Voice First Health Teri Fisher, MD

In this episode, Teri welcomes Dr. Gabriel Charbonneau, a family physician (Family medicine specialist) in Stevensville, MT.
Dr. Charbonneau comes on to share his experience in using voice technology at his practice and specifically the voice assistant called Saykara. SayKara’s goal is to free physicians from the mountains of paperwork that await them at the end of each day. They use their own speech recognition model and AI, to tackle the issue of clinicians being in a room and having to chart their notes on a computer while they are interacting with their patient.
That AI-powered healthcare virtual assistant that simplifies the documentation process is actually called Saykara or Kara. Saykara listens to the interaction between a physician/clinician and their patient, and then transcribes the audio recording into the EHR.
 
Key Points From Dr. Charbonneau!
His experience using Saykara in his medical practice.The huge role SayKara is playing in preventing physician fatigue and burn out.Background
He experienced burnout right out of residency and it led him into researching whether there were tools that could help take the edge off of some of the electronic charting (EHR) they were doing, which was very slow back then.He experimented with Dragon Assistant although it was not elegant.He was competitive with his partner at the practice when it came to building tools to make EHR easier, and that included building skills. They then came up with a way to make the process of treating patients easier using Dragon and Macro Recorder.They even taught other people to use the system and also built voice commands for other physicians.When he got tired of being a travelling consultant, he started a software startup and built a prototype add-on macro tool that could be used to take multiple steps in an EHR and make them into one step. The business didn’t do very well, but he still uses the tool and there are other physicians who use it too.He finds the intersection of technology and medicine very interesting.He was introduced to Tenor, a company that builds digital medical assistants to help clinicians provide better care, be more efficient and make better decisions, and served there as a physician advisor. That's where he developed a huge interest in AI and voice AI.Tenor eventually went out business so he decided to focus more on what he could do to solve the issue of physician burnout. He started by creating a T-Shirt with the words, “Fight Burnout”, and his work was noticed by people at SayKara, which led to them working together.He helped bring a SayKara pilot project to Montana and has been working with the company ever since.Using SayKara
Before using SayKara, his office work environment was very optimized because he already had the tools he was using. He didn’t think SayKara would make any difference for him, but when he started with the pilot project, he was amazed by just how much more it streamlined things at his practice.SayKara is a mobile iOS app he uses on his phone and it always has his patient list for the day on there.He selects the patient he wants to see before going in to see them, and then walks in and requests the patient for permission to use the AI assistant in recording their conversation. So far, no patient has objected to it.He then turns it into listening mode which enables the assistant to listen to the conversation. It captures all the audio, but one still has to give it occasional commands to get it to do things. The wake word is “Hey Kara” or “Okay Kara”The technology is evolving towards a fully autonomous solution that will listen to whole conversations and work on everything without any human editing to produce accurate transcripts.He basically uses SayKara like an Alexa in the exam room because he talks to it with voice commands and he doesn’t have to speak any punctuation because it’s very natural and intuitive.He’s very excited that he is helping make SayKara better with the

In this episode, Teri welcomes Eric Sauvé, the Chief of Product and User Experience at Speebly.
Eric has been a serial entrepreneur for years and has started and built numerous startups, some of which were acquired by larger companies. He developed an interest in voice technology somewhere along the journey and ended up co-founding Speebly, a voice assistant program that can be used across multiple platforms.
 
Key Points From Eric!
