The development of the Pan American Health Organization digital health specialist on alcohol use

Abstract

IntroductionOn 19 November 2021 the Pan American Health Organization (PAHO) developed and deployed the first-ever digital health worker dedicated to alcohol-related topics, named Pahola. This paper describes this developmental process and the first results of its uptake and interactions with the public.MethodsPAHO secured a non-exclusive worldwide license with a technology company to use their Human OS ecosystem, which enables human-like interactions between digital people and users via an application. Google Digital flow ES was used to develop the conversations of Pahola on topics related to alcohol and health, screening of alcohol risk using the AUDIT and providing a quit/cut back plan to users, along with additional treatment services and resources in each country of the Americas. A communication campaign was also implemented from launching date until 31 December 2021.ResultsPahola attracted good attention from the media, and potentially reached 1.6 million people, leading to 236,000 sessions on its landing page, mostly through mobile devices. The average time people effectively spent talking to Pahola was five minutes. Major dropouts were observed in different steps of the conversation flow.DiscussionPahola was quickly able to connect to a large worldwide population with reliable alcohol information. It could potentially increase the delivery of SBI and improve alcohol health literacy. However, its preliminary results pointed to much needed changes to its corpus and on its accessibility, which are being currently implemented.

The future landscape of large language models in medicine

“…Digital tools addressing this need have been developed since smartphones became broadly available in the late 2000s. Examples of such tools are First Derm 36 , 37 , a teledermoscopy application for the diagnosis of skin conditions, enabling dermatologists to remotely assess and provide guidance, and Pahola 38 , a digital chatbot to provide guidance on alcohol consumption. Currently, the success of such digital health applications is mostly limited by technical constraints 39 and limited acceptance by healthcare practitioners 40 .…”

Die kommende Entwicklung großer Sprachmodelle in der Medizin

“…Seit der starken Verbreitung von Smartphones in den späten 2000er Jahren wurden digitale Tools entwickelt, die diesem Bedarf gerecht werden. Beispiele für solche Tools sind First Derm [36, 37], eine Teledermatoskopie-Anwendung zur Diagnose von Hauterkrankungen, die es Dermatologen ermöglicht, Hauterkrankungen aus der Ferne zu beurteilen und zu beraten, und Pahola [38], ein digitaler Chatbot, der Beratung zum Alkoholkonsum bietet. Derzeit ist der Erfolg solcher digitalen Gesundheitsanwendungen vor allem durch technische Einschränkungen [39] und die begrenzte Akzeptanz bei den Angehörigen der Gesundheitsberufe begrenzt [40].…”