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Megatrends for this decade – XXXIII

Chatbots interface the whole value layers in healthcare from access to data to information and up to knowledge and services as shown in this graphic. Image credit: Kyungyong Chung, Research Gate – Cluster Computing

6. chatbots

Chatbots are seen as the ultimate interface between a person and the healthcare system assuring continuous access, anytime, anywhere, to healthcare consultancy.

There are already a number of chatbots on the market and more will become available. Some will be provided by independent third parties, other by insurance companies, other as a fringe benefit by the company you are working with and others by the official healthcare institutions.

Of all the innovations, novelty, in healthcare Chatbots are likely to become the signature of this decade in terms of their impact on people habits and way to deal with their own health. In a way it will have the same impact the cellular phone had on our way of looking at “communication”. Before the “cellphone” we had to look for a “phone” and when on the move for a “telephone booth”. It required a conscious search that created the awareness of becoming engaged in a “telecommunications”. No more so. Today telecommunications has lost the “tele” in terms of perception, we simply communicate when we want wherever we are. Picking up the smartphone from the pocket, or the purse, is so natural that we no longer give it a second thought. Add to this the fact that we no longer have to diatl a number, most of the time we just pronounce the name of the person we want to talk to, and you realise how seamless communication has become. A third, subtle but not less important aspect to create this seamless flow: we no longer perceive communication as a “cost”. Most people today have some sort of all you can eat, with the consequence that a single call, or access to the internet, is perceived as costless (a telephone booth reminded us every single time that making a call had a cost!).

An implementation of a chatbot (interface) on a smartphone. Using the smartphone as interface has the additional benefit of leveraging on a familiar platform/User Interface. This is reflected by a recent poll showing that 96% of healthcare chatbot (patients) users find the interaction useful. Image credit: Proxet

Now consider the chatbot in healthcare. At any time of the day, doesn’t matter where you are, you can call your chatbot and talk to it (him/her?) telling that your throat feels sore. Ten minutes after that, looking at the menu of a restaurant, you call it again asking if a certain item on the menu would be ok, taking into consideration the pills you are taking…  So here you see the same “continuity” of service that the smartphone is providing. You also see that you are not talking to a chatbot, rather to your chatbot, hence to something that knows you! (like pronouncing the name of a friend to call him only works if you are using your smartphone, because it is your smartphone. Thirdly, your chatbot will come as part of the healthcare service, you are not paying for its consultancy (at least that is the most likely situation in the future).

Today’s chatbots have a limited set of “functionalities” and interact through natural language. In the coming years they will want to look at you and will be asking, sometimes -as needed- to use videoconference. Our face can tell quite a bit to a keen observer and it is most likely that the future chatbots will be using signal processing to check our heart beat, respiratory frequency, blood pressure and more (all of this just by looking at our face with the smartphone camera) and possibly will get further data collected by our smartphone (like our physical activity in the last days, hours and minutes) or by some wearables (smartwatch, fitness bands…).

Like your family doctor, actually better, your chatbot will know more and more about you as time goes by. The more you use it, the more it will be in synch with you. It will be the chatbot that, in case of need, will contact the appropriate doctor, sharing with her the relevant data and will set up an appointment or just provide feedback, depending on the situation.

This will be a profound change in the healthcare world, for us as users, and for all healthcare providers. Doctors will have to learn to interface with people’s chatbots (and some biz models will need to be invented for these types of consultation) as well as to see their patient as a set consisting of a physical and a digital persona (the digital reality we are addressing in the DRI). Insurance companies will be competing on the bases of the kind of chatbot that can provide, and their efficiency will depend on the way the chatbot manages the consultancies with the client (person/patient). A pretty scary scenario arising from this business role of the chatbot in the insurance world is well described in the Robin Cook triller “Cell” (I would advise you to read it). Not necessarily there will be just one chatbot for accessing healthcare services. Actually, I am pretty sure that doctors will start to offer their own chatbot to interface with their clients and they will be able to transfer part of their knowledge (and the specific knowledge related to that client) to the chatbot that will be interacting with him. Interestingly, the transfer of the chatbot acquired knowledge to the doctor will become an important issue, not just in terms of a notebook reporting symptoms, time of the call, prescriptions taken… rather in terms of general knowledge deriving from those interactions (a doctor learns every day by interacting with her patients, with the mediation of a chatbot she would be losing quite a bit!).

Chatbots and Personal Digital Twins will be intertwined, but I do not think they will be one and the same, mostly because of the need to keep separate ownership. The PDT will connect to the chatbot (possibly to several of them, since there will be others outside of the healthcare domain) but it will be owned by its physical twin whilst the chatbot may be owned by an insurance company (as an example). Also, we can expect our PDT to take the initiative to interact with the chatbot, in case it detects some anomaly in our physiology or behaviour and if needed have the chatbot calling us or prompting us to call the chatbot.

In addition to the above all the evolution of genetic based diagnostic and cure (see the CRISPR Megatrend) will characterise healthcare in this and in the following decades.

 It is obvious that progress in genetic understanding will lead to more personalised diagnoses and cure. The challenges that we have today in correlating a given sindrome to a genetic map will be overcome through data analytics and artificial intelligence: the availability of hundred of millions, billions of sequenced genome create a vast pool of data that can support machine learning.

All in all, we can expect this Megatrend to lead to a new and better healthcare supporting the change in paradigm emphasising proactive and personalised support, aiming at keeping healthy rather than stepping in once people have become sick.

About Roberto Saracco

Roberto Saracco fell in love with technology and its implications long time ago. His background is in math and computer science. Until April 2017 he led the EIT Digital Italian Node and then was head of the Industrial Doctoral School of EIT Digital up to September 2018. Previously, up to December 2011 he was the Director of the Telecom Italia Future Centre in Venice, looking at the interplay of technology evolution, economics and society. At the turn of the century he led a World Bank-Infodev project to stimulate entrepreneurship in Latin America. He is a senior member of IEEE where he leads the Industry Advisory Board within the Future Directions Committee and co-chairs the Digital Reality Initiative. He teaches a Master course on Technology Forecasting and Market impact at the University of Trento. He has published over 100 papers in journals and magazines and 14 books.