How they are using voice technology (Siri) and the Apple Watch to help with handwashing during the current Covid-19 pandemic.Focusing on Siri
Their initial inspiration was using Siri. The fact that Siri gives users a bunch of web results when she can’t answer a question gave him the idea of creating a seamless hand-off from Siri to the different web properties.That would mean that a user could continue searching using their voice.They have also worked with Google Assistant and Amazon Alexa, but their focus on Siri was informed by the fact that Siri has way more users.Inspiration Behind Speebly
Their inspiration is based on the fact that when people are doing anything, they will either want to type or use their voice, and voice is, of course, the best option especially where there is a lot of text input.Siri is a closed ecosystem compared to Alexa and Google on the speaker side of things, but it has a ton of users and an app environment of third-party developers. This is why they focus more on Siri.Their main aim is to make it so that anyone who has an app can take advantage of voice search to drive traffic to their app or so that there can be a seamless handoff where a user asks Siri a question and they can keep talking to the app on their phone.They released a software development toolkit (SDK) that app developers can put in their iPhone or Android projects to serve as the talking interface of their app.The toolkit is also available for Apple watch OS and people can use it without their phones.Helping With the Pandemic
They have been aiming at helping people understand that they could use voice in the context of smartphones and the Apple watch.They’ve been working on an in-house app called Handwash Circles to encourage people to not only wash their hands but wash them long enough.It’s a touch-less voice first hand wash timer. A user can say, “Hey Siri, start handwash” and the app will start a countdown timer for the appropriate amount of seconds that one is supposed to wash their hands.They plan on implementing accelerometer and gyroscope features where the app can determine if someone has done a good job washing their hands.The community feature of the app enables circles of people, for example, a person’s workplace to access data on their handwashing activities.Studies have shown that there is an improvement in the quality of hand washing where people have devices on them to monitor their hand washing. They ensure people’s data privacy in different ways.They are currently in the process of onboarding their first 10 organizations that are interested in implementing the use of the app at their workplaces.People can also sign up to be beta testers.Links and Resources in this Episode
www.Speebly.com/circleThe Comprehensive Flash Briefing Formula CourseVoice Technology in Healthcare Bookwww.TheVoiceDen.com
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In this episode, Teri welcomes Heather Utzig, the Co-Founder and CEO at Pragmatic Voice, a tech innovation company that combines big data, analytics, tech & creativity to drive businesses.
Heather has an extensive background in healthcare having worked for companies like Johnson & Johnson and Eli Lilly & Co with her efforts focused on the rapid growth of their sales and sales teams. She was responsible for managing over 130 field sales and sales managers in the area of Brain Health and Sleep efficacy. Her team won the most awards for sales success. She was awarded the Summit Award for outstanding leadership. She has also been a successful entrepreneur and has helped a lot of people launch businesses in catering, construction, healthcare, etc. She has owned and sold successful businesses, and worked with several technological platforms and implementation projects with companies over the past 10 years.
 
Key Points From Heather!
The voice applications they have been developing at Pragmatic Voice, specifically the ones geared towards helping surgeons keep track of instruments in the operating room and so much more.Her Introduction Into Voice
She was developing a technology with one of her companies and she had requested voice to be developed for it because it was around medical instrumentation in general (they worked with medical instrument service providers and were looking at how to prevent infections through the touching of the instruments so voice would ensure that a lot of the processes were hands-free and mobile).In the process of having that voice application developed, she met her co-founder and learned a lot about voice from him.What They’re Doing In The Healthcare Space
From her healthcare background, she has always considered how voice can be applied to solve the problems in healthcare.The fact that there is a lot of human connection in healthcare, especially when it comes to doctor-patient interactions, makes voice very crucial in ensuring that there’s more effectiveness in the delivery of healthcare.Pragmatic works with healthcare companies, facilities, and even physicians to help them place their applications into voice, and advice them on how that is related to HIPAA (privacy) and other areas. They have developed several voice applications in relation to that.One of those applications is Instrument Voice which works inside a hospital, surgery center, or doctor’s office where there is instrumentation that needs to either be repaired, maintained, sterilized, or logged.Anyone working with the instruments within a healthcare setting can look at an instrument’s history, ask questions, pull out manuals, see videos, and even request repairs through the voice app. Pragmatic is streamlining that whole process to make it easier for the healthcare providers.They also have Instrument Wiki, an application that enables doctors, hospitals, and manufacturers to collaborate on information to help each other out in working with their instruments and assets in the hospital.The applications are built on Amazon Alexa and Google Assistant, with their own proprietary open-source database technology.Most hospitals have had a problem in unifying their biomed and sterilization departments, and Pragmatic’s applications, because of their ease of use, can help in bringing a couple of departments in the hospitals together to work in an easier way. Their Presence
They have been working with some hospitals in New York and they are working on refining several things with plans to go to full scale market in the next month.Links and Resources in this Episode
Pragmatic Voice WebsiteInstrument VoiceThe Comprehensive Flash Briefing Formula CourseVoice Technology in Healthcare Bookwww.TheVoiceDen.com
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In this episode, Teri welcomes Ilana Meir, a voice designer and mentor in the voice technology space. 
