To ChatBot or Not to ChatBot: That is the Question

Telehealth has come a long way over the past few years. New technology has been added to Telehealth visits, like the use of chatbots. Here is a look at artificial intelligence and chatbot use in mobile health.

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To ChatBot or Not to ChatBot: That is the Question

Mobile Health

According to Statista, during the second quarter of 2019, there were nearly 50,000 health apps available in the iOS app store. By 2020, the mobile health market is expected to be worth 21 million dollars globally. Many consumers turn to mobile health (mHealth) for overall health and wellness. You can do things like track your meals, log chronic symptoms, keep detailed records of the amount of water intake, or keep track of your workouts.

More healthcare companies and practitioners are turning to mobile health to reach patients, and some are using chatbots to increase how quickly they can connect. Health insurer Anthem is taking a shot at a new digital service where patients can pay for a text chat with a physician to review symptoms and receive treatment. However, their first interaction is with artificial intelligence (A.I.) chatbot that asks about symptoms and suggests diagnoses. The patient is then connected to a physician for follow-up that happens at the patient's convenience for an agreed-upon fee.

As more people turn to mHealth for disease management, we need to get a clear picture of the pros and cons. Kevin Campbell, MD, took an in-depth look into the good and bad of mobile health and why he thinks patients will like it and physicians won't. Here is a look at the good and bad around using mHealth and A.I. for medical care.

Understanding the Benefits

Most medical care and treatments come with pros. Here is a look at the positives of using AI-based apps for healthcare treatment.

Price Transparency

Most care happens with little or no conversations about what it might cost the patient. However, in our current healthcare market, more patients want to know what their out-of-pocket contribution will be before they sign on the line consenting for treatment. Anthem understands this desire of patients and is meeting them halfway by giving them the cost of their chatbot visit and MD appointment upfront. Not only do patients know the cost of the visit, but they also get an appointment that fits into their schedule from the comfort of their home, office, or breakroom.

Of course, price transparency doesn't only come from apps. The Affordable Care Act requires hospitals to publish a master list of costs so that consumers can shop around for the best price. This rule was enforced on January 1 of this year but has become nothing more than a long list of expenses that mean little to most consumers. With the Anthem app, prices are clearly communicated to the patient before care so that an informed decision can be made.

Increased Patient Engagement

As nurses, we know that a highly engaged patient typically sees better outcomes. When dealing with complex medical issues like cardiovascular disease or diabetes, being well-versed in their symptoms, medications, and any possible side effects can keep patients healthy. App visits can also provide a level of anonymity that may allow some individuals to ask questions that they may not feel comfortable asking during a face-to-face visit.

Understanding the Possible Drawbacks

Just like all medical treatments, there are potential cons to using A.I. and mHealth. Here are a few of the potential dangers of chatbot visits.

Legal Implications for ChatBots

As Dr. Campbell points out, artificial intelligence is an excellent tool for healthcare professionals. However, seeing your physician or nurse practitioner and their office staff will always be the gold-standard for medical diagnoses and treatment. If a doctor does not have the ability to see the patient and do a physical exam, the risk of misdiagnosing the condition is significant.

One question that is concerning for some experts is who would be responsible if an incorrect diagnosis is given to a patient during the chatbot conversation. Chatbots can't be sued, but physicians, nurse practitioners, and other care providers can be held responsible for misdiagnosing a patient's condition.

Physician Burnout

Could healthcare systems start expecting physicians to see patients all day and then go home and be connected to their phones? More doctors are talking about symptoms of burnout they feel from their day jobs. The American Academy of Family Physicians called burnout an epidemic in 2015, with about 46 percent of physicians reporting symptoms of the condition. Burnout can lead to low job satisfaction, anxiety, depression, and lower quality of patient care.

Quick Fixes Aren't Always a Good Thing

Our society likes a good quick fix. You can find a hack for almost anything these days. However, when it comes to your health, choosing the quick fix may not be the best answer. Dr. Campbell worries that patients may chat with the bot, get a few possible diagnoses and then end the visit before ever-texting an actual human. This could lead to poor outcomes and misdiagnosis because the patient didn't take the time to speak with the physician.

The Future of MHealth and A.I.

Healthcare was slow on the uptake of technology. Today, the industry has caught up and is even leading the charge in many areas of technology. So, what do you think about mHealth and chatbots? Would you use this service for yourself, and would you recommend it to your patients? Share your thoughts in the comments below.

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Melissa Mills

About Melissa Mills, BSN

Workforce Development Columnist

Melissa is a nurse with over two decades of experience in leadership and workforce development. She loves to help other healthcare professionals advance their careers.

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Telehealth is going to become more common whether or not people like it. It will be a great convenience for the homebound or people who are far from a health provider. Some important parts of assessment will be missed, like odors and tactile factors such as heat or lumps. Patients may not be able to accurately describe those things that are not apparent through a screen or the phone.  

 As you say, it may lead to misdiagnosis and lawsuits. 

I don't use it because I don't need it. But I would if I were homebound or lived in a rural area. I think it is a great tool to reach more patients in need.

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Specializes in Med-Surg.

I'm intrigued.  I do want my annual physical to be done live and in person where my doctor can see me and listen to me.   If I had something minor, I might consider a chat bot, but I might be a bit too old school and just continue to go to a convenient care clinic.  

I do think it's a growing trend.  There's a doctor here that opened up for business and does only virtual and is licensed in about 40 states so far.  I'm well established with my doctor but if I were younger and in my usual state of good health, I'd consider it.  

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