting a huge strain on the system. In the past, when health services were put in place, they were designed to support and cover acute health needs. They were not designed for long-term medical support which require regular check-ins with doctors. In Germany, the Ärzteblat, did a study indicating that the average German sees their doctor twenty-five times a year and much of this is due to an aging population and chronic ailments such as Diabetes, COPD, Heart Disease, Arthritis and Cancer.
Voice technology, including Alexa, Google Home, Siri and Bixby, offer possible solutions for some of these issues. They can act as a dictation device for doctors who can then focus on patients instead of paperwork. The patients can set reminders to improve adherence, book appointments, submit refills, and track health indicators, all of which can be sent directly to the doctor’s office for monitoring.
And, now, Alexa has won permission to use protected patient health records controlled under the U.S. privacy law known as the Health Insurance Portability and Accountability Act (HIPAA). Previously, U.S. Alexa was limited to providing generic responses about medical conditions. Now that Alexa can transmit private patient information, Amazon has extended its Alexa Skills Kit, the software development tools used to add functions. This virtual assistant will be able to transmit patient records, allowing companies to create in-home healthcare services for consumers in the U.S. This more-than-likely means that the rest of the world will follow suit soon.
Adoption of this new voice technology requires more than bureaucratic approval. No matter how many apps you download, they only work if you change your behavior. On a recent client initiative, our behavioral science team was challenged with finding the personality traits for a consumer health brand. They came up with competence, status, relatability, trustworthiness, likability and authority—traits that directly impact the use of a digital voice assistant in healthcare. The better these attributes score, the higher the expected outcomes.
The use of digital voice assistants in healthcare raises potentially problematic questions, but, for me, the obviously simple yet important immediate one is: what should this voice sound like? Should a brand or a conversation guide have an old voice? Young? English? American? Who should provide this voice? What accent should they have? Is there a reason why female voices are the voices for all current devices? Should providers acquiesce to racially motivated or sexist preferences? Should it perhaps be the person’s doctor’s voice? A friend? A parent?
Being more personal and specific in these conversations will increase successful adoption. Each and every brand requires their own voice or voices. These need to be carefully calibrated, and so far, they have not been. The industry has relied on robotic, accent free, generic solutions provided by the technology.
Would it not be much more engaging to have David Beckham keep us on track for a training program or Maggie Smith help with blood pressure monitoring? Sure, the costs would be higher for talent, but so, perhaps, would be the outcomes. Amazon just announced that, for a small fee, one can revise the Alexa voice to be Samuel L. Jackson, with or without the colorful language he is known for. Just imagine having Samuel L. tell you to take your “F-ing Meds.” Would that be more motivating? Or, John Legend, whose smoky voice is an option from Google Assistant? In my mind, they would certainly be better than the dull and robotic non-human Alexa, who sounds like Hal from 2001, Space Odyssey.
I once had a client want us to find a “English speaking, neutral, genderless, European voice” for a pharmacy designed for the year 2025. The goal was to communicate and guide a person throughout the pre-store, in-store and post-shop experience. The end result was awful. Our client was happy but the test users felt like they were being “mind controlled.” In using digital assistants, healthcare brands will have to consider which voices will make a difference.
And, just like a person, a well-designed VUI (voice-user interface) uses tone of voice, inflection, suprasegmentals and other elements in conversation to shape behaviors. How does it work? VUI designers start with the end objective in mind, such as motivating someone to quit smoking. Then, it maps out numerous responses for each state of patient interaction. More complex conditions, such as diabetes, can include thousands of possible conversation flows that feature varying tone and inflection considerations. This provides patients with personalized content and support specific to their needs based on numerous variables including their personalized care plan, progress, interests and time of year. Just like a human to human conversation, these need to be crafted and delivered in a user-friendly way.
Each conversation flow must be carefully crafted to demonstrate what a conversation might look like over time. Conversation flows incorporate virtual memory, so that the program will know what to tell a patient the next time a conversation takes place rather than starting all over. If a patient talked about not feeling well in a previous interaction, then the VUI solution, based on the former response, would ask that patient next time how they are feeling and if they need specific support. Stored information forms the basis for all future conversations; captured in this will be patient inflection and voice analysis to ensure the interaction is positive.
The new wave of VUI and communicating with voices is moving us towards having conversations again (though not, perhaps, human to human). And, it may surpass most, if not all, written content in the next five years. While this is an audacious statement, it is also conceivable. Who will own this new arena of communications? Will it be brands? Communications specialists? Digital companies? Or an entirely new format? Are we ready to start conversations with our clients about the literal voice of their brand and how it might feel to others? What conversation arc should brands take? What story should we tell?
Voice in health is here, but it’s not fit for purpose, yet. It will quickly need to be. Just like the other comms tech in this industry, the health sector is behind. All major brands, not just those in the health sector, need to “find their voice,” refining the journey and figuring out ways to get some humanity back into who they are and what they offer. We will all be finding our voices again in a big way, and there’s no better discipline than communications to lead the way.