Virtual health assistants and trust in patient care

By Thomas J. Morrow, M.D.
03:02 PM

Doctors, patients and insurance companies don’t agree on much. But ask them what they think of call centers, and you can rest assured you’ll get complaints from every quarter. 

Not only do patients dread having to navigate cumbersome voicemail menus to get even the simplest medical information, but doctors, nurses, administrators – and just about everyone in the medical community – also dislike them. Even call center operators are frustrated by them.
They cost a lot of money, waste a lot of time and often leave more questions unanswered than answered.
And yet, the entire medical industry relies on them. Why?
There hasn’t really been a better alternative: when patients have a specific question about their health, nothing has been able to match a live person’s ability to help them.
Companies have been trying to solve the problem by creating websites, chock full of information. But the sites are often just as confusing to navigate, with their morass of tabs, links and FAQ sections that rarely answer every question.
But there is a way to enhance websites and smartphone apps, turning them into tools that deliver personalized service that equals what live representatives can offer, with added value that a call center simply can’t match.
Imagine going to a website or logging into an app in which you were greeted by a friendly virtual assistant who asked what you wanted – and then immediately gave you the right answer – or directed you to the right place.
That’s the promise of virtual health assistants (VHAs) -- digital representatives (also called avatars) that live on websites, smart phones and other devices.
VHAs are going to see increasing use in the healthcare arena, where they can do everything from answering billing questions to encouraging patients to remain adherent to treatment and wellness regimens. 
They can save companies money while empowering patients to achieve better outcomes. Infinitely scalable, they can help millions people navigate all kinds of information and deliver the high-touch, proactive engagement that call centers can’t afford to offer. 
Why Virtual Health Assistants are Necessary
Left on their own, patients often make small mistakes that affect their health in big ways. Those simple mistakes include everything from forgetting to take their medicine to delaying or avoiding treatment to failing to schedule important health tests like mammograms and colonoscopies.
There are already other technology-driven solutions, such as phone applications, medication text reminder systems, smart medication bottles and shipments of medication and goods that are automatically sent when an old prescription is due to run out. Those help, but they don’t go far enough.
Virtual health assistants accomplish what other solutions can – and a lot more.
To be clear, VHAs won’t replace real humans. In fact, they work in conjunction with them. They are an engagement technology that are infused with the knowledge of a specific domain, therapy or wellness regimen as deciphered by each client. They are infinitely scalable, therefore saving money by addressing issues once reserved for call centers and healthcare professionals. When they can’t answer a question, they are programmed to direct you to the person or place that can.
For instance, VHAs can track individual health needs and send out reminders (with the full consent of patients) as often as a patient needs them. They can then communicate with healthcare providers (again with full consent) to help doctors figure out treatment plans.
As the number of patients outstrips the number of healthcare professionals available to serve them, VHAs will allow scalable, effective provision of wellness, prevention and disease- management care.
Perhaps most importantly, VHAs can actually converse and empathise with patients using real language, thereby developing relationships with them. That ability changes the whole equation.
VHAs are there for patients to answer personal questions about such delicate topics as sexual function to patients on specific types of medication. In fact, in some cases, it turns out that it actually can be easier to talk to a VHA than a real person, who might be full of judgments. And achieving this level of trust is something new and important in VHA capabilities.  
How VHA’s Establish Relationships with Patients
These assistants are there to help. They work because they don’t rely merely on voice recognition software, and technology has improved to the point where they now are able to use and understand natural language.
But in addition to being able to converse with people, VHAs use personal data and context to establish emotional and social relationships much in the same way that people do – by delivering valuable information.
For instance, your VHA might start a conversation by telling you about the local weather and traffic conditions, which it knows because it can read (with permission, of course) the GPS embedded in your smartphone and has access to data sites that store such information.
Once your VHA is talking to you, it might offer you something useful, such as alternate routes. Then, it might quiz you about what you ate for breakfast and when you planned to exercise.
Sure, you understand that the VHA a computer program, but because it gives you real information you can use, you begin to trust it, just as you would a real person.
In other words, you’re making a real connection with your VHA and will likely grow more emotionally attached to and dependent on the technology to be there.
That shouldn’t sound far-fetched. Humans make emotional connections with objects all the time. From their earliest years, most toddlers cling to a favorite inanimate object, such as a rattle or a fuzzy blanket. When we grow older, we become attached to other things. Some 55% of us would give up caffeine and 70% would give up alcohol before giving up their smart phones, according to a recent survey.
The point is, that we can develop a human- like connection with objects – including VHAs. Dr. Timothy Bickmore, a professor at Northeastern University calls this type of connection a “therapeutic alliance.” He likens it to the relationship patients once had with a neighborhood doctor or pharmacist.
Because patients develop this alliance, they learn to trust virtual assistants. That’s what leads to real change. Science shows that human behavior changes when several factors are present: people must be motivated, they must have the ability to change and they must be spurred to change by a specific trigger, according to B.J. Fogg, a popular behavioral psychologist.
Virtual assistants also have the advantage of being with patients 24 hours a day, with the ability to engage them at the precise moments they want and need to interact.
That means that the (virtually endless) tasks and activities a VHA can facilitate and monitor -- actions like being able to answer questions in real-time about medications, proactively and discreetly answer sensitive questions, or even provide on-going measurements of disability progressions -- actively work to build an invaluable and necessary level of trust into patients’ care. 
In short, VHAs will have a central role in how we interact with a broader digital world, allowing patients to make the most of the vast resources available to them and offering healthcare professionals a means to deliver a high level of personalized service without having to employ more people.
There is no easier way to connect with patients than by talking to them. It’s the one, natural way of gathering real, unfiltered patient data. That’s something that our current inefficient call-center patient service models can not provide, and virtual health assistants are already being deployed to transform healthcare.