Ilana is a conversational interface designer and is one of the leading experts in Voice User Interface (VUI) design specifically at the intersection of voice technology and health. Using her immense knowledge and experience, she thinks critically about the future of voice design in ways only few industry experts do, and she encourages her students to do the same. Ilana was a chapter contributor to the recently released book, Voice Technology in Healthcare.
 
Key Points From Ilana!
Her expertise in Voice User Interface (VUI) design and some of the tips she can share.How to design a great voice experience.Getting Into Voice Design
She came into the field of voice design from a prior background in the fields of anthropology, psychology and marketing.During her period in marketing she wanted so badly to make the transition into product design but she found herself falling into voice design which blended perfectly with her background in strategic communications, her creative thinking and her vocal ability in singing.Ilana thinks the landscape of voice design is gradually shifting in relation to how it used to be historically.Voice design is now attracting a variety of people from different fields such as interaction design.Importance of Voice User Interface Design
She considers design as the last mile logistics, and in regards to that, she feels that it helps in organization and ensuring everything is in perfect condition for patients.The Voice Design Framework
Her thoughts on the first step into getting into voice design is doing the correct research and having the perfect understanding of the stakeholder’s side and patients side.In terms of the stakeholder’s side, thinking about their customer base, knowing how they are trying to forge relationships with their patients, the legal considerations, understanding the kind of technology available and understanding the downstream effects that might come along the way are key.On the patients side you need to understand how they are receiving this interaction so you can package it perfectly, think about the patient’s day to day interaction so you can know who’s affected.When it comes to voice design in healthcare, one has to think about it as a strategic communication. With every strategic initiative, a lot of efforts and meetings are put into them, and so the same should be applied when designing a voice experience.Best Practices in Designing for the Patient
She advocates for the creation of a culture of participatory medicine which is achieved by creating a dynamic set up where patients and doctors are equal partners in healthcare delivery.How a computer system will communicate with patients is the second consideration, and the focus should be on questions and other things.When it comes to building rapport with patients, one of the main goals should be to mitigate the presumptions a patient might have regarding the healthcare system.A conversational system should be designed to keep interactions with patients brief, precise, and informative.Links and Resources in this Episode
Ilana on LinkedinThe Comprehensive Flash Briefing Formula CourseVoice Technology in Healthcare Bookwww.TheVoiceDen.com
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In this episode, Teri welcomes Dr. Bob Kolock, a retired physician, executive, and active Amazon Alexa skills developer.
Dr. Bob Kolock has over 35 years of experience in healthcare delivery. Since retirement, he has had the opportunity to spend more time on things that really interest him. That led him to begin learning JavaScript and the Amazon Alexa development process. To date, he has 5 Alexa Skills certified by Amazon. He is currently working on 2 more and one of the two is very much aligned with his healthcare career. It’s focused on improving the transition of care of patients who have undergone a medical procedure. He will be looking for partners to make this Alexa Skill a routine way to deliver post-procedure care instructions in health care delivery systems.
Key Points from Dr. Kolock!
