scholarly journals Conversational Agents in Health Care: Scoping Review and Conceptual Analysis

10.2196/17158 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e17158 ◽  
Author(s):  
Lorainne Tudor Car ◽  
Dhakshenya Ardhithy Dhinagaran ◽  
Bhone Myint Kyaw ◽  
Tobias Kowatsch ◽  
Shafiq Joty ◽  
...  
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Literature Search ◽  
Care Service ◽  
Health Care Service ◽  
Improve Patient Care ◽  
Future Research ◽  
Free Text ◽  
Conversational Agents ◽  
Service Support

Background Conversational agents, also known as chatbots, are computer programs designed to simulate human text or verbal conversations. They are increasingly used in a range of fields, including health care. By enabling better accessibility, personalization, and efficiency, conversational agents have the potential to improve patient care. Objective This study aimed to review the current applications, gaps, and challenges in the literature on conversational agents in health care and provide recommendations for their future research, design, and application. Methods We performed a scoping review. A broad literature search was performed in MEDLINE (Medical Literature Analysis and Retrieval System Online; Ovid), EMBASE (Excerpta Medica database; Ovid), PubMed, Scopus, and Cochrane Central with the search terms “conversational agents,” “conversational AI,” “chatbots,” and associated synonyms. We also searched the gray literature using sources such as the OCLC (Online Computer Library Center) WorldCat database and ResearchGate in April 2019. Reference lists of relevant articles were checked for further articles. Screening and data extraction were performed in parallel by 2 reviewers. The included evidence was analyzed narratively by employing the principles of thematic analysis. Results The literature search yielded 47 study reports (45 articles and 2 ongoing clinical trials) that matched the inclusion criteria. The identified conversational agents were largely delivered via smartphone apps (n=23) and used free text only as the main input (n=19) and output (n=30) modality. Case studies describing chatbot development (n=18) were the most prevalent, and only 11 randomized controlled trials were identified. The 3 most commonly reported conversational agent applications in the literature were treatment and monitoring, health care service support, and patient education. Conclusions The literature on conversational agents in health care is largely descriptive and aimed at treatment and monitoring and health service support. It mostly reports on text-based, artificial intelligence–driven, and smartphone app–delivered conversational agents. There is an urgent need for a robust evaluation of diverse health care conversational agents’ formats, focusing on their acceptability, safety, and effectiveness.

scholarly journals Conversational Agents in Health Care: Scoping Review and Conceptual Analysis (Preprint)

2019 ◽  
Author(s):  
Lorainne Tudor Car ◽  
Dhakshenya Ardhithy Dhinagaran ◽  
Bhone Myint Kyaw ◽  
Tobias Kowatsch ◽  
Shafiq Joty ◽  
...  
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Literature Search ◽  
Care Service ◽  
Health Care Service ◽  
Improve Patient Care ◽  
Future Research ◽  
Free Text ◽  
Conversational Agents ◽  
Service Support

BACKGROUND Conversational agents, also known as chatbots, are computer programs designed to simulate human text or verbal conversations. They are increasingly used in a range of fields, including health care. By enabling better accessibility, personalization, and efficiency, conversational agents have the potential to improve patient care. OBJECTIVE This study aimed to review the current applications, gaps, and challenges in the literature on conversational agents in health care and provide recommendations for their future research, design, and application. METHODS We performed a scoping review. A broad literature search was performed in MEDLINE (Medical Literature Analysis and Retrieval System Online; Ovid), EMBASE (Excerpta Medica database; Ovid), PubMed, Scopus, and Cochrane Central with the search terms “conversational agents,” “conversational AI,” “chatbots,” and associated synonyms. We also searched the gray literature using sources such as the OCLC (Online Computer Library Center) WorldCat database and ResearchGate in April 2019. Reference lists of relevant articles were checked for further articles. Screening and data extraction were performed in parallel by 2 reviewers. The included evidence was analyzed narratively by employing the principles of thematic analysis. RESULTS The literature search yielded 47 study reports (45 articles and 2 ongoing clinical trials) that matched the inclusion criteria. The identified conversational agents were largely delivered via smartphone apps (n=23) and used free text only as the main input (n=19) and output (n=30) modality. Case studies describing chatbot development (n=18) were the most prevalent, and only 11 randomized controlled trials were identified. The 3 most commonly reported conversational agent applications in the literature were treatment and monitoring, health care service support, and patient education. CONCLUSIONS The literature on conversational agents in health care is largely descriptive and aimed at treatment and monitoring and health service support. It mostly reports on text-based, artificial intelligence–driven, and smartphone app–delivered conversational agents. There is an urgent need for a robust evaluation of diverse health care conversational agents’ formats, focusing on their acceptability, safety, and effectiveness.

