Alexa, Take My Vitals: How Digital Assistants Can Help Clinical Trials

 
In just a few years from now, more than half of US households will be using a voice assistant device.

That projection, from Juniper Research, represents a significant increase and while experts debate how soon this technology will become ubiquitous, it is clear that CROs and pharma companies slow to adopt it could stand to lose their competitive edge.

Here is some insight into the technologies, their benefits and the considerations when implementing them into clinical trials.

Four Clinical Trial Uses of Voice Assistants

There are four main ways that voice assistants can be used in clinical trials, Alessandro Renzi at GoPraxis writes: compliance, support, recruitment and treatment.

Compliance

Voice assistants can learn use data from calendars and the internet, as well as machine learning, to remind patients when to engage in certain activities. These can include when to take medicine, how to complete forms and other tasks as well as engaging patients in a verbal diary entry. The result, Renzi says, will be more engaged patients, which will lead to their compliance with trial demands.

Support

With a simple call and response, voice assistants can act as companions and guides in a patient’s clinical trial experience. They can respond to any number of trial-related questions to bring patients comfort and knowledge — and all of this at a patient’s home.

Recruitment

With the unobtrusiveness of voice assistants, and indeed as they become more common in homes, it is likely patients will be able to use them to find out more about clinical trials. This could be accomplished by easier access to pre-screening surveys or by trial sponsors advertising via these mediums.

Treatment

While not strictly limited to clinical trials, Renzi suggests that with AI developing capabilities in emotion recognition, patients with mental health disorders could seek companionship and guidance from voice assistants.

The Clinical Capabilities of Voice Assistants

Voice assistants can also help connect patients with care teams, Ken Fabianovicz at Applied Clinical Trials writes.

Citing Lenovo’s use of Alexa and HealthTap’s Doctor AI, Fabianovicz says the tech can answer patient queries about their conditions and other trial information. Pairing voice recognition technology with a connected ecosystem makes trials more patient-centric.

Voice assistants can be used as follows:

  • Remind patients when they have an appointment or reschedule if necessary.
  • Record patient experience by asking patients questions to complete their trial diary.
  • Enable collaboration between site investigators and sponsors by requesting the other party to call back or respond to questions after accessing FAQs.
  • Increase awareness of trials among doctors and patients.

cool teen - Digital assistants

Voice Assistants Have the Cool Factor

In a text-heavy world, it may well be the respite that voice assistants offer that make them so valuable, Jeff Green at DRG Digital, says. While we all get tired of typing and tapping, patients with debilitating conditions, arthritis or age-related issues could really benefit from voice technology.

According to research, Green says voice assistants appeal to patients because of their convenience — they make daily reminders to do certain tasks or take medication easier. They also appeal to younger patients, even though the “cool factor” may diminish over time.

At the moment, though, Green points to Otra Mobility’s PSOteen, an Alexa voice skill that provides disease management tips for teens with psoriasis. It keeps them current as to treatments and clinical trials and even includes encouragement from other teen psoriasis patients.

Pairing Voice Assistants With Trial Data Software

Voice assistants combined with trial data technologies can lead to more interactive voice surveys and increased analytics based on user engagement and responses, Dave Gray at Med Tech Innovation News explains.

He references a collaboration between voice-first software provider Orbita and clinical trial data firm ERT. The partnership enables better data collection and analytics while also “creating conversational applications,” Gray says.

Together, these technologies grant study coordinators and trial investigators enhanced capability to create care tasks by setting goals in accordance with defined timelines. Patients and family members can use the voice assistants to review these tasks.

Voice Assistants for the Emotional Self

Digital assistants are useful in “quantifying the emotional self,” Eric Wicklund at mHealth Intelligence writes. These assistants will move from dimming lights and changing the thermostat to connecting with caregivers or calling for help.

It’s not hard to imagine, Wicklund says, these assistants will also encourage medication adherence, increased exercise and encouragement in reducing unhealthy food and drink consumption.

The big shift, enabled by the IoT, will see voice assistants play a significant role when “patient monitoring becomes remote interactive patient monitoring,” Wicklund says.

