Change agents: Will virtual nurses and pocket health coaches improve patient engagement?

SIRI, RN? Mobile IVAs could help with engagement and compliance.

BOSTON  -  Healthcare organizations have a lot on their plates nowadays, and the challenges are only growing. Meaningful use is a big one, of course  -  not least Stage 2's new focus on patient engagement. 

Another is a lack of new physicians, with the Association of American Medical Colleges projecting a shortage of some 150,000 docs in the coming years  -  even as ACA is set to add millions of newly-insured patients to the rolls. Still another is low health literacy, especially on the part of many of those same new patients.

Could virtual reality be the answer? Timothy Bickmore, associate professor at Northeastern University's College of Computer and Information Science, thinks so. 

Bickmore works with relational agents, which he describes as "computational artifacts designed to build and maintain long-term, social-emotional relationships with their users."

Avatars like them, sometimes called "chatbots," have found footholds in the airline industry, at IKEA, at AT&T and beyond, offering help in lieu of actual humans. Health insurers, such as Aetna  -  whose online "Ann" avatar, unveiled in 2010, talks to plan members and takes their questions as she helps them navigate their benefits on the site  -  use them. But these intelligent virtual assistants (IVAs) could soon be poised for a much more significant clinical role.

Gartner has predicted that within the next eight years perhaps 85 percent of interactions between customers and companies could take place without a human on the other end. Healthcare could soon be headed for a similar shift, according to Tim Bickmore, associate professor in the College of Computer and Information Science at Northeastern University.

Working toward his Ph.D at the MIT Media Lab years ago, Bickmore's research included the study of "face-to-face conversation between people as a kind of user interface." That meant "studying hand gestures, facial displays of emotion, body posture shifts and head nods, and how these are used to convey information in face-to-face conversation."

His dissertation showed how that type of virtual interface could be brought to bear on healthcare counseling: "studying how doctors talk to patients, how nurses talk to patients and how we can take best practices from face-to-face counseling and build that into automated systems for educating patients and doing longitudinal health behavior change interventions."

Now he develops these virtual agents, which he says are well suited for healthcare, especially in areas around education and behavior change. He does so after real-life research of provider-patient interactions.

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