scholarly journals An evaluation of factors affecting the management of COVID-19 in Bangladesh

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Syed S.M Sadrul Huda ◽  
Afsana Akhtar ◽  
Segufta Dilshad ◽  
Syeeda Raisa Maliha
Keyword(s):  
Health Care ◽  
Care Management ◽  
Service Providers ◽  
Care Service ◽  
Health Care Service ◽  
Health Care Management ◽  
Lessons Learned ◽  
Future Research ◽  
Content Type ◽  
The Social

PurposeThe study aims to gain insights into the management of COVID-19 in Bangladesh to identify the factors that are relevant to managing the pandemic in a developing country.Design/methodology/approachThe study was carried out by pursuing the archival method. The information was collected from credible newspaper reports over the previous months, as well as articles published on the subject of COVID-19.FindingsThe research revealed important and relevant dimensions of the health sector in managing the COVID-19 pandemic. The major factors were doctors, nurses (health service providers), patients, (customers) and society. This is a pioneering paper, which documents the major lessons learned from the management of COVID-19 in Bangladesh concerning three stakeholders of the health-care system, i.e. providers, patients and society. This paper covers the situation regarding the ongoing pandemic from three perspectives – provider, customers and society, and thus, may help to develop future research regarding the development of health-care management models for addressing the pandemic.Research limitations/implicationsThe major limitations of this paper is its over dependence on secondary sources for collecting the information.Practical implicationsThis paper presents the learnings from the pandemic in health-care management in different categories (e.g. social, doctor/nurse, patients), which can help the managers in understanding different dimensions of the health-care sector from different perspectives. The problems as well as the learnings stated in the paper can help the policy makers implement such strategies to ensure better delivery of the medical health-care service during a pandemic.Social implicationsThis paper clearly reveals the social dimensions of the COVID-19 by assessing the social aspects of COVID-19 management. Both social stigma and support are traced out during evaluating the situation. Thus, the social forces will be able to rethink about their role in addressing the social costs of pandemic.Originality/valueThis is a commentary piece.

Evaluation of a Care Coordination/Home-Telehealth Program for Veterans with Diabetes

2005 ◽  
Vol 28 (4) ◽  
pp. 464-478 ◽  
Author(s):  
Neale R. Chumbler ◽  
Britta Neugaard ◽  
Rita Kobb ◽  
Patricia Ryan ◽  
Haijing Qin ◽  
...  
Keyword(s):  
Health Care ◽  
Care Coordination ◽  
Care Service ◽  
Controlled Trial ◽  
Health Care Service ◽  
Bodily Pain ◽  
Future Research ◽  
Veterans Health ◽  
Health Administration ◽  
Regression To The Mean

We evaluated a Veterans Health Administration (VHA) care coordination/ hometelehealth (CC/HT) programon the utilization of health care services and health-related quality of life (HRQL) in veterans with diabetes. Administrative records of 445 veterans with diabetes were reviewed to compare health care service utilization in the 1-year period before and 1-year period postenrollment and also examined self-reported HRQL at enrollment and 1 year later. Multivariate analyses indicated a statistically significant reduction in the proportion of patients who were hospitalized (50% reduction), emergency room use (11% reduction), reduction in the average number of bed days of care (decreased an average of 3.0 days), and improvement in the HRQL role-physical functioning, bodily pain, and social functioning. The results need to be interpreted with caution because we used a single-group study design that may be influenced by regression to the mean. Ideally, future research should use a randomized controlled trial design.