Ambient Digital Assistants

Think of ambient digital assistants as healthcare providers’ helpers; a “child of artificial intelligence (AI) and modern analytics and a cousin to the virtual assistants in the consumer space,”  Pam Baker at Hewlett Packard Enterprise describes.

Consider that voice assistants in the consumer market already use visual and audio input, she explains, meaning that they can listen or watch for “commands and execute them immediately.” Add to audio and camera-based input, ambient digital assistants in medical applications will also rely on sensors to collect and analyse data.

Baker adds that an ambient digital assistant will “always be present and alert, and often sterile as well” — there will be no need to touch the device and risk the spread of germs — making it an effective assistant to a physician.

Smart Tech Will Erode Barriers to Participation

It’s not just voice assistants that can bring about significant changes to clinical trials. Indeed, wearable tech has already made effective entries into the clinical trial market.

For Belinda Tan, M.D., Ph.D., co-founder and chief medical officer of Science 37, mobile apps and Apple watches can remotely monitor patients removing the need for physical attendance at a trial site.

Drugs can be sent to and administered in the patient’s home by a local medical professional, negating the need for the patient to travel. Transport remains a major concern and impacts enrollment for many trials — technology that can eliminate or at least reduce travel will be a huge boon to patient recruitment.

AI concept - Digital assistants

AI Pulls It All Together

While voice assistants and wearable tech devices are the items we see, it’s the artificial intelligence driving them that make them so valuable. The team at Icon say AI can translate real-world big data into insights to shape protocol designs.

That data will be captured in real time through smart devices and sensors while patients carry on with their activities. And because the information is taken in a natural setting, it will likely “capture more meaningful clinically relevant insights and be used to assess and develop trial objectives, endpoints and procedures,” the team writes.

Because subjective responses, usually gathered from traditional patient surveys, will be removed from data collected by technology, it will be more accurate.

Tech Already Improves Patient Adherence

Smart tech has already made significant inroads into the medical and clinical trial communities.

IoT-enabled smart pills and blister packs, connected to mobile apps, inform patients when and how to take their drugs and communicate this to healthcare providers. This is what Niraj Vyas, at Industrial Internet Consortium, refers to as a “connected community of patients and caregivers.”

Indeed, this automated capability is what will ensure smoother running clinical trials, with the smart tech eliminating the need for manual tasks. Benefits range from patient compliance through reminders to adherence tracking, more accurate data, less physical intervention from trial staff or healthcare providers and substantial costs savings.

Digital Trends to Expect

Digital technologies enable trial managers to be more strategic through targeted communication with patients, personalize patient care and increase efficiency through saved time and money. These were the takeaways from a report by Dawn Anderson, Jonathan Fox, Natasha Elsner at Deloitte Insights.

Additionally, the report stated that improved data collection and analysis from a digital approach will deliver “significant” rewards.

It’s worth pointing out is that many clinical trial organizations referenced in the report were reluctant to lead this digital charge. They’d prefer to follow after these processes become more normalized. However, the writers argue that this approach could likely leave these companies lagging behind.

Digital Technology Timeline

Adding analysis to the Deloitte’s report, Dan Stempel at MD Connect sets out a projected timeline for the adoption of digital technologies. Although some companies are ready for immediate adoption, others will take as long as ten years to implement new technology.

The time periods can be broken down into three distinct phases:

0-3 years: Technologies include protocol design and patient inclusion-exclusion criteria, as well as tools to improve medication adherence and monitor risk at trial sites.

3-5 years: Pilot stage technologies can assess electronic health records for information about patients and “measure endpoints in partially virtual trials.” Natural  language processing and cognitive technologies will be able to construct patient narratives.

5-10 years: These include technology to conduct wholly virtual trials and natural language processing capable of complex medical writing. Digital biomarkers will also be used as primary endpoints.

Stempel says while some of the technologies aren’t ready to be implemented at the moment, companies can still embrace digital marketing tools and social media to recruit and connect with patients. Ten years may seem like a a long time, but pharma companies and CROs should begin implementing these new means of conducting clinical trials now to remain competitive in the future.

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