Virtual Agents as a Service: Applications in Healthcare
Abstract
Virtual agents can engage users on a social-emotional level and have great potential in improving population health, so it would be advantageous if one could create and distribute them without requiring advanced technical skills. We present a flexible commercial platform for scripting conversational interactions with virtual agents that can be easily published through a mobile app available to everyone. Trials of two different agents that have been jointly developed with healthcare partners, one in mental health and another in heart failure, demonstrate post-intervention improvements in psychological distress and health knowledge, respectively. Encouraging rates of engagement with the agent have also been observed, although with a notable decline over time for the mental health coach -- additional trials are scheduled to explore how to retain engagement more effectively.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In another study [36], distress significantly decreased from pre-intervention 33.27 to post-intervention 28.90 (P<.001).
“Likewise, the other study found a statistically significant decrease (P<.001) in distress from a pre-intervention score of 33.27 to a post-intervention score of 28.90 [36].”
From Effectiveness and safety of using chatbots to improve mental health: systematic review and meta-analysis (2020) · cites this paper as [36]
Cites
Screening for serious mental illness in the general population
Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., Howes, M. J., Normand, S.-L. T., Manderscheid, R. W., Walters, E. E., et al. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.2.184 · Cited by 5,692 · see citing works
Green, C. P., Porter, C. B., Bresnahan, D. R., & Spertus, J. A. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)00531-3 · Cited by 1,827 · see citing works
It's only a computer: virtual humans increase willingness to disclose
Lucas, G. M., Gratch, J., King, A., & Morency, L.-P. (2014) · Computers in Human Behavior · doi:10.1016/j.chb.2014.04.043 · Cited by 977 · see citing works
Relational agents: a model and implementation of building user trust
Bickmore, T., & Cassell, J. (2001) · Proceedings of the SIGCHI Conference on Human Factors in Computing Systems · doi:10.1145/365024.365304 · Cited by 479 · see citing works
A randomized controlled trial of an automated exercise coach for older adults
Bickmore, T. W., Silliman, R. A., Nelson, K., Cheng, D. M., Winter, M., Henault, L., & Paasche‐Orlow, M. K. (2013) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12449 · Cited by 305 · cited 1× · see citing works
“IVAs have been shown to improve exercise [16], depression and other malaise [15], including anxiety [14].”
BackgroundTaking the time to care: empowering low health literacy hospital patients with virtual nurse agents
Bickmore, T. W., Pfeifer, L. M., & Jack, B. W. (2009) · Proceedings of the SIGCHI Conference on Human Factors in Computing Systems · doi:10.1145/1518701.1518891 · Cited by 289 · see citing works
MAINTAINING ENGAGEMENT IN LONG-TERM INTERVENTIONS WITH RELATIONAL AGENTS
Bickmore, T., Schulman, D., & Yin, L. (2010) · Applied Artificial Intelligence · doi:10.1080/08839514.2010.492259 · Cited by 246 · see citing works
Development and Testing of the Dutch Heart Failure Knowledge Scale
van der Wal, M. H. L., Jaarsma, T., Moser, D. K., & van Veldhuisen, D. J. (2005) · European Journal of Cardiovascular Nursing · doi:10.1016/j.ejcnurse.2005.07.003 · Cited by 214 · see citing works
Context awareness in a handheld exercise agent
Bickmore, T., Mauer, D., & Brown, T. (2008) · Pervasive and Mobile Computing · doi:10.1016/j.pmcj.2008.05.004 · Cited by 50 · see citing works
Breathe with Me: A Virtual Meditation Coach
Shamekhi, A., & Bickmore, T. (2015) · Lecture notes in computer science · doi:10.1007/978-3-319-21996-7_29 · Cited by 36 · see citing works
Blissful Agents: Adjuncts to Group Medical Visits for Chronic Pain and Depression
Shamekhi, A., Bickmore, T., Lessios, A. S., Negash, N. L., & Gardiner, P. M. (2016) · Lecture notes in computer science · doi:10.1007/978-3-319-47665-0_49 · Cited by 13 · see citing works
Head X: Customizable Audiovisual Synthesis for a Multi-purpose Virtual Head
Luerssen, M. H., Lewis, T. W., & Powers, D. M. W. (2010) · Lecture notes in computer science · doi:10.1007/978-3-642-17432-2_49 · Cited by 7 · see citing works
Self-citationFrom Talking to Thinking Heads: Report 2008
Kim, J., & Powers, G. (2008) · AVSP · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Abd-Alrazaq, A. A., Rababeh, A., Alajlani, M., Bewick, B. M., & Househ, M. (2020) · Journal of Medical Internet Research · doi:10.2196/16021 · Cited by 503 · see citing works
Perceptions and opinions of patients about mental health chatbots: scoping review
Abd-Alrazaq, A. A., Alajlani, M., Ali, N., Denecke, K., Bewick, B. M., & Househ, M. (2021) · Journal of Medical Internet Research · doi:10.2196/17828 · Cited by 301 · see citing works
Petsolari, M., Ibrahim, S. B., & Slovak, P. (2024) · Proceedings of the CHI Conference on Human Factors in Computing Systems · doi:10.1145/3613904.3642619 · Cited by 35 · see citing works
- Authors
- Luerssen, M. H., & Hawke, T.
- Affiliations
- Clevertar P/L, Adelaide, SA, Australia
- Venue
- Proceedings of the 18th International Conference on Intelligent Virtual Agents
- Publisher
- ACM
- Published
- 2018-11-05
- Pages
- 107-112
- OpenAlex
- W2901662521
- Cited by
- 28
- References
- 13
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 4 · 2023: 8 · 2022: 1 · 2021: 1 · 2020: 3
- FWCI
- 3.09
- Type
- conference paper
- Language
- en
- Open access
- closed
- Locations
- ACM International Conference on Intelligent Virtual Agents (IVA) (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Social Robot Interaction and HRI
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- virtual agents, chatbots, heart failure, psychological distress, health knowledge, user engagement, digital health interventions, population health
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