The relationship between perceived dissimilarity and feedback avoidance behaviour

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Meng Song ◽  
Kubilay Gok ◽  
Sherry Moss ◽  
Nancy Borkowski
Keyword(s):  
Health Care ◽  
Service Sector ◽  
Care Service ◽  
Health Care Service ◽  
Avoidance Behaviour ◽  
Future Research ◽  
Interpersonal Processes ◽  
Conflict Task ◽  
Content Type ◽  
Study Results

Purpose The purpose of this study is to understand the conditions in which subordinates, after making a mistake, are more likely to engage in feedback avoidance behaviour (FAB), a set of behaviours that could ultimately jeopardise patient safety in a health care context. Design/methodology/approach This study used a sample of 183 independent leader-subordinate dyads in the health care service sector. For this study, a multiple mediator model in which three types of conflict (task conflict, relationship conflict and process conflict) were tested and acted as mediating mechanisms that transmitted the effects of perceived dissimilarity to FAB. Findings The results supported the mediating role of two of the three forms of conflict and highlighted the consequences of dissimilarity between supervisors and subordinates in the healthcare setting. Research limitations/implications One of the noteworthy limitations of this study was that this study used cross-sectional time-lagged data. Future research should use a more rigorous longitudinal approach such as a cross-lagged design (Whitman et al., 2012) to explore the dynamic nature of dyadic relationships over time. Practical implications An important implication of our study results suggests that health care leadership development training should provide opportunities to increase awareness of the tendency of leaders to treat subordinates perceived as dissimilar more negatively. Originality/value These results contribute to our understanding of the interpersonal processes between subordinates and their supervisors, which could have a significant impact on organisational outcomes in the health care setting.

Self- and Other-Dehumanization Processes in Health-Related Contexts: A Critical Review of the Literature

2019 ◽  
Vol 23 (4) ◽  
pp. 475-495 ◽  
Author(s):  
Eva Diniz ◽  
Sónia F. Bernardes ◽  
Paula Castro
Keyword(s):  
Health Care ◽  
Critical Review ◽  
Person Perception ◽  
Meaning Making ◽  
Care Service ◽  
Health Care Service ◽  
Service Research ◽  
Future Research ◽  
Self And Other ◽  
Health Related

Dehumanization is an everyday, pervasive phenomenon in health contexts. Given its detrimental consequences to health care, much research has been dedicated to understanding and promoting the humanization of health services. However, health care service research has neglected the sociopsychological processes involved in the dehumanization of self and others, in formal but also informal health-related contexts. Drawing upon sociopsychological models of dehumanization, this article will bridge this gap by presenting a critical review of studies on everyday meaning-making and person perception processes of dehumanization in health-related contexts. A database search was conducted in PsycINFO, Web of Science, Scopus, and PubMed, using a combination of keywords on dehumanization and health/illness/body; 3,229 references were screened; 95 full texts were assessed for eligibility; 59 studies were included. Most studies focused on informal contexts, reflecting a decontextualized and one-sided view of dehumanization (i.e., not integrating actors’ and victims’ perspectives). Despite the dominant focus on self-dehumanization, emerging perspectives uncover the role of processes that deny human uniqueness to others, and their individual determinants and consequences for mental health. A few studies bring to light the functions of a variety of dehumanizing body metaphors on self- and other-dehumanization. These trends in the literature leave several gaps, which are here critically analyzed to inform future research.

scholarly journals Perceptions and Needs of Artificial Intelligence in Health Care to Increase Adoption: Scoping Review (Preprint)

2021 ◽  
Author(s):  
Han Shi Jocelyn Chew ◽  
Palakorn Achananuparp
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Service Delivery ◽  
Scoping Review ◽  
Data Privacy ◽  
Care Service ◽  
Health Care Service ◽  
Mitigation Strategies ◽  
User Experience Design ◽  
Health Care Service Delivery

