Newsbytes

Chatbot market revving up: COVID-19 a driving force

June 2020—The global market for health care chatbots has been growing at a fairly rapid pace in recent years, but “COVID-19 is the thing that’s going to make chatbots mainstream,” says Greg Kefer, chief marketing officer at the chatbot company LifeLink Health.

A 2019 Allied Market Research report, released just months prior to the COVID-19 pandemic, projected the health care chatbot industry would reach $345.3 million by 2026, a steep rise from 2018, when it garnered $116.9 million (www.allied​market​research.​com/healthcare-chatbots-market). But now, the COVID-19 pandemic has put into sharp relief one of the key value propositions of chatbots—unlimited scale, which means the timeline for adoption “just got massively compressed,” says Kefer, whose software-as-a-service company develops enterprise-level chatbots for large health care organizations.

Among the institutions that have adopted LifeLink’s health care chatbots on a large scale is Arizona-based Banner Health, which implemented the company’s software across the 28 emergency departments in its system to improve the check-in procedure and convey information related to the status of lab results and other types of testing. Organizations like Banner, says Kefer, are pioneers because they have “a more aggressive risk-taking strategy when it comes to innovation and are willing to work with companies to try things. They’re willing to fail, and when they succeed, they start talking about it in public forums. Then, gradually, the rest of the industry begins to follow their lead.”

It’s this can-do attitude that led Banner to install in its emergency departments a bot from LifeLink that acts as a virtual concierge, answering questions that range from “Where’s the bathroom?” to “When can I expect my test results?” To get the conversation started, says Kefer, visitors to the ED are prompted with an SMS message upon check-in that includes a link inviting them to chat with the bot. The conversation looks and behaves like a regular cell phone text message, “but it’s in Web browsers, such as Safari, and that’s because it’s a HIPAA-compliant platform, whereas SMS isn’t,” he adds.

It’s because the bot is integrated into Banner’s Cerner EHR that it can present patients with information about lab testing, imaging, and other procedures that are ordered during their stay in the emergency department. “The chatbot will remind patients what labs have been ordered and present a series of ETAs that project when they will be done,” Kefer explains. In other words, it gives patients an estimate of when their emergency department visit will be complete.

LifeLink is able to do this using algorithms that analyze “a number of different data sources from Cerner—which labs, how many, historical processing time, and the condition of the specific patient,” Kefer says. The information typically is delivered to patients as a graphic that shows the percentage of labs completed. “The technology is configurable,” he continues, “so providers have the option of using exact time estimates, but most prefer the percentage so there’s some wiggle room if something unexpected happens.”

LifeLink’s chatbot technology is also being used to conduct clinical trials at scale, Kefer says. The company provided a digital platform for the BRCA Founder Outreach Study, which connected high-risk individuals with genetic testing for the BRCA mutation. The bot screened potential participants and sent participants’ orders for genetic testing directly to Quest Diagnostics through a backend lab information system integration, he explains. “The whole aspect of [managing] the clinical trial participant was done by the bot.”

With regard to more widespread use, LifeLink is talking to some “very large” lab companies about how to increase the percentage of patients who adhere to their physician’s request to get a blood draw for their physical. “There’s a chatbot dimension there to make sure people do all the right things,” says Kefer. “So if you ask patients, for example, to fast before you draw their blood, the bot can remind them that at 8 PM [the night before], they need to stop eating. That kind of thing is perfect for this kind of technology.”

But despite some outward similarities, Kefer is quick to note the differences between LifeLink’s chatbot technology and a digital assistant like Siri or Alexa: “Our bot is not a natural language processing bot,” he says. In other words, patients can’t ask the bot open-ended queries. Rather, the bot’s conversations with users flow based on dynamically generated decision trees that have been designed for different workflows. Kefer cites an appointment request bot, which LifeLink developed for Philadelphia-based Jefferson Health, as an example. “The next company that wants an appointment bot can use the same pattern,” he explains. “The general flow of that conversation has been designed and optimized to deliver the desired outcome—a scheduled appointment. But it’s also scalable.” This allows health care institutions to potentially go live with the company’s bots “in a matter of weeks,” he adds.

While chatbots are being deployed throughout various areas of health care systems, the symptoms check segment of the health care chatbot industry holds the largest share of the global market, as compared to medical and drug information assistance, appointment scheduling and monitoring, and other applications, according to the Allied Market Research study. A company catering to this market segment is Buoy Health, a SaaS vendor that markets the Buoy Assistant comprehensive symptom checker and patient-facing care triage tool.

The company developed Buoy Assistant, says Eliza Wilson, director of product, by creating what she calls a “map of medicine,” or a catalog of diagnoses and associated symptoms. The map, a Bayesian network, drives the chat experience. Each time an end user provides information about their symptoms, the network uses that information to re-evaluate the question it will ask next, with the intent of ruling out the largest number of potential explanations for the symptoms the user is experiencing, Wilson explains. The bot pulls from a pool of approximately 30,000 questions.

The company, too, is developing technology that allows users to ask the bot open-ended queries. “We’re starting to create more flexible conversation paths, including starting with an open-ended ‘tell us what brings you here today,’ and letting people describe, in their own words, exactly what they’re worried about,” Wilson says.

Like LifeLink, Buoy Health is a vendor of choice at Banner Health. While LifeLink assists patients in the emergency department, “Buoy helps Banner patients decide if they need to seek care in the first place—and what type of care,” Wilson says. People can access Buoy Assistant from Banner’s website to check their symptoms before visiting the hospital.

By February, the company had added COVID-related symptom diagnosis functionality to Buoy Assistant based on CDC guidelines, making the vendor one of the first among a burgeoning number of health care chatbot companies to respond to the COVID-19 pandemic. “When coronavirus started appearing in the U.S., we were able to identify spikes in coronavirus-like symptoms in 17 states before they had been detected by public health agencies,” Wilson says.