Healthcare chatbots are increasingly being used to streamline patient interactions and streamline administrative tasks. However, a recent study from the University of Surrey reveals a potential pitfall: aggressive messaging and blurred boundaries can push away cervical screening patients. The research, published in Lingua, highlights the importance of communication style in building rapport and trust with patients, especially in sensitive healthcare contexts.
The study focused on Asa, a generative AI receptionist that invites patients to book appointments via WhatsApp. Researchers conducted interviews with patients at a North London GP surgery and surveyed 300 people eligible for cervical screening via the NHS. The findings reveal that patients respond positively to friendliness and choice-oriented language but are put off by over-messaging, pushy reminders, and unclear boundaries between human and AI.
One key insight is that patients appreciate a friendly, kind tone that doesn't feel forceful. Integrating the chatbot into their routines and interacting with a named, female-presenting AI made it easier to disclose sensitive information. However, follow-up messages sent within 24 hours were often seen as intrusive, and imperative phrasing like 'Let's book you in' was perceived as aggressive.
The study also uncovered ethical concerns. Patients raised worries about data security, impersonation, and the blurring of human and AI boundaries. The chatbot's statement that users could 'chat to me as if I am a real person' backfired for many, who read it as suspicious rather than reassuring.
Dr. Doris Dippold, lead author of the study, emphasizes the importance of transparency and respect in chatbot design. She states, 'Anthropomorphism can build rapport, but when it clashes with patients' expectations for transparency in a healthcare setting, it undermines trust.'
The findings carry significant implications for cervical screening uptake, which fell 5.3% in 2023-24, with ethnic minority groups consistently underrepresented. The study's key principles for chatbot design include helping patients achieve their goals, giving them control over decisions, responding appropriately to their needs, treating them with respect, ensuring fairness, and being transparent about the technology's workings.
Dr. Dippold concludes, 'Feeling seen, appreciated, and emotionally supported is not a luxury feature in health AI - it is a condition of access. If patients disengage because a chatbot feels pushy or untrustworthy, the health service loses them entirely.' This highlights the need for thoughtful chatbot design that prioritizes patient rapport and trust, especially in sensitive healthcare contexts.