BACKGROUND Artificial intelligence (AI) has the potential to improve the efficiency and effectiveness of health care service delivery. However, the perceptions and needs of such systems remain elusive, hindering efforts to promote AI adoption in health care. OBJECTIVE This study aims to provide an overview of the perceptions and needs of AI to increase its adoption in health care. METHODS A systematic scoping review was conducted according to the 5-stage framework by Arksey and O’Malley. Articles that described the perceptions and needs of AI in health care were searched across nine databases: ACM Library, CINAHL, Cochrane Central, Embase, IEEE Xplore, PsycINFO, PubMed, Scopus, and Web of Science for studies that were published from inception until June 21, 2021. Articles that were not specific to AI, not research studies, and not written in English were omitted. RESULTS Of the 3666 articles retrieved, 26 (0.71%) were eligible and included in this review. The mean age of the participants ranged from 30 to 72.6 years, the proportion of men ranged from 0% to 73.4%, and the sample sizes for primary studies ranged from 11 to 2780. The perceptions and needs of various populations in the use of AI were identified for general, primary, and community health care; chronic diseases self-management and self-diagnosis; mental health; and diagnostic procedures. The use of AI was perceived to be positive because of its availability, ease of use, and potential to improve efficiency and reduce the cost of health care service delivery. However, concerns were raised regarding the lack of trust in data privacy, patient safety, technological maturity, and the possibility of full automation. Suggestions for improving the adoption of AI in health care were highlighted: enhancing personalization and customizability; enhancing empathy and personification of AI-enabled chatbots and avatars; enhancing user experience, design, and interconnectedness with other devices; and educating the public on AI capabilities. Several corresponding mitigation strategies were also identified in this study. CONCLUSIONS The perceptions and needs of AI in its use in health care are crucial in improving its adoption by various stakeholders. Future studies and implementations should consider the points highlighted in this study to enhance the acceptability and adoption of AI in health care. This would facilitate an increase in the effectiveness and efficiency of health care service delivery to improve patient outcomes and satisfaction.

scholarly journals Perceptions and Needs of Artificial Intelligence in Health Care to Increase Adoption: Scoping Review

10.2196/32939 ◽  
2022 ◽  
Vol 24 (1) ◽  
pp. e32939
Author(s):  
Han Shi Jocelyn Chew ◽  
Palakorn Achananuparp
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Service Delivery ◽  
Scoping Review ◽  
Data Privacy ◽  
Care Service ◽  
Health Care Service ◽  
Mitigation Strategies ◽  
User Experience Design ◽  
Health Care Service Delivery

Background Artificial intelligence (AI) has the potential to improve the efficiency and effectiveness of health care service delivery. However, the perceptions and needs of such systems remain elusive, hindering efforts to promote AI adoption in health care. Objective This study aims to provide an overview of the perceptions and needs of AI to increase its adoption in health care. Methods A systematic scoping review was conducted according to the 5-stage framework by Arksey and O’Malley. Articles that described the perceptions and needs of AI in health care were searched across nine databases: ACM Library, CINAHL, Cochrane Central, Embase, IEEE Xplore, PsycINFO, PubMed, Scopus, and Web of Science for studies that were published from inception until June 21, 2021. Articles that were not specific to AI, not research studies, and not written in English were omitted. Results Of the 3666 articles retrieved, 26 (0.71%) were eligible and included in this review. The mean age of the participants ranged from 30 to 72.6 years, the proportion of men ranged from 0% to 73.4%, and the sample sizes for primary studies ranged from 11 to 2780. The perceptions and needs of various populations in the use of AI were identified for general, primary, and community health care; chronic diseases self-management and self-diagnosis; mental health; and diagnostic procedures. The use of AI was perceived to be positive because of its availability, ease of use, and potential to improve efficiency and reduce the cost of health care service delivery. However, concerns were raised regarding the lack of trust in data privacy, patient safety, technological maturity, and the possibility of full automation. Suggestions for improving the adoption of AI in health care were highlighted: enhancing personalization and customizability; enhancing empathy and personification of AI-enabled chatbots and avatars; enhancing user experience, design, and interconnectedness with other devices; and educating the public on AI capabilities. Several corresponding mitigation strategies were also identified in this study. Conclusions The perceptions and needs of AI in its use in health care are crucial in improving its adoption by various stakeholders. Future studies and implementations should consider the points highlighted in this study to enhance the acceptability and adoption of AI in health care. This would facilitate an increase in the effectiveness and efficiency of health care service delivery to improve patient outcomes and satisfaction.

