• Jessica Franco, Yauheni Solad, Arjun K Venkatesh, Reinier Van Tonder, Alexander Solod, Tomek Stachowiak, Allen L Hsiao, and Rohit B Sangal.
• Yale University School of Medicine, New Haven, Connecticut.
• J Emerg Med. 2023 Apr 1; 64 (4): 506512506-512.

BackgroundIn March 2020, the U.S. Department of Health and Human Services Office for Civil Rights stated that they would use discretion when enforcing the Health Insurance Portability and Accountability Act regarding remote communication technologies that promoted telehealth delivery during the COVID-19 pandemic. This was in an effort to protect patients, clinicians, and staff. More recently, smart speakers-voice-activated, hands-free devices-are being proposed as productivity tools within hospitals.ObjectiveWe aimed to characterize the novel use of smart speakers in the emergency department (ED).MethodsA retrospective observational study of Amazon Echo Show® utilization from May 2020 to October 2020 in a large academic Northeast health system ED. Voice commands and queries were classified as either patient care-related or non-patient care-related, and then further subcategorized to explore the content of given commands.ResultsOf 1232 commands analyzed, 200 (16.23%) were determined to be patient care-related. Of these commands, 155 (77.5%) were clinical in nature (i.e., "drop in on triage") and 23 (11.5%) were environment-enhancing commands (i.e., "play calming sounds"). Among non-patient care-related commands, 644 (62.4%) were for entertainment. Among all commands, 804 (65.3%) were during night-shift hours, which was statistically significant (p < 0.001).ConclusionsSmart speakers showed notable engagement, primarily being used for patient communication and entertainment. Future studies should examine content of patient care conversations using these devices, effects on frontline staff wellbeing, productivity, patient satisfaction, and even explore opportunities for "smart" hospital rooms.Copyright © 2023 Elsevier Inc. All rights reserved.

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