I’d Never Admit That to My Doctor. But to a Computer? Sure



We share more honestly with impersonal methods of communication

Writing in the Pacific Standard Magazine Tom Jacobs discusses recent research (Computers in Human Behaviour: It’s only a computer: Virtual humans increase willingness to disclose) revealing that Patients are more likely to respond honestly to personal questions when they are posed by “Virtual Humans” rather than in face to face encounters with Doctors:

Admit it: The last time you sat down with a physician and revealed your medical history, did you fudge a bit? Were there certain incidents you were too embarrassed to admit? Did you gloss over certain behaviours that might make you look bad? It’s a serious problem for health professionals and patients alike. With less-complete information to work with, doctors are more likely to misdiagnose an illness, or prescribe an inappropriate drug.

People disclosed information more honestly and openly when they were told they were speaking exclusively to the computer. The participants also “reported significantly lower fear of self-disclosure” under those circumstances.

“The power of VH (virtual human) interviewers to elicit more honest responding comes from the sense that no one is observing or judging,” note the researchers, led by Gale Lucas of the University of Southern California’s Institute for Creative Technologies. People have a strong tendency to want to look good in front of others, including doctors; this problematic tendency can be short-circuited using this high-tech tool.

Half of the participants were told that their conversation was entirely computer-driven and not being observed. The others were informed they were being watched by a person in another room who was also manipulating the machine to ask certain questions. In all cases, video images of their faces were recorded and later analyzed to gauge their level of emotional expression.

Afterwards, participants responded to a series of statements measuring their comfort level with the experience. Finally, an outside observer noted their responses to certain sensitive questions (such as “How close are you to your family?”) and gauged their willingness to disclose personal information.

The result: People disclosed information more honestly and openly when they were told they were speaking exclusively to the computer. The participants also “reported significantly lower fear of self-disclosure” under those circumstances. These results were reiterated by the analysis of their facial expressions, which found they “allowed themselves to display more intense expressions of sadness” when they believed no human was watching them.

So the perception of anonymity was the key. That conclusion was confirmed in several ways, including by noting the closing remarks of many participants. “This is way better than talking to a person,” one commented. “I don’t really feel comfortable talking about personal stuff to other people.”

When it comes to fixing our health-care system, very few people would agree that part of the answer lies in less human interaction. Patients generally want more, not less, contact with health professionals. Yet this study suggests that, at least for the intake interview, a little less of the human touch—and a little more perceived privacy—may be precisely what the doctor ordered

mHealth Insights:

> This work builds on lots of research that shows Patients will interact more honestly with online questionnaires (eg. Why telephone consultations with Doctors fail, At first I was very skeptical. How could a computer replace my excellent history-taking skills, which had been formed by a rigorous education, then honed by 10 years of small-town family practice and 5 years of academic teaching?, Computers take histories better than doctors – why don’t they do it more?, etc) but I wouldn’t be at all surprised if a lot of the value that a ‘Virtual Human’ interaction offers beyond the use of a well designed questionnaire on a device like an iPad will be lost as soon as the move is made to real Patients with real health concerns instead of citizens who have volunteered online to help with some research.

> I’m not sure there is any real distinction between what the researchers refer to as a “Virtual Human” and an SIRI style mobile interface to an interactive structured medical history taking questionnaire like Instant Medical History (the tool we leverage to provide documented mobile video consultations at 3G Doctor).

Nuance natural language interface for Instant Medical History

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2 Responses to I’d Never Admit That to My Doctor. But to a Computer? Sure

  1. Pingback: AllTrials.com or AllConsultations.com? | mHealth Insight: the blog of 3G Doctor

  2. Pingback: Are you more honest with your Phone than your Doctor? – mHealth Insight

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