Klick Health

I, HealthBot

VP Strategy

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"Chatbots" are the new focus in tech, Microsoft building them into Skype, and Facebook into Messenger. What exactly are they, why should we care, and what might they mean for healthcare and pharma marketers? Let's find out!

Digital technology is essentially Boolean logic performed by tiny switches that are either on or off, zero or one. Since 1965, Moore’s Law has successfully predicted that these electronic gates double in density on their circuit boards every year, thereby packing exponential punch into gizmos that have rapidly evolved from primitive calculators the size of office buildings into global real-time multimedia communication hubs we now carry in our pockets.

Along the way the relationship between hardware and software, development and design, user interface, experience, and behavior has been complex and interdependent—at worst confusing and contradictory, and at best symbiotic and self-reinforcing. Akin to hand-cranked, all-black Model T automobiles, early computers were marvels of inconvenience and specialization, the buyer more eagerly naïve victim than empowered discriminating consumer.

Continue the analogy and digital has similarly grown up, users like drivers expecting to get from here to there as efficiently and stylishly as possible. Nobody really cares anymore what goes inside so long as it works; and everybody already licensed expects to jump right in and go go go with no additional training or preparation. That demand puts acute pressure on engineers to focus less on the tech, and more on the end-users who’ve become increasingly demanding.


From Portals to Search & Back Again

Seen through this light the major milestones in digital communication seem inevitable, each characterized by steadily heightening interactivity and personalization. Consider the trajectory from standalone PCs to networks to the Web, from broadcast to social media, from desktop to mobile to wearables. At each point the user has become progressively more empowered, maturing from being slaves of C:\ to accessing the world’s data in real time, from actively searching existing content to creating and distributing their own on social platforms.

As we discussed in a prior post, the rapid rise of mobile has brought us back full-circle to smartphone and tablet user experiences that are actually more reflective of Yahoo 1998 than Google 2010. That’s because the paradigm shift into mobile has once again changed hardware and software, demanding fresh approaches to development and design—all while end-users try to figure out what’s going on, the reciprocal relationship between user interface, experience, and behavior an ongoing work-in-progress, ultimately driving toward intuitive simplicity.

Take a look at the Yahoo home page from nearly two decades ago, then the most visited website in the world:




Back then the “World Wide Web” was for most users the Wild Wild West of information, a vast and often frightening unknown that demanded assurances and hand-holding. Portal structures such as this and others such as AOL provided visitors with pre-baked categories of content and functionality that directly took them with a single click to what they were seeking. The “search box” was an after-thought, meant for the tiny minority of enterprising and precocious users who felt empowered enough to actually conduct their own search of the Web.

The astonishing ascendency of Google makes us take search and the active seeking of online content for granted. But does the antiquated portal structure look oddly familiar? Well it certainly should, since we all now spend a vast majority of our screen time on smartphones and tablets that are structured quite similarly, the crude blue hyperlinks of the desktop portal swapped for colorful visual mobile app icons, the click of a mouse now the tap of our finger—today’s user experience and its navigational functionality essentially the same as Yahoo circa 1998:




Surprise! In 2016 we access individual categories of content and functionality much like we did twenty years ago. Want to know the weather? Back then you clicked the link, and now we tap the Weather app. Access your email? Read the news? Check your favorite sports team? Click, click, click—now tap, tap, tap. Obviously the content destinations have evolved in sophistication, personalization, and power—But most significantly, the user experience for accessing this content is analogous, and so are the epic business challenges and opportunities facing the tech giants vying for hegemony.


Goodbye Portals & Hello Chatbots

Google crushed Yahoo not only because Larry and Sergei had the best search algorithm, but because search is a much more efficient and stylish way to access content. Notice two things had to happen for the leap to take place: 1) Search technology had to significantly improve, and 2) Digital users had to mature into being comfortable with and actively utilize search. And notice how the two feed off each other: The better search got, the more users were willing to try it; and the more users tried it, the more powerful search became.

Not only did the inexorable evolution from portal-driven navigation to search shift user experiences and behaviors, but it made Google as successful and well-known as Coca-Cola or Exxon, and redefined the entire business model of the Web. Literally trillions of dollars have changed hands as a direct result of nothing more complicated than digital users forgoing rows of blue hyperlinks for a blank box they type keywords into. What’s even more mind-blowing is how digital history now repeats itself, the same model only with different players.

