Reviewing current evidence, we identified some of the gaps in current knowledge and possible next steps for the development and use of chatbots for public health provision. We examined the evidence for the development and use of chatbots in public health to assess the current state of the field, the application domains in which chatbot uptake is the most prolific, and the ways in which chatbots are being evaluated. This paper aimed to help address this deficit. In the light of the huge growth in the deployment of chatbots to support public health provision, there is pressing need for research to help guide their strategic development and application. WHO has itself made use of chatbots to provide guidance and combat misinformation about COVID-19 through its Health Alert chatbot that communicates in a number of different languages through WhatsApp, Viber, and Facebook messenger, which has reportedly reached over 12 million people.
Recognizing the need to provide guidance in the field, the World Health Organization (WHO) has recently issued a set of guidelines for the ethics and principles of the use of AI in health.
The use of AI for symptom checking and triage at scale has now become the norm throughout much of the world, signaling a move away from human-centered health care in a remarkably short period of time. In the face of the burden placed upon health care systems by the pandemic, chatbots have enabled the automation of services toward addressing the need for physical distancing and helped disseminate information and relieve the pressure on medical services by public health systems around the globe. The ongoing COVID-19 pandemic has further driven the rapid uptake and deployment of chatbots, many making use of commercial chatbot development platforms such as IBM’s Watson Assistant, Google Dialogflow, Yellow Messenger, and Turn.io to develop custom chatbots to help combat the disease. Chatbots are now found to be in use in business and e-commerce, customer service and support, financial services, law, education, government, and entertainment and increasingly across many aspects of health service provision. Improvements to natural language processing (NLP which includes speech recognition, text-to-speech, speech-to-text, natural language understanding, and natural language generation), as well as the emergence and publicity of commercial “virtual assistants” such as Siri, Google Now, Cortana, and Alexa have brought AI into many aspects of our daily lives. Recent advances in the development and application of chatbot technologies and the rapid uptake of messenger platforms have fueled the explosion in chatbot use and development that has taken place since 2016.
Notable early chatbots include ELIZA (1966 “a mock Rogerian psychotherapist”), PARRY (1972 a chatbot simulating a person with paranoid schizophrenia, developed by a psychiatrist in response to ELIZA), and ALICE (1995 a general conversational chatbot, inspired by ELIZA). Made to mimic natural language conversations to facilitate interaction between humans and computers, they are also referred to as “conversational agents,” “dialog assistants,” or “intelligent virtual assistants,” and they can support speech and text conversation. A salient feature of this rapidly changing technological landscape is the burgeoning development and use of conversational agents, or “chatbots.”Ĭhatbots-software programs designed to interact in human-like conversation-are being applied increasingly to many aspects of our daily lives. Although Pichai has a vested interest in propagating visions of AI-enhanced futures, there is no doubting the extent to which advances in computing technology are driving rapid transformations in the ways in which we interact with computing systems, organizations, one another, and the world. Sundar Pichai, the chief executive officer of Google, expressed in a recent interview his view that artificial intelligence (AI) will have a more profound impact on humanity than the advent of fire, the internet, or electricity.
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