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What do you do when Big Tech drops your initiative like a hot potato. Today we explore.

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Today in health, it Amazon and support for Alexa skills with HIPAA protections. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health, a set of channels dedicated to keeping health it staff, current and engaged. We want to thank our show sponsors who are investing in developing the next generation of health leaders, Gordian dynamics, Quill health tau site nuance, Canon medical.

And current health, check them out at this week. health.com/today now. I know I told you I was going to go back to my, I believe statements and give you some things. That I thought were, must do projects for 2023. I have two of those already lined up. I'll talk about them tomorrow and Friday. And just keep in mind that.

Uh, this week or next week will be the last week we do the today shows, uh, it really depends on how my schedule looks, but, uh, we have a production break through the end of the year. And, um, yeah. I'm ready for the production break, but, uh, I do want to make sure that I share the final couple of stories with you for this year. So, uh, tune in tomorrow, we'll talk about two projects that I think are, must do projects. They have a ROI within a year.

And their investments in the future of your health system. But I wanted to cover this story. This is an interesting one, I think has interesting ramifications. Uh, Amazon and support for Alexa skills with HIPAA protections, Amazon is ending support for programs. That allow patients to share health insurance, portability and accountability act.

Protected information. If you're wondering what hit him. Stands for that's what it stands for with hospitals and health insurers over the artificial intelligence enabled. Device Alexa, the tech giant said Thursday, if you wondering what drove this, uh, it turns out Alexa, that whole device division is losing.

Gobs of money. Like they haven't made money in a long time, even though they're selling a lot of the devices, they, they do not make money. And so they had to do a significant amount of cuts in that division and an analyze the programs that make money in the programs that don't the ones that are very labor intensive and technology intensive. They cost money to support, and this is what they decided to cut. I'll go on. Amazon said it will stop supporting Alexa third-party HIPAA eligible programs and any protected health information on the program will be deleted by the end of next week.

Wow. Quick artificial intelligence, new site. Site. Voice bot first reported Amazon's decision. Amazon rolled out the program in April, 2019, inviting select hospitals and health insurers to develop HIPAA compliant applications referred internally as skills that could be used with Alexa. Amazon launched it with six healthcare organizations, including.

Atrium Boston. Children's. Uh, Providence. Let's see. They have all this detail that doesn't need to be there. Cigna. And Lavango. Which has been sold to Teladoc health and pharmacy benefit. Company express scripts, initial capabilities included, scheduling appointments, reading blood sugar levels through connected devices, reading post operation progress notes.

And managing delivery of prescriptions on Wednesday, three of those organizations, Boston children's Providence and express scripts, which is owned by Cigna. Had apps active on Alexa skills store, none of the three immediately responded to her request for comment. I'm sure there'll be taken down. Amazon also announced.

Alexa capabilities with Teladoc and February. They spoke versa for Teladoc said, Teladoc for Alexa is no longer active. And a statement and Amazon spokesperson said the company, uh, it will continue to support Alexis smart properties for healthcare, a division that sells Alexa devices and voice tools to hospitals.

And providers to deploy and centrally managed throughout their organizations. And it's used at a BayCare Cedar, Sinai and Houston Methodist. Amazon's decision to end. Alexa initiative is the latest in a. Uh, latest twist and a tech giants, topsy turvy push in the healthcare in July. The company announced plans to acquire one medical, a.

A membership based primary care company for 3.9 million, the federal trade commission is reviewing the transaction. In August, Amazon announced it was shutting down. It's the Amazon care service by the end of the year, a month later, the company laid off 400 workers related to closing Amazon care. In November, the company launched Amazon clinic, a virtual health storefront offering.

Users access to third-party providers. All right. So that's the story. What's the, so what on this, as you know, when I go through these. News stories. I try to give what the. This is what I'm. I try to get that perspective from the. Health provider perspective. And, um, this is a situation of buyer beware.

Right. If you get into bed with these organizations that are profit based profit motive based. And their organizations don't make mine. It's the same thing with going with a startup, by the way. If their companies don't make money. You're going to lose their product. Like. They're not going to be viable. And if they were a startup, they would go out of business. If they're a large tech company.

They're just going to pull the plug. At some point, they can only not make money on a program for so long. And, uh, we thought that the tech industry, the big, especially the big tech industry, that the Googles Amazons, the Microsofts, that those programs would go on forever. But historically that's not the case. I mean, we saw that with health fault.

Um, we see that with, uh, you know, just various programs over the years, even at Google, which makes almost all of its money from advertising. Uh, some of the programs get cut from time to time. And so buyer beware, I think is one of those things. We have to stop looking at things through a rose colored glasses and really just take a realistic look. Even with Amazon, you have to look at it and say, is this going to be viable longterm? Because if it's not from a financial standpoint, if there's not a good financial model,

If it's too good to be true. If you're saying, oh my gosh, look at all the services I get for such little money. It means they're subsidizing it from some other aspect of their business. And that only goes on so long until. Eh, you know, until it either takes off or doesn't take off and if it doesn't take off, it goes away.

