A novel engagement of suicidality in the emergency department: Virtual Collaborative Assessment and Management of Suicidality
Abstract
Objective A novel avatar system (Virtual Collaborative Assessment and Management of Suicidality System; V-CAMS) for suicidal patients and medical personnel in emergency departments (EDs) was developed and evaluated. V-CAMS facilitates the delivery of CAMS and other evidence-based interventions to reduce unnecessary hospitalization, readmissions, and suicide following an ED visit.Method Using iterative user-centered design with 24 suicidal patients, an avatar prototype, "Dr. Dave" (based on Dr. Jobes) was created, along with other patient-facing tools; provider-facing tools, including a clinical decision support tool were also designed and tested to aid discharge disposition.Results Feasibility tests supported proof of concept. Suicidal patients affirmed the system's overall merit, positive Perception of Care, and acceptability; medical providers (n = 21) viewed the system as an efficient, effective, and safe method of improving care for suicidal ED patients and reducing unnecessary hospitalization.Conclusions Technology tools including a patient-facing avatar and e-caring contacts, along with provider-facing tools may offer a powerful method of facilitating best-practice suicide prevention interventions and point-of-care tools for suicidal patients seeking ED services and their medical providers. Future directions include full development of V-CAMS and integration into a health electronic medical record and a rigorous randomized controlled trial to study its effectiveness.
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Users in 2 studies suggested that better integration of the agent with electronic health record systems or health care providers would be useful.
“Additionally, users in 2 studies suggested that better integration of the agent with electronic health record (EHR) systems (for a virtual doctor [42]) or health care providers (for an asthma self-management chatbot [48]) would be useful.”
From The Effectiveness of Artificial Intelligence Conversational Agents in Health Care: Systematic Review (2020) · cites this paper as [42]
Users in 4 studies reported liking that the agent had a personality and/or showed empathy, whereas users in other studies reported disliking the lack of personal connection or had difficulty empathizing with the agent or reported disliking its limited conversation and responses.
“Similarly, users in 4 studies reported liking that the agent had a personality and/or showed empathy [13,32,34,42], whereas users in other studies reported disliking the lack of personal connection or had difficulty in empathizing with the agent [35,37,50] or reported disliking its limited conversation and responses [35,56].”
From The Effectiveness of Artificial Intelligence Conversational Agents in Health Care: Systematic Review (2020) · cites this paper as [42]
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The Effectiveness of Artificial Intelligence Conversational Agents in Health Care: Systematic Review
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- Authors
- Dimeff, L. A., Jobes, D. A., Chalker, S. A., Piehl, B. M., Duvivier, L. L., Lok, B. C., Zalake, M. S., Chung, J., & Koerner, K.
- Affiliations
- Catholic University of America (US)
- Central Arkansas Veterans Healthcare System (US)
- University of Florida (US)
- Corresponding author
- Dimeff, Linda A.
- ORCID
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 63
- Pages
- 119-126
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W2804380175
- Cited by
- 49
- References
- 64
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 8 · 2023: 11 · 2022: 3 · 2021: 11 · 2020: 5 · 2019: 2
- FWCI
- 5.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (1 R43 MH108222-01A1)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- suicidality, emergency department, avatars, suicide prevention, Collaborative Assessment and Management of Suicidality, clinical decision support, discharge disposition, unnecessary hospitalization, hospital readmission, point-of-care devices, user-centered design, acceptability, perceptions of care
- MeSH terms
- Proof of Concept Study, Suicide Prevention, Adolescent, Adult, Attitude of Health Personnel, Decision Support Techniques, Emergency Service, Hospital, Feasibility Studies, Female, Humans, Inpatients, Male, Medical Informatics Applications, Middle Aged, Outpatients, Patient Acceptance of Health Care, User-Computer Interface, Process Assessment, Health Care, Point-of-Care Systems, Young Adult
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