Fifth in a Series: The Future Is Here Today
Behavioral models work because they are based on patients interacting with a healthcare professional to obtain knowledge, improve motivation, provide the proper recognition of and treatment of adverse events, deal with financial hardship, improve attitude, promote a reasonable expectation, and deal with cognitive impairment—basically, solve the root causes of non-adherence.
But, these approaches are very time-consuming and require a myriad of interactions beyond the reach of all of the technologies mentioned in the last article
But, another technology is now available that can provide a human-to-human level of involvement at a small fraction of the cost to both the healthcare delivery system and patient. This technology has been called a number of things including Healthcare Guide, Intelligent Digital Assistant, Intelligent Digital Avatar, Avatar, Virtual Health Assistant, Virtual Health Coach, and even relational agents. This article will describe general characteristics and abilities and will be followed by highlights of 4 of the leading companies who are creating this technology.
For the purposes of this article I will use the term Virtual Health Assistant (VHA). This technology, enabled by the cloud, is the culmination of the rapid advancements and adoption of smart phone technology, the ability to process “natural language” along with advanced artificial intelligence.
By blending these 3 technologies, a VHA can understand normal every day language and respond in a conversational manner. With the ablity to converse, the VHA can provide not only scripted education but also answers to complex questions. In fact in at least one existing application, a VHA has been made capable of understanding and answering 10,000 or more specific questions.
A VHA can also ask questions and pinpoint exactly why a person is not following the best medical evidence in caring for his or her specific condition. It can also, in a non-judgmental fashion, “discuss” sensitive topics such as money, sex, and socially stigmatized behavior. It can easily inquire about whether a drug is causing “performance” difficulties for a man, or ask an HIV patient about unprotected sexual activity with a sero-negative partner and discuss these issues.
A VHA can ask about and educate people about adverse drug events. Some VHAs can integrate with wearables, sleep monitors, glucometers, scales, and virtually any device using an API and in some applications display the data in a “dashboard” manner. A VHA can also literally “discuss” the findings in a motivational interviewing approach help people make sense of their condition, help with resistance, ambivalence and help move people along the Transtheoritical “Readiness to Change” model. A VHA can also do everything an app can do and if desired actually use apps as just another data source. Some VHAs can integrate with enterprise wide systems and electronic health records to augment the resource-intense activities that most integrated systems and others such as retail pharmacies currently offer.
The use of technology to improve health is in its teenage years. But, the use of intelligent engagement is just starting. Think about the revolutionary ways your organization can utilize a virtual health assistant. Instead of just reminding people to take their medication or refill their prescription, what if you could actually help them with their nutrition and exercise well as? What if you could help motivate them with teams, contests, tracking and goals? What if you could gain intimate insight into their daily lives? And most importantly, what if you could delay or eliminate the consequences of progressive diseases by helping people stay at goal?
The problems are immense, and the solution is not throwing more people at our population. The solution is to have a personal person-centric VHA available to each and every one of your clients.
The next 2 articles in this series will highlight several of the companies specializing in this innovative approach to adherence. (Note, all 6 companies were invited to submit information for this series but 2, due to other commitments declined to do so.)