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UNC researchers led by Arlene Chung, MD, MHA, reviewed more than 300 apps in the health and fitness categories of app stores for hands-free, voice-activated assistants, including Amazon’s Alexa and Google Assistant; they found very few had a clear health focus.


UNC researchers led by Arlene Chung, MD, MHA, reviewed more than 300 apps in the health and fitness categories of app stores for hands-free, voice-activated assistants, including Amazon’s Alexa and Google Assistant; they found very few had a clear health focus.

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Arlene Chung, MD, MHA

Media Contact: Jamie Williams, jamie.williams@unchealth.unc.edu, 984-974-1149

September 26, 2018

CHAPEL HILL, NC — As the market for smart speakers like Amazon’s Alexa continues to expand, there is a potential for these devices to help enhance the health of users. But, while the app stores of these devices are full of apps in the health and fitness categories, a first-of-its-kind review, led by UNC School of Medicine researchers, found that many of the apps currently available don’t have much to do with health at all.

In the study, published in the JMIR mHealth and uHealth, a leading medical informatics journal, researchers examined apps released in the health and fitness categories of the app stores for hands-free, voice-activated assistants, including the Amazon Alexa and Google Assistant. Study authors examined information provided by vendors and reviewer ratings, also analyzing app features, target audiences, age groups, and content categories such as nutrition, health monitoring, and education.

Researchers found that many apps did not provide a clear health focus despite being labeled as such. Most were found to be focused on health education or fitness. And very few targeted patients, caregivers, older adults, or those with disabilities — populations that may benefit most from this technology. Additionally, apps for monitoring health and wellness were rare.

As the United States smart speaker market for voice assistants like Amazon Alexa expands and adoption rises, these devices can be a medium through which educational and interventional information is delivered with just a simple voice command. This could improve access to information for people with limited vision, physical limitations, and individuals with low literacy. However, these apps and devices are not without security and privacy concerns.

“The lack of HIPAA compliant platforms and restrictions from Amazon and Google for publishing apps that focus on health monitoring and delivery of care are barriers to the release of potentially impactful voice-assistant apps that could help to improve health outcomes,” says senior author Arlene Chung, MD, MHA, Associate Director of Program on Health and Clinical Informatics at the UNC School of Medicine.

Authors reviewed the privacy features of the apps using VAA and found only a small proportion had protection of user privacy or published their terms of use policies. Authors explain that vendor transparency is important so that users understand when their voice data is stored and transmitted, who has access to the data, and what is recorded and stored either on the device or in the cloud.

Authors also explained that the voice-assistant app market has not yet evolved like the current mobile phone health app market, which focuses on chronic diseases, health monitoring, and self-management. There has been a sharp uptick in these mobile apps released following the release of developer’s platforms and APIs, and this trend is expected to continue for voice-assistant apps. Chung said, while there is much potential for these apps to enhance health, the current market does not offer many apps to meet the needs of patients.

In addition to Dr. Chung, other authors include Ashley Griffin, MSPH, Daria Selezneva and David Gotz, PhD (UNC School of Information & Library Science). Dr. Chung is faculty in the Departments of Medicine and Pediatrics and the UNC School of Medicine Program on Health and Clinical Informatics. Drs. Chung and Gotz are members of the UNC Lineberger Comprehensive Cancer Center. Ms. Griffin, Drs. Chung and Gotz are also members of the Carolina Health Informatics Program.