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Cited by 30Empathy and Medical EducationPatient-Provider Communication in HealthcareHealth Literacy and Information Accessibility

Digital clinical empathy in a live chat: multiple findings from a formative qualitative study and usability tests

Open access
Luetke Lanfer, Hanna, Reifegerste, Doreen, Weber, Winja, Memenga, Paula, Baumann, Eva, Geulen, Julia, Klein, Stefanie, Müller, Anne +2 more·2024·BMC Health Services Research
DOI 10.1186/s12913-024-10785-8PMC PMC10921626
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Abstract

Background: Clinical empathy is considered a crucial element in patient-centered care. The advent of digital technology in healthcare has introduced new dynamics to empathy which needs to be explored in the context of the technology, particularly within the context of written live chats. Given the growing prevalence of written live chats, this study aimed to explore and evaluate techniques of digital clinical empathy within a familial cancer-focused live chat, focusing on how health professionals can (a) understand, (b) communicate, and (c) act upon users’ perspectives and emotional states. Methods: The study utilized a qualitative approach in two research phases. It examined the expected and implemented techniques and effectiveness of digital clinical empathy in a live chat service, involving semi-structured interviews with health professionals (n = 9), focus group discussions with potential users (n = 42), and two rounds of usability tests between health professionals (n = 9) and users (n = 18). Data were examined using qualitative content analysis. Results: Expected techniques of digital clinical empathy, as articulated by both users and health professionals, involve reciprocal engagement, timely responses, genuine authenticity, and a balance between professionalism and informality, all while going beyond immediate queries to facilitate informed decision-making. Usability tests confirm these complexities and introduce new challenges, such as balancing timely, authentic responses with effective, personalized information management and carefully framed referrals. Conclusions: The study reveals that the digital realm adds layers of complexity to the practice of clinical empathy. It underscores the importance of ongoing adaptation and suggests that future developments could benefit from a hybrid model that integrates the strengths of both AI and human health professionals to meet evolving user needs and maintain high-quality, empathetic healthcare interactions.

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  • Recent work explored hybrid and simulation-based approaches, including live-chat models emphasizing digital clinical empathy and virtual patient systems designed to train clinicians in empathic and end-of-life communication.

    “Recent work has also explored hybrid and simulation-based approaches, including live-chat models emphasizing digital clinical empathy [34] and virtual patient systems designed to train clinicians in empathic and end-of-life communication [3536].”

    From Empathic AI for Patient-Centered Cancer Care: A Scoping Review of Patient Navigation, Support, and Clinical Practice (2026) · cites this paper as [34]

  • Digital clinical empathy requires intentional strategies (timely acknowledgment, authenticity, appropriate boundary setting, contextual responsiveness) and may be best sustained through hybrid models combining AI-enabled support with human oversight.

    “Studies measuring cancer-related live chat environments and simulation-based systems highlight that digital clinical empathy requires intentional strategies (ie, timely acknowledgment, authenticity, appropriate boundary setting, and contextual responsiveness) and may be best sustained through hybrid models that combine AI-enabled support with human oversight [34-36].”

    From Empathic AI for Patient-Centered Cancer Care: A Scoping Review of Patient Navigation, Support, and Clinical Practice (2026) · cites this paper as [34]

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Cited by

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Authors
Luetke Lanfer, H., Reifegerste, D., Weber, W., Memenga, P., Baumann, E., Geulen, J., Klein, S., Müller, A., Hahne, A., & Weg-Remers, S.
Affiliations
  • Bielefeld University (DE)
  • German Cancer Research Center (DE)
  • Hanover University of Music Drama and Media (DE)
ORCID
Venue
BMC Health Services Research
Publisher
Springer Science and Business Media LLC
Published
2024-03-08
Volume
24
Issue
1
Pages
314-314
ISSN
1472-6963 (ISSN-L)
DOI
10.1186/s12913-024-10785-8
PMC
PMC10921626
OpenAlex
W4392595299
Cited by
30
References
9
Citations by year
2026: 15 · 2025: 11 · 2024: 4
FWCI
8.82
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Health Services Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PUBLISSO (German National Library of Medicine) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Universität Bielefeld
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
  • Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
Keywords
live chat, online patient support, hereditary cancer, patient-centered care, health professional-patient communication, emotional state, referral management, usability
MeSH terms
Delivery of Health Care, Empathy, Health Personnel, Humans, Focus Groups, Qualitative Research

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