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Can Artificial Intelligence Coaches Boost Patient Engagement?

Artificial intelligence is entering the patient engagement sphere through virtual health coaches driving patient-provider conversations.

Virtual health coaches driven by artificial intelligence can improve patient-provider communication in the clinic setting by helping to activate patients in their care and encourage them to initiate healthy lifestyle discussions with their clinicians, according to a study published in the American Journal of Managed Care.

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According to the researchers, a virtual health coach (VHC) that leverages natural language understanding similar to Apple’s Siri can guide patients in “conversations” about their health needs. These virtual conversations can help fill in care gaps that persist in the clinic setting, they said.

“[Seventy-five percent] of patients are not adequately informed or confident, nor do they have the necessary skills to manage their health,” the research team reported.

“In particular, healthy lifestyle behaviors are problematic for most patients. Those with lower activation rarely participate in behaviors that require active self-management, such as exercise, eating a healthy diet, and managing stress.”

VHCs are viable solutions to this problem because they are scalable and consistent in quality. Additionally, VHCs can facilitate more efficient conversations by keeping patients on target and are less costly than physician communication training.

The researchers tested their VHC at women’s health clinics and adult medicine clinics throughout the Kaiser Permanente Medical Group. All clinic patients were offered the opportunity to test the VHC while they waited for their appointments to begin.

The VHC asked the 89 participating patients questions about their health, specifically about lifestyle concerns such as weight, smoking, drinking, stress, and medication adherence. Following the appointments, the researchers issued qualitative surveys to the participants.

Overall, 51 percent of patients used the tool to initiate conversations with their providers about healthy lifestyle. Of those patients, 26 percent had never before discussed this concern with their providers.

The most common health concern was weight (18 percent), followed by stress (7 percent), medication adherence (6 percent), drinking (2 percent), and smoking (1 percent).

Participants also reported high satisfaction with the tool, stating that it was easy-to-use and enhanced their healthcare experience.

“The verbal comments regarding feedback on the VHC included it was ‘fun,’ ‘interesting,’ ‘very cool,’ ‘impressive,’ as well as ‘It was great to have something to do while waiting’ and ‘I love this about this organization,’” the researchers reported.

“A number of other comments were similar to ‘It would be great if it related to the reason I’m here,’” they continued. This observation aligns with other findings showing that some patients attempted to discuss specific and personal health concerns with the VHC.

Although patients reported high usability and approval for the tool, they also offered critical feedback regarding technological glitches.

“Some patients described the voice of the VHC as ‘robotic’ and the movements as ‘unnatural’ and ‘jerky,’” the researchers reported. “Based on greater success of an earlier prototype, we speculate that the appearance, movement, and/or voice of the VHC could be distractive to patients.”

Overall, however, the VHC showed promise in improving the patient experience, especially with regard to patient-provider communication and patient activation in health.

“A virtual health coach (VHC) offers a solution to the problem of patient activation and patient–physician discussions of lifestyle issues,” the researchers explained.

With some technological fixes, as well as efforts to more clearly explain the tool to patients, VHCs can become a mainstay in patient engagement technology and patient-provider communication strategies.

“Strengthening the instructions about the purpose of the interaction will be important… to ensure the desired conversation takes place,” the researchers concluded. “Additional advancements could leverage data from electronic health records to personalize the exchange, and the VHC’s questions could address specific visits, such as birth control considerations for women’s health and alcohol screening in adult medicine.”

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