The Virtual Nurse Will See You Now

In the hectic world of a hospital, a computer-simulated nurse can be surprisingly comforting.

Researchers at Northeastern University have developed a virtual nurse and exercise coach that are surprisingly likable and effective—even if they're not quite as affable as the medical hologram on Star Trek. In fact, patients who interacted with a virtual nurse named Elizabeth said they preferred the computer simulation to an actual doctor or nurse because they didn't feel rushed or talked down to.

A recent clinical trial of the technology found that Elizabeth also appears to have a beneficial effect on care. A month after discharge, people who interacted with the virtual nurse were more likely to know their diagnosis and to make a follow-up appointment with their primary-care doctor. The results of the study are currently under review for publication.

"We try to present something that is not just an information exchange but is a social exchange," says Timothy Bickmore, associate professor in Northeastern's College of Computer and Information Science. Bickmore led the research. "It expresses empathy if the patient is having problems, and patients seem to resonate with that."

Bickmore first became interested in working on "virtual agents" after seeing demonstrations of very early interactive animated characters. "I was amazed at how people were instantly mesmerized by them, and how quickly this effect vanished when the characters did something stupid," he says. "I was interested in seeing how they could be engineered to maintain the enchantment over long periods of time and be used for practical purposes beyond entertainment."

He adds that patients with little or no computer experience seem to prefer the virtual person to more standard computer interactions, because it feels more natural.

"Most people get frightened when they hear they are going to get care from a computer, so to hear so clearly that we are not short-changing patients is gratifying," says Joseph Kvedar, a physician and founder and director of the Center for Connected Health at Partners Healthcare. Kvedar has collaborated with Bickmore in the past.

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To develop the computer-controlled avatars, researchers first recorded interactions between patients and nurses. They then tried to emulate the nurses' nonverbal communication by endowing the virtual character with hand gestures and facial expressions. (The resulting animation is, however, much simpler than today's sophisticated video games.)

Researchers also add small talk, asking users about local sports teams and the weather, which real nurses and coaches often do to put patients at ease. The verbal interactions are fairly basic; the nurse or trainer has a set repertoire of questions, and users choose from a selection of possible answers. For anything beyond that repertoire, the virtual agent will refer the patient to a human health-care provider.

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