Becoming an extremely prolific Alexa skills developer after retirement from the healthcare space.The healthcare oriented suite of skills that he’s developing.Getting in Voice Technology
He retired 6 years ago and he had had an idea to build a smartphone tool to help manage foods in the pantry or refrigerator so someone could identify them before they got spoiled. He therefore started learning iOS, Android, JavaScript, and how to create an Alexa skill.His first skill was Food Manager and he initially thought that a bar code scan would give the necessary information in as far as expiration dates were concerned, but they didn’t, so he had to find another way to import the information.His Skills So Far
He has created a variety of 18 Alexa skills, 3 of which are revised, and a number of them have to do with healthcare and behavior change. They also relate to the website that he built to function with his database.One of his most popular skills is called Our Little Secret, and the concept behind it is that a brother or sister gives the user secrets based on what they hear around the user’s house. This plays on the privacy concern but the secrets are fictitious and are meant to be funny.Another one is Wine Jester where the idea is to hold a glass of wine to the smart speaker and it will say what the taste, fragrance, and components of the wine are.Healthcare Skills
One of his first healthcare skills was Blood Pressure Check, and it’s based on the American Heart Association guidelines. The user tells the skill what their blood pressure reading is and the skill gives them feedback as to where that blood pressure might fall.Another one is My Weigh Loss Coach that helps users track their weight loss goals, and gives them positive or negative feedback based on their results.On his website, one can set up text messages to themselves to help with behavior change, and hence he has a skill called Healthy Text Scheduler that sends users scheduled healthy eating texts.The other one is Track My Dose, which helps people manage the medication they’re supposed to take on an as-needed basis.He also has Kindness Counts, a skill that was inspired by all the negativity that’s been in the world. It helps people focus on the good things that are happening around us.He also has two other skills that are geared towards helping physicians become more efficient so they can deliver care to more patients, and also help patients with their follow up care after a medical procedure.Links and Resources in this Episode
The Comprehensive Flash Briefing Formula CourseVoice Technology in Healthcare Bookwww.TheVoiceDen.comDr. Kolock’s email - rakolock1@gmail.comFood ManagerOur Little SecretWine JesterBlood Pressure CheckMy Weigh Loss CoachHealthy Text SchedulerTrack My DoseKindness Counts
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In this episode, Teri welcomes Israel Krush, the CEO and Co-Founder at Hyro, a voice platform that allows enterprises to easily add voice capabilities to their websites and mobile apps.
Israel is based in Israel, and is a former elite intelligence officer in the Israeli Defense Forces. He studied Computer Science and Statistics, has a background in machine learning. He previously worked as a software engineer for Intel and various startup companies. His company Hyro allows customers to have two-way conversations to simplify their access to relevant information. Starting with healthcare, the software enables organizations to better engage with their existing customers and reduce the cost of customer support.
Key Points from Israel!
What they’re doing in the voice technology and conversational AI space taking data from various places and serving it up via their AI technology for people to incorporate into their websites, businesses, and other entities.The interesting work they’re doing to help with the COVID-19 pandemic.What Hyro Does
It’s a plug and play conversational AI platform for healthcare providers.The company is focused on both voice and text as long as it’s natural language.They target enterprises and organizations that have massive amounts of data that is hard to navigate.The most important aspect of their solution is the plug and play.While researching the voice assistant and chatbot market, they learned that a lot of the existing solutions are based on a creation platform.Hyro gives their users a creation platform where they can define their intents and build their workflows or conversational flows. They discovered that there was a lot of friction in the deployment and maintenance of their platform for users, so they decided to look for a plug and play approach.  One of the main valuable use cases of their solution for healthcare providers has been helping patients find a physician when they need one. They find a physician based on various attributes of the physician.Another use case is in helping patients find the services that a healthcare provider offers.The patients and other users can interact through various modes and devices. Most traffic comes from mobile devices through typing (texting).Helping Battle COVID-19
When the pandemic started, they gathered in conference rooms in all their locations to discuss how they could help with the situation because they knew that patients would have multiple questions regarding the Coronavirus.Based on their technology, they scrapped the certified resources that have answers for questions around COVID-19. They specifically scrapped the WHO and CDC websites, and then constructed a knowledge graph about the virus and released a free chatbot that is also addressing issues around the virus. The chatbot answers frequently asked questions about the virus and gives people a risk assessment based on a short dialogue with a user about their age, where they’re based, whether they’ve interacted with a COVID-19 patient, and other things.Feedback From Users
Hyro doesn’t offer a one-fits-all solution. Every healthcare provider has their own unique needs, data sources, and how they handle their patients.With the COVID-19 solution, some healthcare providers have provided additional resources about the virus like their own FAQ webpages.Healthcare providers saw a need for a conversational solution to help patients in getting relevant information. They therefore felt Hyro’s solutions made sense.The Rise of Telemedicine
People are adopting telemedicine more and more because it has become clear that the old way of healthcare is gone and patients are more willing to use telemedicine.They see the same adoption in the conversational aspect of their solution. Patients are constantly asking how they can schedule a virtual appointment.Links and Resources in this Episode
The Comprehensive Flash Briefing Formula CourseVoice Technology in Healthcare BookHyro WebsiteHyro on Linkedin