An empathic virtual medical specialist: It's not what you say but how you say it

This paper reports a project involving a virtual specialist in the domain of paediatric incontinence, known as Dr Evie (eVirtual agent for Incontinence and Enuresis) who was added to an interactive website that provided tailored treatment advice. The virtual human provides a familiar face-to-face means of communication that seeks to overcome health literacy barriers and build a working alliance to encourage trust and ongoing motivation to follow the treatment advice offered while the patient is awaiting specialist appointment. Our pilot study with 79 patients recruited from patients on a two-year waiting list to access a specialist, found that those patients who utilized Dr Evie to discuss the treatment/s all reported trying at least one treatment suggestion resulting in improvement in health outcomes, in some cases no longer needing an appointment and in other cases requiring fewer appointments. In previous pilots, adherence to the text-based treatment advice provided by the website was around 50%. Patients and families found Dr Evie to be empathic and caring, even when they did not follow the advice. We attribute increased adherence due to the empathic nature of the conversations and thus in this paper we analysed these dialogues.