  The rapid dissemination and adoption of smart speakers has enabled
substantial opportunities to improve human health. Just as the introduction of
the mobile phone led to considerable health innovation, smart speaker computing
systems carry several unique advantages that have the potential to catalyze new
fields of health research, particularly in out-of-hospital environments. The
recent rise and ubiquity of these smart computing systems hold significant
potential for enhancing chronic disease management, enabling passive
identification of unwitnessed medical emergencies, detecting subtle changes in
human behavior and cognition, limiting isolation, and potentially allowing
widespread, passive, remote monitoring of respiratory diseases that impact the
public health. There are 3 broad mechanisms for how a smart speaker can
interact with a person to improve health. These include (i) as an intelligent
conversational agent, (ii) a passive identifier of medically relevant
diagnostic sounds and (iii) active sensing using the device's internal hardware
to measure physiologic parameters, such as with active sonar, radar or computer
vision. Each of these different modalities have specific clinical use cases,
all of which need to be balanced against potential privacy concerns, equity
related to system access and regulatory frameworks which have not yet been
developed for this unique type of passive data collection.
