Reputational risk, the NHS and Amazon’s Alexa

Did NHS satisfy itself that Amazon’s Alexa has all the possible systems in place to guarantee ‘a safe space’ for those seeking medical advice from the NHS?

That is a very simple question yet the most important one, I could argue, that NHS’ recent announcement mentioned nothing about. And it should have.

What was supposed to be a beautiful, breakthrough and much needed – as per the arguments used in NHS’ press release – announcement, left the UK’s news media adding a “BUT …” to this initiative.

And the media are right; there is a very big “BUT…” here, especially when tried live, on BBC News, Alexa doesn’t answer with advice from the NHS but with advice from the Mayo Clinic!!! Watch this caption of the on-air test!

There are several questions that this collaboration between the NHS and Amazon leaves unanswered:

1: How is the privacy of the searches (questions asked) ensured? After all, there is no secret anymore that Alexa’s recorded conversations, by Amazon’s own staff and various WiFi “intruders”, make for a highly “enjoyable” listening.

2: How is the NHS’ ensuring emergency advice like “go see a doctor now!” or “call an ambulance immediately” being relayed back to those who are “blind and those who cannot access the internet through traditional means“? After all, not everyone’s level of discernment on what constitutes an emergency and what doesn’t is the same!

3: Why Amazon’s Alexa’s and not Apple’s Siri since so many of us have Apple iPhones (the latest data I could find, for 2017, indicated that 38.99% of the UK population uses an iPhone)?

4: What are the financial arrangements between the NHS and Amazon to make this “partnership” happen? Who paid whom and how much? After all, this announcement today has been a Public Relations coup for Amazon who is now a “formal”, whether we like it or not or whether it is written down or not, “NHS provider”!

5: Why hasn’t the NHS, in partnership with BT for example (since not everyone subscribes to the same mobile operator), created its own “gizmo” which could have been delivered free of charge to those who are elderly, blind and cannot access the internet through traditional means? A way of capturing and monitoring their queries which could also be linked up to their medical files?

6: How is the data in “search queries” going to be used, by whom and when?

From a reputational risk perspective, this news raises a significant number of issues which, I believe, NHS needs to answer. Unlike Amazon – a privately held profit making organisation, NHS belongs to the tax payers, to you and I.

NHS is under pressure, of course. When isn’t it? But imagine the financial pressure and public backlash it may be faced with if someone dies based on the advice “Alexa gave me because the NHS said so?”

Would an artificial intelligence (AI) like Alexa or any other be likely to replace face to face interactions with a GP or practice nurse? No.

Would you trust that an AI would give you the best information or read you the “small print”? Probably not.

How many of us would actually be able to differentiate between psoriasis and eczema and ask Alexa about it?

There is a lot to be said about the “companionship” of voice activated technologies; they are appreciated by the elderly because “it feels like there’s someone else in the house“. But there is a clear line between “play me a song” and asking medical questions.

And if nothing else, NHS has missed the most important aspect of all, from a PR perspective, in announcing this partnership with Amazon:

The NHS is collaborating with Amazon to provide reliable health information from the NHS website through voice-assisted technology – [and it is safe to use].

Photo by Fabian Hurnaus from Pexels

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