An expert view of voice user interfaces
While voice technology can help reduce wait times for patients and allow them faster access to the health information they need, a lack of diversity in voice technology can negatively impact patient engagement and outcomes, according to Freddie Feldman, Director of Voice and Conversational Interfaces for Wolters Kluwer, Health. He spoke on “Closing care gaps with conversational AI, inclusive interfaces, and meaningful patient engagements” for a recent Scottsdale Institute webinar.
Although voice interfaces are prevalent in many aspects of our lives — from film and television to Siri, Alexa, and Google Assistant — white voices dominate, Feldman observes in the webinar. When you do hear non-white voices, they are usually a caricature of the way an ethnic group speaks, which doesn’t necessarily engender trust. “In many ways, this example is a shockingly insensitive portrayal that sheds light on a crucial issue that often goes unnoticed, meaningful patient engagement with diverse populations.” Implementing voice user interfaces (VUIs) with diverse voices helps more patients and members relate to the content and vital health information being shared, Feldman explains.
The importance of voice technology diversity in healthcare
“On average, black individuals and other people of color experience shorter lifespans than their white counterparts,” Feldman says. “They face higher mortality risk due to treatable illnesses, increased maternal mortality rates, greater susceptibility to severe pregnancy-related complications and elevated infant mortality rates.”
The disparity between health outcomes for people of color and whites suggests that the healthcare industry could do more to improve patient engagement and adherence. Meaningful patient engagement is critical to improving patient outcomes and experiences, he says.
What is the role of voice user interfaces in healthcare?
In today’s healthcare environment, VUIs are ubiquitous when accessing information, scheduling appointments, and navigating customer service menus, Feldman notes. Patients often must trust the virtual assistant with personal, sensitive, and sometimes embarrassing information to get the needed services or information.
Why are racial and cultural representation in voice user interfaces important?
Feldman poses the question of whether you can actually hear someone’s race in their voice? “You bet you can. Especially if that race matches your own. You can tell. It’s like radar. And, now, we’re not talking necessarily about the words someone is saying. We’re talking about the voice tone. It’s inflection and accent and the timber or sound of the voice. We’re getting at racial and ethnic disparities in healthcare that are historically pervasive in the United States.”
Trust can be hard to come by when the patient can’t identify with the virtual assistant’s voice, he explains. Utilizing a racially inclusive VUI that patients can identify with forges a bond between the patient and the virtual assistant’s persona, increasing trust and improving patient engagement and adherence.
Wolters Kluwer has used a female voice actor for its UpToDate® patient and member engagement (formerly Emmi®) English voice programs, an approach that is a step up from a synthetic voice and gives the program a human quality. However, although she connects with customers more deeply than an artificial voice, Feldman observes that because she is identifiably white, many users could have difficulty identifying with her voice, creating an unintentional care gap.
What are some examples of diverse voice options in VUIs?
Since 2020, Feldman and his team have been working to bridge the care gap in the VUI, designing interfaces that build trust and rapport in healthcare communication. A critical element of their approach is ensuring racially inclusive voices, beginning with a new Black female voice for programs with the UpToDate Outreach, UpToDate Journeys, and UpToDate Engage solutions. The team also developed a campaign-specific Black male voice for a hospital conducting prostate cancer screening outreach.
The racially inclusive voice user interfaces in the UpToDate engagement programs are among the first in the healthcare ecosystem. Indeed, VUI diversity is rare across industries and environments. As Feldman notes, the only voice choice in most commercial user interfaces is gender, though a couple of platforms are exploring a racial options.
