Physicians’ expectations of the use of conversational agents in healthcare: a qualitative study

Abstract

Conversational agents (CAs) have become an emerging field of research in healthcare, driven by their potential to support medical workflows, improve efficiency and enhance access to health services. However, despite growing technological development, their actual implementation in healthcare remains limited. In particular, little is known about physicians’ expectations regarding the potential use of CAs in healthcare. This study therefore investigates physicians’ expectations toward CAs and identifies expected barriers and facilitating factors for a possible future implementation. We conducted semi-structured interviews with 16 physicians from various specialties and care settings (inpatient and outpatient) across Germany. Maximum variation sampling was applied to ensure diversity in gender, age, prior experience with CAs, and medical discipline. The interviewees were encouraged to share their expectations regarding the potential use of CAs, their preferred characteristics, and expected barriers and facilitators for future implementation. Interview data were analyzed based on the concept of the Framework Method. Five main topics were identified regarding how physicians expect the potential use of CAs in healthcare. Only one of sixteen physicians reported practical experience with a medical CA, highlighting a critical gap between expected potential and real-world application. Physicians viewed CAs as promising tools for maintaining the quality of care in the face of increasing workloads and staff shortages. Expected benefits included time savings, efficiency gains, and improved patient access, particularly through administrative support, symptom assessment, and patient empowerment. At the same time, substantial expected barriers were reported, including legal uncertainties, lack of interoperability, data privacy concerns, and limited real-world experience. Physicians emphasized that the true potential of CAs becomes apparent only through practical application. This study provides insights into physicians’ expectations regarding the potential use of CAs in healthcare and key factors for future implementation. According to physicians, successful implementation requires consideration of technical performance, regulatory frameworks, integration into clinical workflows, and human factors such as acceptance, trust, and user competence. CAs should support decision making without undermining clinical judgment. Practical trials and pilot programs are essential to foster trust through transparency and real-world experience, providing an orientation for evidence-based implementation initiatives.

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