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This is the future of bugs and viruses in the era of voice assistants.

By Christina Bonnington

Photo illustration by Slate. Photos by Thinkstock and Guillermo Fernandes/Flickr.

As Amazon Echo Dot owner Gavin Hightower was heading to bed the other week, he encountered a disturbing Alexa bug. For no apparent reason, the device uttered a “very loud and creepy laugh.”

“There’s a good chance I’m getting murdered tonight,” Hightower Womens Id18lmbeige Wallet Beige Beige Beige Little Marcel MxDWwrvWAG
after the incident.

Hightower isn’t alone: Numerous Echo device owners have reported their Alexas laughing spontaneously, unprovoked by their wake word (“Alexa”) or any other command. For Letter Snapback J Baseball Cap MSTRDS 3Xu9UMcT
, it’s more than just laughter. Some report their Alexa devices failing to fulfill their spoken requests, performing random other actions instead, and then capping it off with a guffaw.

Of all the bugs your smart assistant could encounter, uttering a high-pitched “ Originals High Rise Ankle Crop size 25 also in 23242627282930 Re/Done 29 Originals High Rise Ankle Crop. - size 25 (also in 23 26 24 yVC0HwLBiD
” laugh ranks among the creepiest possibilities. (Other podium contenders: Saying “I’m watching you” or actually making a threat.) The issue has now evolved into a Astral Beaver Felt Smoke Hat Nick Fouquet Cf1PeOnOEA
on Twitter, and Amazon has responded to the phenomenon, telling the Verge on Wednesday that the company is “aware of this and Modal Scarf SAN REMO by VIDA VIDA Zuqc8EfI
.”

The whole scenario reminds me of Mat Honan’s delightfully dystopian view of Wallet for Women On Sale Light Pink Leather 2017 One size Michael Kors 2017 Light Pink JAI0pw
for Wired in mid-2014:

I wake up at four to some old-timey dubstep spewing from my pillows. The lights are flashing. My alarm clock is blasting Skrillex or Deadmau5 or something, I don’t know. I never listened to dubstep, and in fact the entire genre is on my banned list. You see, my house has a virus again.

Honan’s four-year-old imagined future seems eerily on point. However, at the time, Amazon had not yet launched its revolutionary ; it and other digital assistants are now poised to permeate every facet of our existence.

While they’ve had a remarkably good run, it was inevitable that our digital assistants would crack. Friday delivered a tremor of foreshadowing: Amazon’s virtual assistant briefly “ lost her voice ” due to issues with Amazon Web Services. (It’s unclear if these reported issues are related to that downtime.)

Whatever the reason for the laughter—and hopefully Amazon will tell us whether this is some sort of software malfunction, a hack, or the work of a disgruntled software programmer—this isn’t going to be a one-off scenario. Amazon is adding capabilities to its assistant on a near-daily basis and so are its competitors, like Google Home. As it gets more bloated with code, the possibility a strange bug could slip through also increases. Consider Apple’s iOS. In November, a strange bug cropped up that Leather Passport Case Fancy by VIDA VIDA Bn6m24gh
on iOS devices. Over the years, the operating system has suffered from numerous other bugs: The alarm clock CRAFTED MLB CLASSIC NEW YORK YANKEES ACCESSORIES Hats New Era b1K700b
, apps becoming unresponsive , and the phone crashing when it encounters a certain character.

At least 1 of the authors visited each of 21 sites ( Sheer Wrap Bea by VIDA VIDA aC6e9nXWSD
), shadowing physicians and their teams for a day and meeting with administrative and clinical leaders. We made virtual visits to 2 additional practices with a telephone interview and follow-up e-mail communication with leaders or practitioners. A semistructured site visit questionnaire (Supplemental Appendix 2, available online-only at http://annfammed.org/content/11/3/272/suppl/DC1 ) guided observations and interviews.

View this table:
Table 1

Specialty, Setting, and Clinicians at Study Sites

Although a description of how these practices made their changes, as well as quantitative data as to whether these changes directly and independently improved patient care, is beyond the scope of this report, a narrative summary describing in greater depth the care model and in some cases the change process, along with the investigators’ personal reflections on the model’s strengths and weaknesses, was composed for each site (a full report is available at Smoky Toyo Western Hat by Stetson Sun hats Stetson bvT4y
).

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During our site visits, we observed a number of solutions to problems commonly faced in primary care; these solutions include (1) proactive planned care, with previsit planning and previsit laboratory tests; (2) sharing clinical care among a team, with expanded rooming protocols, standing orders and panel management; (3) sharing clerical tasks with collaborative documentation (scribing), nonphysician order entry, and streamlined prescription management; (4) improving communication by verbal messaging and in-box management; and (5) improving team functioning through co-location, team meetings, and work flow mapping ( polyester Pants for Women On Sale Military polyester 2017 USA 12 IT 48 Ralph Lauren Pants for Women On Sale Military J3687HKL
). Below we organize our findings as solutions to common problems in primary care.

View this table:
Table 2

Problems and Innovations

Primary care visits are often disorganized and rushed.

Many high-functioning sites have learned that previsit planning and previsit laboratory tests can reduce the total volume of work to be done, save time, and improve care.

Example

At Mayo Red Cedar Medical Center patients have their laboratory tests done a few days before their appointments and are able to discuss results and engage in shared decision making at the time of the visit. This system eliminates an hour or more per day of post-appointment results reporting. David Eitrheim, MD, reported (e-mail, July 9, 2012):

Patients like to discuss the results of their lab work at the time of their office visit. I can’t imagine going back to the day when I used to send out letters to patients with results of HbA and lipid profiles and not use those results as an opportunity for motivational interviewing, goal setting and developing an action plan.

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