“Partnership deals are already being struck without the benefit of comprehensive national guidance for this evolving field.”
Leading opposition politicians have warned that the decision today by Health Secretary Matt Hancock to work with Amazon so that Alexa users can access health advice from the NHS website is “opening the door to the Holy Grail” of personal data.
The new service is to all extents and purposes simply a voice-powered application that plugs user’s verbal requests into already public NHS content via an API. User privacy concerns should be of no more concern, in theory, at this point than those for users searching up symptoms online, although Amazon’s recent admissions on this front perhaps mitigate against such easy acceptance.
As Kaspersky’s principal security researcher David Emm puts it: “We know that Amazon is storing and analysing data that these devices collect, which also raises cybersecurity alarms when it comes to how this data will be used.”
“They will be privy to sensitive health data, and so it must be made clear to the public how our data will be protected. It is integral, however the many benefits they can provide the NHS with, that Amazon is totally transparent about this, to provide consumers with the assurance they need that their data is well safeguarded.”
The unease with which it has been met in some quarters meanwhile points to both a latent discomfort with voice assistant-based approaches, and an ongoing push to monetise NHS data. Labour’s Tom Watson tweeted: “This is the beginning of Mission Creep”.
The giant data monopolies want one thing: more and more data to drive their huge profits. Entrusting Amazon's Alexa to dispense health advice to patients simply opens the door to the holy grail – our NHS data. This is the beginning of a Mission Creep.https://t.co/UXN05bHMZU
— Tom Watson (@tom_watson) July 10, 2019
Secretary of State for Health and Social Care Matt Hancock says the service will help reduce the pressure “on our hardworking GPs and pharmacists.”
The move comes a month after Amazon opened up an app development programme to British developers for its voice assistant. The “in-skill purchasing” (ISP) program enables enterprises or organisations to design and integrate applications such as language lessons, personalised weather information or personal training into Alexa.
Amazon wants people to move away from the idea of a smart device which needs applications to be downloaded to it when they think of Alexa. Instead, they see it as device that has a knowledge base and capability that can be expanded depending on the human requirements, (as well as the premium level of service paid for) all of it processed and enabled by cloud infrastructure.
NHS Alexa and Data Concerns
The NHS is keen to bring in more development when it comes to applications that can help its patients, while also, allegedly, eliminate the burden on medical staff. The NHS library holds over 70 applications, covering health issues such as mental health, diabetes management and fitness.
Last June it launched the digital assessment portal for developers which aims to greatly reduce the time required to develop an application that is in line with NHS standards and is suitable for the NHS Digital Apps Library.
The NHS application standards are constantly being scrutinised as they have had issues in the past in relation to the handling of patients personal data. Following a review of the applications in the library in 2015, 70 out of 79 applications were found to be sending personal data back to associated online service, while 23 were found to be sending data in an unencrypted format. Four applications were sending out not just user identifying information, but were sending patient medical data, all in an unencrypted manner.
The move to let Amazon let its algorithm loose on the resources in the NHS website will no doubt be watched by many in the halls of Westminster, as in 2018 a House of Commons’ Science and Technology Committee urged the government to: “Set out a procurement model for algorithms developed with private sector partners which fully realises the value for the public sector.”
“The Government could do more to realise some of the great value that is tied up in its databases, including in the NHS, and negotiate for the improved public service delivery it seeks from the arrangements and for transparency, and not simply accept what the developers offer in return for data access…”
“The Government should explore how proposed ‘data trusts’ could be fully developed as a forum for striking such algorithm partnering deals. These are urgent requirements because partnership deals are already being struck without the benefit of comprehensive national guidance for this evolving field,” that Committee warned.
Business Sees an Opportunity for Further Automation
Gary Williams, Director of Sales and Consultancy, UK, at natural language application specialist Spitch said in an emailed comment: “In the past few years, many people may have seen voice technology and, by extension, voice assistants as a bit of a gimmick. However, the popularity of Alexa and Siri has proved the appetite is there for such technology. If the NHS can utilise this successfully, they can help lift the pressure on already strained emergency call centre operators and deliver real impact – driving enquiries to the voice assistant and freeing up operators to deal with the most pressing emergencies.”
He added: “Voice technology is now so advanced it can identify regional accents, slang and even emotion. While Alexa may not yet have all of these capabilities, we will continue to see the healthcare sector innovate through voice technology so that they can deliver information to people from across the country and completely change the way they engage and interact with the public.
“The next stage will be for healthcare providers to begin to implement voice biometrics – so that callers can be identified just by their natural voice.”
“Everybody knows how difficult it is to get through to the reception at their GP, so imagine being able to call up your doctors, speak to an AI-powered voice bot that can identify you and help deal with your basic enquiries, such as re-arranging an appointment or checking up on a prescription, ridding the need for you to sit in a call queue. If your query is more personal, or complex, you could be transferred to a human operator who will already know who is calling thanks to the voice biometrics, and can advise you accordingly.
“Going forward, we will increasingly see the healthcare sector explore how they can drive efficiencies and increase engagement with patients through voice technology. This may be the first foray into this type of technology by the NHS, but it certainly won’t be the last.”