So for these. Organizations, by the way, all these organizations mentioned. Our forward-leaning companies, they know the risk involved. And they decided, Hey, it was worth the risk. To put the skills out there for the good of their community. I'm not sure how much it really impacts some of them. Um, I would have to know their specific programs and how they rolled it out. I do know some of them actually, and that's, it's pretty serious.

What would I do if this just happened to me, let's assume I was at Providence because technically I was at St. Joe's before it became Providence. I was never actually at Providence, just for the record. But, um, being a St. Joseph, this happened to me. What would I be looking at? I'd be looking at, um,

Uh, I'd look at building our own speakers, my friends. It depends on what the use case is. If it's, if it's, um, to the consumer in the home. I wouldn't look at that, but if it's a, we've deployed them in every one of our hospital rooms across the entire enterprise and, or we're deploying them in certain things. I look at building your own speakers. This is not rocket science.

I mean, quite frankly, there's a lot of companies that can build the speakers. There's a lot of companies that can, uh, embed the microphones into those speakers. It's not that hard to do that manufacturing process. If you have the wherewithal. And the creativity to do it. Again, I'm sure there's third parties already out there that have the speakers. The speakers are not the hard part. The hard part is the software behind it.

The good news is that when they started. You know, you had to have a team, a massive team of people behind the scenes. You know, listening to certain things, doing certain things. And hoping that your algorithm could get become smart. That's not the case as much anymore. There's a lot of these, uh, open.

Open eyes, really changing things. Change the thing on the writing side is changing things on the AI chat bot side. It's changing things. Uh, on the, uh, ambient listening side as well. You have self supervised learning. And if you don't know what that is, you should. Uh, look at it. It's a way for AI and machine models to train themselves, to learn from themselves. And this is going to revolutionize how we interact with computers and devices over the next. I'm saying three years. So I'm getting more bullish on this.

It used to be five-year kind of thing. And it used to be the purview of only a few companies with when you open source, something like this, and you put these kinds of powerful tools out there. Um, you can see a lot of progress very rapidly, and it's putting the tools into your hands. So you could do something like this again, if you had the wherewithal.

To do something. And then, because it would be something that's managed internally, you can go beyond what the limitations were of the, um, the Alexa device. Now I understand this is a build versus buy kind of a situation. It's also an opportunity for a third party, by the way. Uh, third party dedicated to health care.

Uh, ambient listening in the room. Uh, or in the home different capabilities and whatnot. I mean, the thing you have to worry about is somebody switching this back on, right? So, uh, Google's home device, um, uh, Alexis home device, obviously, if they switch it back on, you'd end up with instance competitors, uh,

You know, any apple device that's out of the home. Um, but the reality is we are going to start interacting with computers via voice. We're going to have to learn how to handle HIPAA protected information one way or another. Uh, we can do that within our four walls and then expand that out to, uh, maybe home-based care programs.

Uh, or, uh, any of the home-based care programs, hospital home. Uh, home therapies and whatnot, just people who are, uh, recovering from certain conditions. So you can put this stuff out there. Ramp it up that way. So that that's your build strategy, your bias strategy. If I were, if I were to step back now and say, you know, I don't, I don't have the wherewithal and I have to replace these devices because I lost a lot of the capabilities we had deployed.

Oh, gosh, what direction would I go in? I I'd probably, again, I'd probably go into one of the platforms that's out there. There's some voice platforms that exist. We've interviewed some of them. Um, and, uh, I I'd look at them. I'd look at, uh, seeing if they could partner. With a, a. With a, uh, speaker company. The other thing is if I had some investment money,

Uh, I might look at some, uh, Some entrepreneurs and say, can you build this. These are just some of the different ways I would approach. This kind of, of problem. Um, but again, the big, so what on this expire? Buyer beware. Uh, replacement strategies, I think are important. The. And then the final thing is, uh, voice is going to change dramatically in the next three years. It got to keep an eye on it.

Got to get ahead of it. Um, But, you know, if you're taking a buy strategy, just wait until somebody comes back with something. That can replace these devices in your hospital. That's where I start and, and, uh, look to push it into the home. Alright, so remainder of the week tomorrow, I'm going to talk to you about two.

Uh, less than one year ROI kinds of programs that I think every health system should be looking at. Uh, with regard to some of the financial challenges that are out there. And I haven't decided what I'm going to do next week. I might do more, I believe statements. I might start looking at some of the predictions or I might not do anything and just take three week production break instead of two.

I will let you know that tomorrow. That's all for today. If you know, someone that might benefit from our channel, please forward them a note. They can subscribe on our website this week. Help. at.com or wherever you listen to podcast apple, Google, overcast, Spotify, Stitcher. You get the picture? We are.

Everywhere. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health leaders. Gordian dynamics, Quill health. Tau site nuance, Canon medical, and 📍 current health. Check them out at this week. health.com/today. Thanks for listening that's all for now

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