Instead of desktop computer portals with rows of links, we now use smartphones, phablets, and tablets with touch screen rows of mobile app icons. And much like Google offered a viable and inevitable alternative with search, Facebook is now trying to offer a viable and equally inevitable alternative with Chatbots. Both solutions heighten interactivity and personalization; both solutions shift the user experience from passive to active; and both solutions alter essential navigation in a way that transforms the entire digital market place.

If you’ve made it this far your reaction is likely: “Are you serious? Chatbots? As big a deal as Search? Get outta here!” After all, they do sound like this quarter’s widget infatuation or geek obsession. We’ve seen an endless line of digital players and platforms come and go with such volatility that a “chatbot” could hardly constitute a genuine game-changer. Remember Foursquare? MySpace? Orkut? How about the many Facebook duds, including Places and Graph Search? So let’s see exactly what chatbots are, where they’ll live and what they’ll do to make our case.



Mark Zuckerberg presented his vision of Chatbots for Facebook Messenger during last week’s developer conference: “No one wants to have to install a new app for every business or service that they want to interact with. We think that you should just be able to message a business in the same way that you message a friend.” Using 1-800-FLOWERS as an example, he cycled through a demo of ordering a bouquet for your sweetie directly from the Messenger app, ostensibly bypassing the need to use the store app—or website, or Google, for that matter. CNN news and a weather app named Poncho have also joined the first salvo of Messenger Chatbots.




Chatbot technology essentially works by starting with your input—text, or voice, or conceivably even a drawing or image—and using rudimentary artificial intelligence to best understand your command and then connect you with your destination, and even help you purchase a product or service. Sound familiar? It should, because chatbots and their ilk already exist in the form of Apple’s Siri, Amazon’s Alexa, and Microsoft Cortana. Chatbots even go back to the 1960s with Eliza, an MIT experiment in artificial intelligence that mimicked the response-mechanisms of a psychotherapist.

Not only is Zuck’s Chatbot nothing new, but early reviews consider the inchoate functionality so far “frustrating and useless.” Worse still, Microsoft’s own bot Tay, programmed to communicate and learn via Twitter, was shut down after some deliberate crowdsourced sabotage induced it to start tweeting racial slurs and bizarre nonsense. Despite these glitchy startups, WeChat’s Xiaoice bot is flourishing, already connecting millions of users with products, services, and most often rudimentary yet still engaging AI conversation. Like the early search engines, the race is clearly on to optimize the tech, but to what end?

“Bots will largely replace apps,” insists Bruce Wilcox, the creator of Rose, an award-winning chatbot, and founder of the bot startup, Kore. Installing and accessing separate apps is a pain”—just as scrolling through rows of blue hyperlinks was before the advent of search. The exact form such chatbots will take, however, and how they’ll exactly work remains a work-in-progress; but the reality that mobile apps will consolidate and eventually vanish, replaced by single-service providers with the best chatbot interface and intelligence, is inevitable if still very much surprising and utterly transformative.


facebook chatbot


With something as simple as enabling and encouraging products and services to be ordered from Facebook Messenger, Zuck is an industry leader who hopes to integrate eCommerce functionality for more than 1.9 billion users who ostensibly use his platform to connect with each other—not businesses. That one move, if successful, could radically alter not only Facebook’s business model, but the digital user experience itself. From a branding perspective Google is search, Facebook is social, and Amazon is product. The goal of the Zuckbot is to blur the lines and rule the roost by truly monetizing social.

Who will win and how is again dependent on both the tech and the user: 1) Chatbots must improve to the point consumers will find them easier and better to engage with than mobile apps, and 2) Consumers must embrace them to the point chatbots become self-sustaining, sufficiently powerful, and able to fully replace the mobile apps that gradually get abandoned. That reciprocal relationship destroyed desktop portals and ushered in search two decades ago, and is poised to vanquish the plethora of mobile apps and make bots—in whatever form they eventually manifest—the singular mobile interface and user experience of tomorrow.


