'Alexa, what are the symptoms of cyberchondria?'

Amazon's new partnership with the UK's National Health Service will empower patients, but could a little knowledge also be a dangerous thing?

FILE - In this Aug. 16, 2018, file photo a child holds his Amazon Echo Dot in Kennesaw, Ga. Amazon met with skepticism from some privacy advocates and members of Congress last year when it introduced its first kid-oriented voice assistant , along with brightly colored models of its Echo Dot speaker designed for children. (AP Photo/Mike Stewart, File)
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The UK's National Health Service recently announced that it would be partnering with Amazon. This odd alliance aims to empower Alexa, Amazon's virtual assistant, to give NHS-verified medical advice. Alexa uses natural language processing, so you can ask her to turn on the lights, play a song, find your nearest Greek restaurant and no end of other menial tasks. Soon, however, we will also be able to receive credible answers to questions such as "Alexa, how do I treat a migraine?"; "Alexa, what are the symptoms of flu?"; and "Alexa how do I know if I have chickenpox?"

A close friend of mine once had an abscess on his leg. He read online somewhere that honey has unique antibacterial properties that can help heal wounds. After following this advice, however, he almost died. Critically ill, he had to be admitted to an intensive care unit, where the medical team eventually diagnosed botulism. While honey can be used in wound care, wound-care professionals use medical-grade honey, not the stuff that’s been hiding in a kitchen cupboard for months. The webpage my friend accessed had omitted this important little detail.

Hopefully, by eliminating poor quality and unverified health information, the Alexa-NHS partnership will protect us from some of the half-baked and downright dangerous advice presently available online. Beyond merely providing high-quality health information on verbal demand, a principal aim of this initiative is to ease pressure on busy doctors and pharmacists. Additionally, it will help make NHS-verified advice more easily accessible to the blind, the elderly and those living in remote parts of the UK, far from healthcare facilities.

Over the past few decades, we have been increasingly turning to the internet for medical advice

Over the past few decades, we have been increasingly turning to the internet for medical advice. A study published by the American Medical Informatics Association estimated that, globally, we made around 6.75 million health-related searches per day, and that was back in 2003. Data reported by Google earlier this year suggests that Google alone now receives more than a billion health-related enquiries daily, which is around 7 per cent of all searches it performs. Furthermore, a 2019 study published in the British Medical Journal found that in the week before presenting at a hospital's emergency department, patients' health-related Google searches doubled. We search first and visit later, so it appears that we are already very comfortable receiving internet-mediated health advice. It also appears that voice search has become increasingly popular, set to account for around 50 per cent of searches by 2020. The Alexa-NHS partnership, if nothing else, is timely.

However, on the dark side of this innovative partnership, I can envisage a situation where some of us repeatedly interrogate Alexa about every ambiguous symptom or minor ailment we experience. Giving perceived problems excessive and undue attention tends to magnify them, and health concerns are no exception. It’s common enough to have become a cliche that many medical students begin imagining they have the symptoms of the latest illness they read about. Easier access to health information, which is what the Alexa-NHS partnership provides, is likely to further elevate health anxiety in the vulnerable. This is already becoming the case, with some clinicians labelling a pattern of excessive online health-related search activity, subsequent worry and help-seeking behaviour as cyberchondria – a kind of hypochondria for the information age.

Another potentially problematic aspect of this partnership concerns data governance. In other words, who owns all the data generated, where will it be stored, for how long, and how might it be used, now and in the future? If millions of people are routinely divulging their symptoms and health complaints to Alexa, we need to know she is not a gossip. On a personal level, we might not like others knowing that we have been quizzing Alexa about our embarrassing rash. At the big data level, this information would be invaluable to companies with health-related products or services to sell, allowing them to better target market their wares: “People who asked Alexa X also bought Y.”

Amazon has clear intentions to expand into the healthcare industry and has already established several key partnerships. For example, the tech giant is collaborating with Omron Healthcare to give Alexa control of a blood-pressure-monitoring device. Concerning the much bigger Alexa-NHS partnership, however, the company has provided assurances that it would not sell products or make product recommendations based on the data collected as part of this particular collaboration.

Ultimately, we are already reliant on the internet for health information and, short of a global cataclysm, that is not going to change any time soon. In many ways, the internet has empowered patients, giving everyday people access to information that once only resided in the heads of medical experts. The Alexa-NHS partnership simply allows us to do the online searching via voice rather than keyboard. More importantly, it provides assurances that the information we receive is credibly sourced and based on the best available scientific evidence.