Artificial intelligence (AI) is transforming healthcare delivery rapidly through its application in the industry. Artificial Intelligence chatbots (AI chatbots) utilize Natural Language Processing (NLP) and communicate in a natural human-like way. These AI tools have transformed human and computer interaction to the next level. Moreover, there is potential for further evolution of this technology. AI chatbots have already been introduced in patient care, education, administration, and healthcare research. The integration of AI chatbot technology in healthcare has been proposed to relieve stress on healthcare providers as it assists them in performing their tasks efficiently.  Utilising AI chatbots in palliative care could be overwhelming, as there are several domains in palliative care where it could support healthcare providers, patients, and their caregivers.

Roles of AI chatbots in palliative care

Patient Care

One of the most fascinating properties of the AI chatbots is adaptability. These AI tools can learn and adapt over time, develop continuously and can provide personalised support to users. AI chatbots can respond to verbal or written commands – these features could be the basis for use of this technology in patient care in palliative settings; [Figure1]

Information and education

• Health care chatbots trained on palliative care data can respond to patient queries and educate them regarding the disease process such as disease stage, natural course, common symptoms, and how to address them.
• Can provide general information about medications, common side effects, and management.
• Can assist in the management of coexisting chronic conditions, like asthma, diabetes, or hypertension by tracking their status and alerting patients if any red flag symptoms appear.
• The most important aspect is that the information can be accessed at any time of the day in even the remotest geographical region, provided internet access or other prerequisites are met.

Symptom recognition & management

• Can help recognise common or emergent symptoms and guide their management.
• Can help align the potential reasons for such symptoms, identifying red flags and recommend whether a specific intervention or healthcare provider consultation/teleconsultation/referral is required.

Telemedicine Integration

• AI chatbots can help patients gain basic knowledge about their condition and help recognise their needs before telemedicine consultations with specialist care providers.
• Can help record follow-up care instructions and track compliance to the instructions/medications etc.

Monitoring & medication management

• AI chatbots can help remind patients to take their medications at the correct time and right dose.
• Can help improve adherence to the treatment and overall compliance with the management regimen.

Emotional Support

• Depending upon their design, chatbots can offer exercises, coping strategies, and conversation to help to manage conditions like anxiety or depression.
• Recent studies have revealed that chatbot replies were more empathetic than physician replies to general medical inquiries over social media. Thus, AI chatbots could provide emotional support too.

Support to Caregivers

• AI chatbots can help to reduce caregivers’ burden or stress by providing emotional support by responding to their queries at any time of the day and at any place.
• The support from an AI chatbot might reduce caregivers’ feelings of loneliness and can help improve their quality of life by providing information, and resources.

Assistance to Healthcare/Palliative Care Providers

• AI chatbots can assist palliative care providers in diagnosing a condition, working up a plan, and formulating patient-tailored care plans to achieve the intended goals of care.
• They can also assist in predicting outcomes by calculating and analysing various parameters, which might help in prognostication and decision-making.

Administrative Support

• AI chatbots can help schedule appointments with the healthcare centre and send reminders to patients.
• Chatbots can also assist by responding to questions related to billing and insurance claims, etc.

Research

• AI chatbots can collect patient data, and gather information from patients feedbacks, thus providing useful data.
• They can also assist healthcare providers in analysing the collected data.

Limitations with AI chatbots & potential measures to overcome it

Limitations

• The concern of trust and acceptability among patients and caregivers.
• Patients and caregivers might not accept the reliability of AI-based interventions.
• Other drawbacks could be ethical challenges, legal issues, data protection, potential for bias, and validity of the information.

Measures to overcome limitations

There are certain measures that could be undertaken to mitigate the risks associated with the use of AI in palliative care and maximise the potential benefits for patients and caregivers.

• AI chatbot must ensure strong privacy through implementation of strong security interventions.
• AI chatbot could be prone to biases, this must be considered and strategies to reduce this risk should be implemented..
• Establishing accuracy and reliability of AI chatbots is very important and must be established by conducting appropriate randomised control trials before they are released for public service.
• Patients and caregivers’ training regarding function of AI chatbots and their utility in palliative care should be strongly adopted.
• Collaboration of palliative healthcare providers must be ensured by the experts while developing AI chatbots that are compatible with existing palliative care delivery systems.

Summary

• AI chatbots could provide healthcare information and support to vulnerable populations not able to access clinical care due to geographical, or time constraints.
• Legal and ethical considerations are very important while developing and implementing AI chatbot systems that meet the unique needs and preferences of various patient groups requiring palliative care.

Collaboration among various stakeholders including palliative care providers, researchers, developers, and patients is a must to guide and ensure the effective integration of conversational AI chatbots into a palliative care delivery system.

References

1. Altamimi I, Altamimi A, Alhumimidi AS, Altamimi A, Temsah MH. (2023). Artificial intelligence (AI) chatbots in medicine: A supplement, not a substitute. Cureus 2023; 15(6):e40922.
2. Reddy V, Nafees A, Raman S. Recent advances in artificial intelligence applications for supportive and palliative care in cancer patients. Curr Opin Support Palliat Care 2023; 17(2):125-134.
3. Srivastava R, Srivastava S. Can Artificial Intelligence aid communication? Considering the possibilities of GPT-3 in Palliative care. Indian J Palliat Care 2023; 29(4):418-425. doi: 10.25259/IJPC_155_2023.
4. Chen D,Parsa R, Hope A, Hannon B, Mak E, Eng L, et al. Physician and Artificial Intelligence Chatbot Responses to Cancer Questions From Social Media. JAMA Oncol 2024;10(7):956–960.
5. Nair D, Raveendran KU. Consumer satisfaction, palliative care and artificial intelligence (AI).BMJ Support Palliat Care 2024;14:171–177.

Authors 

                                             

Dr Ram Singh, MBBS, MD
Assistant Professor
All India Institute of Medical Sciences, New Delhi, India
Twitter/X: https://x.com/DrRam2001

 

Dr Prakash Gyandev Gondode, MBBS, MD
Assistant Professor
All India Institute of Medical Sciences, New Delhi, India
Twitter/X: https://x.com/PGondode

 

Dr Prashant Sirohiya, MBBS, MD
Assistant Professor
National Cancer Institute, All India Institute of Medical Sciences, New Delhi, India
Twitter/X: https://x.com/sirohiyap

Dr Brajesh Kumar Ratre, MBBS, MD
Associate Professor
Department: Onco-Anaesthesia and Palliative Medicine,
All India Institute of Medical Sciences, New Delhi, India

Declaration of interests

We have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.