From Chatbot to Healthbot

Amid this backdrop of mobile transformation and Tech Giant Wars is the $3.2 trillion per year US healthcare industry. Acutely suffering from many of the same challenges facing mobile apps, mHealth needs healing even more desperately: Too many health apps with too little meaningful functionality, poorly if at all connected to patient health systems and its numerous stakeholders, the promise of mobile health remains largely untapped. How will the inevitable consolidation and integration of the mobile interface impact health, and what can we start doing now as pharma marketers and commercialization partners?

Perhaps the best way to anticipate the future is to take stock of the present. In addition to the flower, news, and weather chatbots that have already launched for Facebook Messenger, a healthcare startup specializing in Virtual Consult Visits named Healthtap has also developed a bot. Users are able to enter questions into the chatbot and receive referenced answers from doctors. Although not a true telemedicine service, the Healthtap network of over 100,000 physicians across 141 beckons for such a solution, and time will tell how the chatbot figures in.


Screen Shot 2016-04-18 at 2.30.19 AM


The legacy of healthcare chatbots extends several years, an interesting “Body Health” list on chatbots.org including basic AI experiences covering pregnancy, smoking cessation, dentistry, and other specialties. Within the grey area between telehealth, healthbots, and consults is the Cleveland Clinic, constantly innovating and experimenting with the latest technology to bring added value to patients and the professionals serving them. Meanwhile, pharma has also explored the space, for example developing interactive digital tools for patient profiling in diabetes and other disease states. And of course IBM Watson Health is already the brains behind countless bots, from oncology to practice management to hospital administration.

These initial iterations clearly just scratch the surface of the “Healthbot” potential, with exciting possibilities across virtually every facet of healthcare. From symptom assessment to diagnostics, treatment decision making to reimbursement and access assistance, adherence to advocacy, bots can and likely will play central roles throughout the patient journey. Every function now performed by an app or electronic health record can be streamlined using artificial intelligence and an improved digital interface. In fact, the many problems these infrastructures now face, from fragmentation to interoperability challenges, could be solved with the introduction of healthbots, while contextually relevant branded and unbranded communication opportunities for pharma abound.

Meanwhile, personal health data privacy and security are arguably the biggest hurdles for pharma and digital health. Healthbots in whatever form they take will most likely exacerbate these challenges early on as deeper data is collected and shared. But the integration of multiple apps and complex systems into a singular, integrated HIPAA-certified interface should in the longer-term help ensure greater systems security and data privacy. Opportunities for increased personalization and relevance through big data analytics will also benefit all healthcare system stakeholders, saving money and lives. Perhaps a variant of Asimov’s “Three Laws of Robotics” could be adapted for healthcare, mitigating lingering concerns and helping to usher in the inevitable:

  1. A healthbot may not violate a patient’s privacy or, through inaction, allow a patient’s personal health records to be stolen.
  2. A healthbot must obey the orders given it by physicians except where such orders would conflict with the First Law.
  3. A healthbot must protect its own data as long as such protection does not conflict with the First or Second Laws.


The Healthcare Turing Test

Another fascinating potential application is social media, a particularly challenging channel for healthcare and especially pharma. Healthbots hold intriguing promise for community management where automated responses are often necessary, but typically at the cost of spontaneous, naturally human engagement. Bots of ever-increasing sophistication that “pass the Turing Test” could progressively mitigate the artificiality of otherwise “canned” social media responses, making social channels a viable and effective means for providing connectivity, transparency, and optimal customer service within highly regulated environments.

Klick Health is on the pulse of innovation, providing our clients a unique blend of cross-disciplinary expertise necessary to stay inoculated against the status quo. Masters of the science, communications, and technology at the core of digital health, Klick is where the three points of the healthcare triangle meet. Have you given your commercialization partners the Turing Test lately? How well do they hold up to the constantly changing ecosystem, accurately predicting what’s ahead? 1) Do they understand the tech and get it right? and 2) Do they give you the assurance you need to innovate and stay ahead of your competition?

At Klick we understand how macro trends influence and ultimately transform healthcare, providing our clients an advantage by tapping into the powerful forces changing our lives today. The time to start is now, so let’s ask some important questions and provide the right answers…

More About the Author

Michael Spitz

A digital health expert since before digital health was cool, Spitz has since developed omnichannel campaigns for top pharma and device brands, and helps drive agency innovation, digital transformation, and emerging channels. See him present at conferences, read his blogs, and follow him for the latest trends and opinions on Twitter @SpitzStrategy.

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