Health Care Chatbots

Are Here to Help

Virtual assistants can help patients
and providers with a host of
medical-related tasks

Mary Bates

 Say hello to molly, Florence, and Ada— to automatically document elements of the spoken
they’re just a few of the helpful, smart algorithm- clinical encounter.”
powered chatbots taking their place in health care. Clinicians can also use chatbots to quickly and
Chatbots are computer programs designed to carry easily retrieve information about drug interactions
on a dialogue with people, assisting them via text and side effects. Safedrugbot, for example, is a chat
messages, applications, or instant messaging. Essen- messaging service that helps doctors and other
tially, instead of having a conversation with a per- health professionals obtain information about the
son, the user talks with a bot that’s powered by basic safety of drugs for women who are breastfeeding.
rules or artificial intelligence. Chatbots are already For patients, there are chatbots that can book
widely used to support, expedite, and improve pro- appointments and perform other customer service
cesses in other industries, such as retail, and now, tasks. Bertalan Meskó, Director of The Medical
the technology is gaining traction in health care, Futurist Institute (Figure 2), points to the company
where it is helping patients and providers perform [Link], which offers smart bots for health care
myriad tasks.

Meet the chatbots

For clinicians, chatbots can streamline the inter-
action with electronic health records and decrease
documentation burden. “Modern electronic health
records rely on clinicians to either type or dictate
consultation notes, which is associated with clini-
cian burnout, increased cognitive load, information
loss, and distraction from other tasks in the clinical
encounter,” says Liliana Laranjo, a Research Fellow
at the Centre for Health Informatics at Macquarie
University in Australia (Figure 1). “Conversational
interfaces can employ recent advances in speech
recognition, natural language processing, and arti-
ficial intelligence to provide clinicians with tools

Digital Object Identifier 10.1109/MPULS.2019.2911816

Date of current version: 22 May 2019. Figure 1. Liliana Laranjo

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 Chatbots also have the potential to improve
access to health care by delivering advice or coun-
seling remotely at lower costs. This could ease the
burden on medical professionals. “There are so
many simple medical questions out there that do
not require the full attention of a physician but let-
ting them remain unanswered leaves the concerned
people nervous, confused, and clueless,” says
Meskó. “Patients should not have to leave work and
travel to their doctor’s office just to get a ten-second
response to a simple question.”
With chatbots improving patient experiences,
Figure 2. Bertalan Meskó
saving money, and increasing efficiency, is it
f­ acilities. “The digital assistant can connect patients possible that they will replace human workers?
to the right contacts, provide or change appointment Sandeep Reddy, a Professor at the Deakin Uni-
details, assist with refilling prescriptions or paying versity School of Medicine in Victoria, Australia,
bills, and deliver test outcomes,” says Meskó. says that chatbots will complement human health
Chatbots are also becoming the first contact point care professionals, not replace them (Figure 4).
for primary care. People can now turn to chatbots to “Even with advances in chatbot technology, there
identify symptoms and recommend further actions. will be a need for patients to seek medical care
These chatbots are not designed to offer diagnoses, supervised by human clinicians,” he says. “While
but to guide people and help reveal if they are seri- healthcare chatbots work well for screening med-
ously ill and should see a doctor. ical conditions and referring serious patients for
Babylon Health, Ada Health, and [Link] all offer medical care, they cannot replace the medical
chatbots that can check one’s symptoms and recom- environment and equipment that serious medical
mend courses of action. These chatbots ask questions conditions require.”
of patients and compare the answers to cases from their Laranjo agrees with Reddy. “Most likely, chatbots
medical database. Then they provide possible diag- will be able to help with routine tasks, streamlin-
noses, offer actionable health information, and help ing the work of clinicians and facilitating self-care
book the necessary doctor’s appointments. Sensely for patients,” she says. “As a result, the work of cli-
goes a step further: their virtual medical assistant, Molly, nicians will certainly change and adapt, ideally
appears as a virtual persona on the screen that patients leaving more time available for them to focus on
can communicate with using either text or speech. patient care and the art of medicine.”
Other chatbots are designed to monitor a person’s
health status and help manage chronic conditions.
For example, Florence functions as a personal nurse;
she can remind you to take your medicine, provide
instructions if you forget to take a pill, monitor your
health, and find and book doctor’s appointments.
She also helps motivate you to achieve your health
goals and provides medical information.

