The Amazon Echo is a voice-controlled, hands-free speaker. It uses the Alexa Voice Service to search the internet, play music, share the news and more, with the use of a simple command ‘Alexa’ to wake it up. Alexa is able to learn new functionality and skills and is designed to adapt to personal preferences, vocabulary and speech patterns.
PA Consulting, which leads the Argenti Telehealthcare Partnership, and Hampshire County Council, whose care technology services are managed by Argenti, are working on a pilot to trial Alexa in social care.
Steve Carefull, Director at PA Consulting Group explained how the pilot developed, ‘We have been thinking about “where next” for care technology and observing the growth in consumer digital connected devices. The Local Government Association was offering grants for local authorities to try out digital solutions in social care, so we helped the Council to submit a bid and they were awarded funding for the Alexa Cares pilot. We’ve been talking with Amazon about the way “skills” need to be developed to work on the device and getting a heads-up on capabilities that may be relevant in digital care provision.’
The pilot will trial and refine one skill that PA already had in development, which links Alexa with alerts on a digital device, such as an electronic picture frame and prompts users. It will also develop a new skill to support the entry of a care worker into an individual’s home, ideally including prior identification of the care worker and the ability to log in and out. It will test the feasibility of integration with the homecare rostering system. Finally, it will forecast, measure and establish approaches to track the benefits of both skills, to encompass financial savings, as well as improvements perceived by clients and staff.
Alexa will listen to clients’ questions and speak the answers. Steve explained, ‘Speech is human beings’ preferred method of communication, so we hope this interaction will feel natural and warm. Alexa is not a person though, it cannot replace human to human interaction; that is not the aim.
‘Defining the user cohort and need is key; we always seek to start with the problem rather than the technology. We know that medication adherence is an issue for many and that poor adherence can have serious consequences; we also know people can become worried or confused when a care worker is late, so we plan to focus on these first. It is hoped that the devices and skills will be trialled in the homes of 50 of Hampshire’s adult social care clients by the end of 2017, with evaluation taking place in spring 2018.
‘We expect the focus for the pilot to be on frail older people and possibly people with learning disabilities who have a degree of independence. Of course, a key issue will be that people must want to be involved in the pilot; this won’t be imposed on anyone.’
There are obvious benefits to be gained from using Alexa. Steve continued, ‘It provides a route for delivering support in a way that can be seamlessly integrated in people’s lives. The fact that a device like Echo does so many other things: provides the news and weather, plays music, tells jokes, reads stories and so on, makes it desirable and useful in a range of ways.
‘We need to develop a series of expected and measurable outcomes and benefits to test the effectiveness of the pilot. The evidence that Alexa works in the desired way will be essential if we are to expand provision in the future. Benefits will be measured in qualitative terms (user satisfaction) and quantitative terms (tracking actual usage and estimating if and where other costs of care have been reduced or avoided).
‘This is just the start of a revolution in care technology that will see disruptors like Google, Apple, Amazon and others delivering services people want in ways not possible a few years ago.’
The pilot isn’t without its challenges, though. The skills will need to work as intended every time, ownership and use of data will also have to be clear. There are practical considerations at client level too: do they have broadband and are they willing to have an Amazon account?
Steve added, ‘The focus must be on the risk the individual is exposed to and the outcomes they seek. Whilst the technology is exciting, it is only the “how”; the important thing is the “why”.’
Looking to the future, Alexa’s capabilities and limitations are being explored and the team will look at other roles it might play. Steve continued, ‘A consumer device, which can do many different things out of the box would be a tremendous way to seamlessly integrate services, like emergency calls and falls detection, into people’s lives; sitting in the background and ready to respond when needed. ‘As we look further down the road, there’s the challenge of getting the service “wrap” right. For example, who will respond if a vulnerable person calls for help through an Echo?
‘However, even if this pilot is a roaring success, I’m not going to suggest that everyone with a care need should get an Echo; that’s just not the way personalised care works. As we see new technology being deployed in ways perhaps not envisaged even by its developers, more people will start to perceive how they could benefit in their own circumstances.
‘If they then go out and buy a device or an app that helps them to live safely for longer at home, or that can alert a carer in an emergency, then that has to be a good thing. It will also help local authorities, who are struggling with the double-whammy of demographic growth and budget cuts, as people who might previously have turned to social services for help can help themselves instead.’