Pelvic Healthcare In Your Pocket: White Paper On Harnessing The Promise Of Chatbots

Sanjana Ramesh, MPH 

Head of Research

The insidious burden of pelvic health 

Nationally, over 50 million (one in three) people who menstruate suffer from at least one chronic pelvic health disorder, and, by 2050, this number is projected to double. In addition to growing prevalence, the total direct (e.g., physical, mental, social quality of life) and indirect (e.g., diminished work productivity and presenteeism) healthcare costs associated with these disorders exceed $100 billion per year. Therefore, pelvic health poses a tremendous burden on public health and the economy.  

Although many pelvic health disorders can be managed, improved, and prevented altogether - with the right combination of information, motivation, and engagement - relatively few people seek care, and even fewer receive care. Due to the social taboo and stigma surrounding pelvic health, people generally lack the knowledge or awareness needed for early symptom identification. At the same time, feelings of shame and discomfort further delay people from sharing their symptoms with providers. 

Among those who seek care, the healthcare system proves unequipped to support people with adequate pelvic health care. Gynecologists and urogynecologists remain largely inaccessible to many affected populations and primary care providers are burdened by an influx of patients whose symptoms are typically more advanced. In primary care settings, several provider barriers can limit patient-centered care such as time and knowledge of pelvic health treatments. 

Chatbots can revolutionize pelvic healthcare 

Chatbots have long lived in the realm of customer service but have recently gained significant momentum for their potential to revolutionize value-based healthcare. Powered by smart, machine learning algorithms, chatbots can carry out a conversational dialogue with people via text messaging or instant messaging applications. They can function to alleviate provider burden and enhance the patient experience by assisting with a wide variety of tasks. For example, some healthcare chatbots are designed to streamline administrative tasks for providers (e.g., dictate consultation notes, retrieve information about drug interactions) whereas others exist to engage patients along the care pathway (e.g., monitor health status, support chronic disease management). Within primary care, chatbots are increasingly becoming the first point of contact for symptom identification. 

In addition to these functions, chatbots also show great promise for delivering accessible therapeutic care. In fact, people are found more likely to truthfully share sensitive health information with a chatbot than with their provider. Due to anonymity, chatbots can establish rapport without fear of stigmatization. Furthermore, they offer asynchronicity which allows people to have greater autonomy over communication. Although chatbots are not meant to replace providers, they can be designed to deliver remote therapy at lower costs. Chatbots are highly accessible and convenient to use because people can interact with them through their smart devices.

Finally, from a behavior change perspective, chatbots are also proving successful in promoting cognitive (i.e., knowledge, comprehension) and affective (i.e., motivational, attitudinal) learning outcomes. First, chatbots can deliver health information in small, accessible chunks through multiple formats including conversational flow, video and audio clips, simple graphics, and personal stories (Fadhil & Gabrielli, 2017; Pereira & Díaz, 2019). As such, chatbots are more engaging than traditional channels of health communication. Moreover, chatbots can integrate positive psychology, humor, and motivational interviewing to further reinforce healthy behavior change (Ly et al, 2015; Cruzes & Dyba, 2011; Lissett et al., 2015; Inkster, 2018). 

Say hello to CeCeⓇ

At Renalis, our mission is to deliver cost-efficient, effective, data-driven treatments for pelvic health. Thus, after 17 years of creating ground-breaking, evidence-based pelvic health programs, we have designed and developed CeCeⓇ, a machine-learning chatbot based on our proprietary algorithm. As a chatbot, CeCeⓇ delivers accessible and patient-centered pelvic healthcare directly to people’s pockets. With CeCeⓇ, our goal is to teach, motivate, and ultimately treat all people affected by pelvic health disorders

Our current efforts with CeCeⓇ are focused on menstrual health and bladder health. We are now conducting a proof of concept study with our bladder health CeCeⓇ and expect to have early data in 4Q2021.