Status of Compassinate, Respectful and Caring Health Service Delivery: A Scoping Review of Human Factors in Care Delivery (Preprint)

2021 ◽  
Author(s):  
Adane Weldeab ◽  
Binyam Tilahun ◽  
Berhanu Fikadie ◽  
Dessie Abebaw ◽  
Alemayehu Teklu ◽  
...  
Keyword(s):  
Health Care ◽  
Service Delivery ◽  
Health Care Delivery ◽  
Scoping Review ◽  
Care Delivery ◽  
Care Service ◽  
Health Care Service ◽  
Health Service Delivery ◽  
The Status ◽  
Service Training

BACKGROUND As countries are trying to achieve Universal Health Coverage (UHC), quality delivery of health services is crucial. Compassionate, Respectful and Caring health professional (CRC) is an initiative on the need to provide quality services of care to clients and patients. However, there is an evidence gap on the status of compassionate, respectful and caring health care service delivery. OBJECTIVE This scoping review aimed to map global evidences on the status of compassionate, respectful and caring health service delivery practice METHODS An exhaustive literature review and Delphi technique was used to find out the research questions. The studies were searched using electronic databases like MEDLINE (PubMed), Cochrane library, Web of Science, Hinari and WHO library. Additionally, grey literature like Google, Google scholar and World Wide Science were scrutinized. Studies that applied any study design, data collection and analysis methods related to Caring, Respectful and Compassionate care were included. Two authors extracted the data and compared the results. Discrepancies were resolved by discussion or the third reviewer made the decision. The study findings from the existing literature were presented using thematic analysis. RESULTS A total of 1,193 potentially relevant studies were generated from the initial search and 20 studies were included in the final review. From this review, we have identified five thematic areas named as; the status of CRC implementation, facilitators for CRC health care service delivery, barriers in CRC health care delivery, Disrespectful and abusive care encountered by patients; and Perspectives on CRC. The findings of this review indicated that improving the monitoring mechanism of the health facility, improving accountability and aware of the consequences of maltreatment within facilities were critical steps to improve the health care delivery practices. CONCLUSIONS This scoping review identified that as there were low practices of compassionate, respectful and caring (CRC) service provision. Lack of training, the volume of patient flow and bed shortage were founded the main contributors of CRC health care delivery. Therefore, the health care system shall to consider the components of CRC in health care delivery through in-service training, pre-service training, monitoring and evaluation, community engagement, workload division and performance appraisal.

scholarly journals A 360-Degree Examination of the Placement Fit of Medical Clowns

2020 ◽  
Author(s):  
Dorit Efrat-Treister ◽  
Daniel Altman ◽  
Enav Friedmann ◽  
Dalit Lev-Arai Margalit ◽  
Kinneret Teodorescu
Keyword(s):  
Health Care ◽  
Child Health ◽  
Medical Staff ◽  
Consumer Satisfaction ◽  
Care Service ◽  
Health Care Service ◽  
Point Of View ◽  
Optimal Placement ◽  
Future Research ◽  
Health Consumers

Abstract Background – Most existing research on medical clowns in health care service has investigated their usefulness among child health consumers. In a 360-degree research stream, we aim to identify the optimal audience (adults or children health consumers), for which medical clowns are most useful in enhancing health consumers’ satisfaction and, in turn, reducing their aggressive tendencies.Methods – We conducted three studies, which examined the placement fit of medical clowns from a different point of view: medical staff (Study 1a, n = 88), medical clowns (Study 1b, n = 20), and health consumers (Study 2, n = 397).Results – Studies 1a and 1b demonstrate that both medical staff and clowns believe that child health consumers profit most from the clowns. In Study 2, data from health consumers in seven different hospital wards showed that clowns are useful in mitigating the effect of negative affectivity on satisfaction, thereby reducing aggressive tendencies among children. Surprisingly, the effect of medical clowns on adults is not only weaker, but reversed, such that interactions with medical clowns decrease adults’ satisfaction and increase their aggressive tendencies.Discussion - The medical clowns are most useful in elevating satisfaction and reducing aggressive tendencies of children. However, older adults show lower satisfaction and higher aggressive tendencies following the performance of the medical clown. The main limitation of the study is investigating aggressive tendencies rather than actual aggression. Future research should examine actual aggression.Conclusion – Medical clowns should be placed in children’s wards. This conclusion can guide health care service policy makers by indicating the optimal placement of clowns, thereby benefitting most from the clowns’ efforts, elevating health consumer satisfaction, and reducing aggressive tendencies.Trial registration – article doesn’t report a health care intervention on human participants.

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