Our industry seeks to make trial participation simpler, more convenient and more patient-centric.  One of the enablers of this simplification is the novel use of new technology. 

For example, we already see a drive to use remote monitoring solutions and wearable sensors to enable the collection of rich, informative data about the patient and their condition in their home environment, potentially reducing the number of in-clinic visits a patient may be required to attend. 

More and more trial participants own a mobile device, and there is a drive to enable study apps, such as those collecting patient-reported outcome data, to be installed on their own devices (BYOD) as opposed to asking them to carry and maintain a second device during the study.

In addition to the rise in mobile and wearable solutions, we see greater numbers of consumers using Voice Assistant technologies such as Amazon Echo and Google Home.  Gartner predicts that by 2020, 30% of web browsing sessions will be done without a screen [1], using either Voice Assistants or Virtual Reality.  This trend is demonstrated by a 130% rise in US sales of voice-enabled devices such as Amazon Echo and Google home, with over 10% of Americans using a voice-activated assistant device at least once a month [2].

Voice Assistant technologies provide an opportunity to create a different level of engagement and interaction in comparison to regular apps and web pages.  Voice commands and conversational applications offer a refreshing, simplified and engaging alternative to the pinching, scrolling and tapping required by smartphone apps. 

In addition, voice-controlled applications may remove barriers to use, particularly for those that find operation of a mobile device difficult or fiddly, or have low functional literacy.

Conversational applications leveraging Voice Assistants may be of particular value where continued patient interaction and engagement are important. Application areas could include patient training, information and consent, patient engagement and retention, and the collection of patient-reported outcome data and other trial-related information directly from the patient.

Alexa, complete my diary…

Developers within ICON’s dedicated Innovation team have developed a proof-of-concept application operating on the Amazon Echo platform that leverages a Voice Assistant to deliver a patient-reported outcome instrument and collect patient responses. 

The purpose of the early research project was to explore the capabilities of the platform, understand how to program applications, and to consider the kind of applications that would be feasible to deliver in future within our highly regulated environment.  

Operating in multiple languages, initial informal testing of the application, which is launched using the command “Alexa, complete my diary”, has indicated that the platform is able to operate robustly with multiple users and languages with minimal training.

When it comes to collection of patient-reported outcomes there is more work to do in terms of ensuring measurement equivalence to standard formats, but there is already a growing body of evidence showing that instrument migration from paper to electronic formats including voice (e.g., Interactive Voice Response Systems) can be accomplished without changing the instruments measurement properties.

However, the development of conversational applications may provide an effective way of interacting with patients in an engaging manner in many other ways in future clinical trials.  Imagine a Voice Assistant becoming your personal trial assistant – providing reminders for upcoming visits, arranging concierge services to get you safely to site, providing study information, managing the trial consenting process, letting you know when to take medication, and delivering patient-reported outcome instruments and other at-home assessments on schedule. 

This may offer a much more engaging approach compared to current methods which may have a positive impact compliance, recruitment and retention.

ICON continues to focus on the factors that are critical to transforming trials for future success, including exploring how to best leverage new technology in novel ways to provide rapid access to, and analysis of, high-quality data to speed and improve decision making in clinical trials.  This work is one part of a programme of innovation projects exploring patient-centric approaches and trials of the future at ICON.


[1] Gartner (2017). Gartner’s Top 10 Strategic Predictions for 2017 and Beyond: Surviving the Storm Winds of Digital Disruption

[2] eMarketer (2017).