‘Mind the Gap’: Using Cognitive Agents to Scale Conversations, Not Only Insights, in Healthcare

4 minute read

Cognitive virtual agents, such as Amelia, can enable health systems to scale their capacity to engage patients and other carers in meaningful conversations.

Here is the data, there are the insights…but where are the people?

There are potentially invaluable benefits to health and well-being in the accelerating ability to generate valuable new insights from the wealth of new data and advanced analytics capabilities available today. Industry investment in more data and analytics is clearly there; for example, the 2017 Global Health Care Outlook report from Deloitte cited research that hospital expenditures on analytics are anticipated to reach USD $18.7 billion by 2020, up from USD $5.8 billion in 2015.

These insights can drive changes in the existing practices of consumers and carers in healthcare, as well as drive the design and delivery of new healthcare products and services. However, these insights will not fully translate into outcomes unless we also address their translation into actions by the right people throughout the healthcare and social care ecosystem.

To translate into an outcome, an insight requires an action to be undertaken by an agent, and in healthcare there are significant resource and capability gaps which we need to simultaneously address to capitalize on these new insights.



Gap #1: Patients are people – and they want to engage in conversations about insights

Many Digital Health innovations and investments seem to be aimed at presenting a personalized insight to a patient/consumer, potentially on an app or wearable device, assuming that insight will be sufficient to translate into a change in patient behavior. The focus seems to be on finding the “perfect insight” (drawn from a wealth of Big Data and advanced analytics) which is so compelling and personalized that users will change their behavior along with it – and the belief that the presentation of these insights (and/or a related offer, product or service associated with that insight) will be enough to motivate patient change.

If only it was that easy. The line between a presentation of facts and a human’s response to those facts is hardly a straight and narrow path. We should reflect on the wisdom which led to the Nobel Prize for Economics being awarded this year to Richard Thaler, who exposed the complexity which drives people’s decisions and actions. Researchers in the field of behaviour economics have demonstrated that people cannot be expected to behave as rational automatons, but instead exhibit limited rationality, social preference influences and lack of self-control in their behavior.

The reality we should anticipate is that any new insight, no matter how personalized and relevant, is likely for most people to first trigger more questions, as well as a need for a conversation about its implications and possible actions. Therefore, we need to invest in scaling these conversations at the same pace as we invest in generating the new insights.

Which leads us to the second gap…

Gap #2: Care coordinators are scarce – so we need to augment their ability to engage

Another “insight to outcomes” implied dependency is the availability and willingness of appropriate care professionals to – proactively or reactively – take an action based on the new insights being made available to them or to their patients/health consumers.

Whether it is a care provider organization receiving an insight about a patient’s risk of readmission to hospital, a health insurer receiving a warning about a gap in care, or a patient being warned about a health or well-being risk, the translation of this insight into a positive outcome requires an intervention. This most commonly includes a conversation between a care coordinator and a patient or with other members of the care team across the health ecosystem.

Given the growing shortages in the healthcare workforce, especially in nursing and adult social care, and increasing reports of burnout by these care workers, it is not realistic to assume they have the capacity and capability to act on (or even be aware of or acknowledge) these new insights. In the UK, recent analysis by NHS Improvement has confirmed a shortage of 36,000 nurses; and in the US, a Mayo Clinic survey revealed an increasing burnout trend, now affecting 55% of physicians  In fact, workforce availability and affordability shortages have been one of the main barriers to scalability of proactive population health management models, even based on less sophisticated insights that have been available for decades.

Cognitive Virtual Agents can help scale conversations about insights – if we design them as virtual colleagues who augment the care team

It is clear that merely supplying patients and overwhelmed practitioners with more data, or even insights, will be insufficient to fill the gap between insights and actionable benefits and outcomes, and in some cases may even add to the confusion and cognitive overload. Rather than looking for a perfect “self-standing” digital solution to completely substitute care coordinators, we believe that digital services must be integrated with care delivery conversations. Several digital health innovators, such as Ginger.io, have recognized this and evolved their service models, moving from the initial provision of a “digital-only” service (e.g. via a mobile app) to an integrated healthcare service combining a digital platform and caregivers providing advice.

Cognitive virtual agents, such as Amelia, can enable health systems to deliver such integrated ‘insights-enabled conversations’ models at scale, as these virtual agents can be designed to join and augment the care team, and help scale their capacity and ability to engage patients and other carers in meaningful conversations.

Cognitive virtual agents can contribute as a valued new care team member in three ways:

  1. Acting as a “healthcare operations concierge,” unburdening care workers from their existing routine, administrative and operational interactions – therefore freeing up more time for patient-facing care coordination conversations.


  1. Acting as a “care coordination whisperer,” supporting care workers in planning and delivering their care conversations and interventions, by providing relevant insights and protocol compliant support via a flexible conversational interface – therefore enabling the care worker to scale the number and improve the effectiveness of their conversations with patients in their care.


  1. Acting as a “care navigation buddy,” enabling 24/7 patient access to routine information and service support via a conversational virtual agent – therefore extending patient access and the frequency of patient interactions with their care team, with positive impact on adherence and engagement, whilst freeing up the care team from routine, transactional interactions.

Through human-like conversational cognitive agents like Amelia, patients can feel more connected to their providers and care plans, with assurance that they are being provided with the most up-to-date, relevant and timely guidance, based on the insights available to patients and the care team. Providers, meanwhile, are empowered rather than overwhelmed by new data and insights; their routine tasks are delegated to their virtual agents, freeing carers to focus on what they do best and enjoy doing most.

Virtual agents are therefore uniquely designed to bridge the gap between insight and outcomes and relieve the healthcare workforce from the pressures they are facing.

Previous Next

The Intelligent Contact Center

Companies have spent decades implementing Interactive Voice Response (IVR) systems in their call and customer care centers, but they've proven unable to keep up with customers' expectations.

In this white paper, we examine the benefits of an Intelligent Contact Center, where companies utilize Conversational AI-powered virtual agents to provide first-line resolution and support for customers, and augment human employees through AI and automation.

Download our paper to learn the benefits of this approach and why current IVR systems simply will not cut it in today’s hyper-paced digital landscape.

Learn More