JMIR Publications

ABSTRACT

Background:

During the COVID-19 pandemic, health care systems were faced with the urgent need to implement strategies to address behavioral health needs of health care workers. A primary concern of any large health care system is developing an easy-to-access, streamlined system of triage and support despite limited behavioral health resources. This piece provides a detailed description of the design and implementation of a chatbot program designed to triage and facilitate access to behavioral health assessment and treatment for the workforce of a large academic medical center.

Objective:

To describe a program that used chatbot technology to address the behavioral health needs of employees at a large academic medical center. The University of California, San Francisco (UCSF) Cope Program aimed to provide timely access to (1) a live telehealth navigator for triage and live telehealth assessment and treatment; (2) curated online self-management tools; and 3) non-treatment support groups for those experiencing stress related to their unique roles.

Methods:

In a public-private partnership, the UCSF Cope team build a chatbot to triage employees based upon behavioral health needs. The chatbot is an algorithm-based, automated, interactive artificial intelligence conversational tool that uses Natural Language Understanding to engage users by presenting a series of questions with simple multiple choice answers. The goal of each chatbot session was to guide users to services appropriate for their needs. Designers developed a Chatbot data dashboard to identify and follow trends directly through the chatbot. Regarding other program elements, website user data was collected monthly, and participant satisfaction was gathered at each non-treatment support group.

Results:

The UCSF Cope Chatbot was rapidly developed and launched on April 20, 2020. As of May 31, 2022, 10.9% (3,785/34,790) of employees accessed the technology; among those reporting any form of psychological distress, 39.7% (708/1783) of employees requested in-person services, including those who had an existing provider. UCSF employees have responded positively to all program elements. As of May 31, 2022, the UCSF Cope website had 615,334 unique users, with 66,585 unique views of webinars, and 601,471 unique views of the video shorts. All Units across UCSF were reached by UCSF Cope staff for Special Interventions, with over 40 units requesting these services. Town Halls were particularly well-received, with over 80% of attendees reporting the experience as helpful.

Conclusions:

The UCSF Cope Program used chatbot technology to incorporate individualized behavioral health triage, assessment, treatment, and general emotional support for an entire employee base (N=34,790). This level of triage for a population of this size would not have been possible without the use of chatbot technology. The UCSF Cope model has the potential to be scaled, adapted, and implemented across both academic and non-academically affiliated medical settings.