A smart health care tool

“One of the nice things about a chatbot is that it’s
very accessible; you can use it on your smartphone,”
says Christopher Lovejoy, a Doctor at St. George’s
Hospital and the Clinical Data Science and Technol-
ogy Lead at Cera Care, both in London (Figure 3).
“People like chatbots for their accessibility and the
convenience of using it.” Figure 3. Christopher Lovejoy

May/June 2019
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 chronic condition patients, especially those who
require nutritional, exercise, and medical manage-
ment advice, to download and use chatbot applica-
tions to help them manage their conditions.”
Meskó also predicts wider use of health care chat-
bots.“In the future, we will be able to share our health
data and medical records with these chatbots to help
them make the wisest decision,” he says.“And I’m sure
software developers and tech companies will recog-
nize the huge potential for the use of ‘gamification,’ as
well,” he continues. “For instance, if you could collect
points or rewards for eating healthy foods or exercising,
patients might be motivated to live healthier lifestyles.”

According to meskó, chatbots could even one

day be able to detect certain medical conditions
based only on our voices. “It’s an exciting time
because there is a lot of research that has gone on
Figure 4. Sandeep Reddy and a lot of potential uses that remain unactualized,”
says Lovejoy. 
Although chatbots may prove useful for prelimi-
nary information, it is important that patients not use
them to replace human doctors. Chatbots still have
 References and Further Reading
[1] E. Coiera et al., “The digital scribe,” Nature Digital
limitations, both in their algorithms’ ability to recog-
Med., vol. 1, no. 1, p. 58, 2018, doi: 10.1038/s41746-
nize and analyze human conversational inputs and in
018-0066-90
their inability to recognize symptoms of certain medi-
[2] L. Laranjo et al., “Conversational agents in healthcare:
cal conditions that require visual and tactile examina-
A systematic review,” J. Amer. Med. Inf. Assoc.,
tion. Lovejoy says that while chatbots are helpful, it’s
vol. 25, no. 9, pp. 1248–1258, 2018, doi: 10.1093/
important to discourage public over-reliance on them.
jamia/ocy072.
“Someone might say to a chatbot, ‘I’m short of breath,’
[3] C. A. Lovejoy, V. Buch, and M. Maruthappu,
but as a clinician, I can examine ten people with short-
“Technology and mental health: The role of artificial
ness of breath and obtain a great deal more informa-
intelligence,” Euro. Psychiat., vol. 55, pp. 1–3, 2019,
tion,” he says. “One of them I might not be concerned
doi: 10.1016/[Link].2018.08.004.
about at all; others I might be severely worried about.
[4] B. Meskó, G. Hetényi, and Z. Győrffy, “Will artificial
A chatbot runs the risk of not picking up that nuance.”
Intelligence solve the human resource crisis in

Bright future
healthcare?” BMC Health Serv. Res., vol. 18, p. 545,
2018, doi: 10.1186/s12913-018-3359-4.
Chatbots are still at a relatively early stage of
[5] E. Miller and D. Polson, “Apps, avatars, and robots:
development but because of their versatility, it’s
The future of mental healthcare,” Issues Mental Health
likely that we will continue to see an expanding role
Nurs., 2019, doi: 10.1080/01612840.2018.1524535.
for them in the health care sector. Reddy believes
[6] S. Reddy, J. Fox, and M. P. Purohit, “Artificial
that advances in machine learning, computer vision,
intelligence-enabled healthcare delivery,” J. Royal
virtual faces, and natural language processing abil-
Soc. Med., vol. 112, no. 1, pp. 22–28, 2019,
ities will enhance chatbots’ capability to recognize
doi: 10.1177/0141076818815510.
and analyze human conversations, screen medical
[7] H. J. Warraich, R. M. Califf, and H. M. Krumholz, “The
conditions, and appeal to humans even more. “Chat-
digital transformation of medicine can revitalize the
bots will increasingly be used by stretched health
patient-clinician relationship,” Nature Digital Med., vol. 1,
care services and insurance organizations to screen
no. 49, pp. 1–3, 2018, doi: 10.1038/s41746-018-0060-2.
their patient populations so only serious patients
are referred to hospitals and primary care clinics,”  Mary Bates is a freelance science writer
he says. “Further, doctors will recommend all their based outside Boston, MA, USA.

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