Enhancing the diversity of voice technologies in healthcare with inclusive interfaces and conversational AI

Voice technology has improved the efficiency of patient care in healthcare, but the 42.2% of the US population who identify as non-white are typically not represented by the voices used in healthcare interfaces.

Expert insight into voice user interfaces

While voice technology can help reduce patient wait times and allow them to access the health information they need more quickly, 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 “Bridging Care Gaps with Conversational AI Involving Interfaces and Meaningful Patient Engagement” for a recent Scottsdale Institute webinar.

Although voice interfaces are prevalent in many aspects of our lives — from movies and television to Siri, Alexa and Google Assistant — white voices dominate, Feldman noted in the webinar. When you hear non-white voices, they are usually a caricature of the way a given ethnic group speaks, which is not necessarily believable. “In many ways, this example is a shockingly insensitive image that sheds light on a crucial issue that often goes unnoticed, meaningful patient engagement with diverse populations.” Implementing Voice User Interfaces (VUI) with different voices helps more patients connect with the content and vital health information being shared, Feldman explains.

The importance of voice technology diversity in healthcare

“On average, blacks and other people of color live shorter lives than their white counterparts,” Feldman says. “They face a higher risk of mortality due to treatable diseases, increased maternal mortality, greater susceptibility to severe pregnancy-related complications, and increased infant mortality rates.”

The disparity between health outcomes for people of color and white people suggests that the health care 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 in accessing information, scheduling appointments and navigating customer service menus, Feldman notes. Patients often have to trust the virtual assistant with personal, sensitive, and sometimes embarrassing information to get the services or information they need.

Why do racial and cultural representations in voice user interfaces matter?

Feldman poses the question, can you really hear someone’s race in their voice? “You bet you can. Especially if that race matches yours. You can tell. It’s like radar. And now, we’re not necessarily talking about the words that someone says. We’re talking about tone of voice. It is inflection and stress and timbre or sound of the voice. We are addressing racial and ethnic disparities in health care that are historically prevalent in the United States.

Trust can be difficult to achieve when the patient cannot identify with the virtual assistant’s voice, he explains. Using a race-inclusive VUI that patients can identify with builds a connection between the patient and the virtual assistant’s personality, increasing trust and improving patient engagement and adherence.

Wolters Kluwer has used a female voice actor for the English voice programs of its Emmi patient engagement solution, an approach that is a step up from synthetic voice and gives the program a human quality. However, even though she connects with customers more deeply than an artificial voice, Feldman notes that because she is white, many users could have difficulty identifying with her voice, creating an unintentional care gap.

What are some examples of various voice options in the VUI?

Since 2020, Feldman and his team have been working to bridge the care gap in Emmi’s VUI by designing interfaces that build trust and understanding in healthcare communication. A critical element of their approach is securing racially inclusive voices, starting with a new black female voice for Emmi’s Outreach, Journeys and Engage programs. The team also developed a campaign-specific black male voice for a prostate cancer screening hospital.

Emmi’s racially inclusive voice user interfaces are among the first in the healthcare ecosystem. Indeed, the diversity of VUI is rare across industries and environments. As Feldman notes, the only voice choice in most commercial user interfaces is gender, although several platforms are exploring racial options.

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