Design and Evaluation Challenges of Conversational Agents in Healthcare and Wellbeing (Preprint)

BACKGROUND Healthcare and wellbeing are two main interconnected application areas of conversational agents (CAs). There is a significant increase in research, development, and commercial implementations in this area. In parallel to the increasing interest, new challenges in designing and evaluating CAs have emerged. OBJECTIVE This study aims to identify key design, development, and evaluation challenges of CAs in healthcare and wellbeing research. The focus is on the very recent projects with their emerging challenges. METHODS A review study was conducted with 17 invited studies, most of which were presented at the ACM CHI2020 conference workshop on CAs for health and wellbeing. Eligibility criteria required the studies to involve a CA applied to a health or wellbeing project in an ongoing or recently finished project. The participating studies were asked to report on their projects' design and evaluation challenges. We used thematic analysis to review the studies. RESULTS The findings include a range of topics from primary care to caring for older adults to health coaching. We identified four major themes: i) domain information and integration, ii) user-system interaction and partnership, iii) evaluation, and iv) conversational competence. CONCLUSIONS While some challenges are shared with other CA application areas, safety and privacy remain the major challenges in the healthcare and wellbeing domains. An increased level of collaboration across different institutions and entities may be a promising direction to address some of the major challenges which otherwise would be too complex to be addressed by the projects with their limited scope and budget.