As pressures on healthcare systems intensify, an increasing number of consumers are turning to the use of symptom checkers in the search for fast answers – or guidance – to any concerns that they may have. But although these tools have become popular, questions around their accuracy, and not only, are plaguing the digital health space.

Last week, at Slush, Ada Health cofounder and chief medical officer Claire Novorol spoke to Wired UK’s Victoria Turk about the Berlin-headquartered company’s approach to building trust in its AI-powered chatbot.

“Absolutely key, first of all, is the quality of the product,” Novorol told the audience. “So what we’ve always focused on from the very beginning, eight years ago now actually, is the quality of the core product, the foundation of everything that we do, and that’s our knowledge base, our reasoning engine, and how it works, the clinical quality of that, accuracy, safety.”

Putting the patient “at the heart of everything” and being “open, transparent and proactive” in interactions with all stakeholders are equally as important, Novorol continued.

Ada Health’s journey

Initially, Ada Health sought to create a tool that would support doctors in the diagnostic decision-making process, following Novorol's experience of working in the UK's NHS as a paediatrician and as a clinical geneticist, where she was seeing patients with rare conditions. 

The team, however, soon identified an opportunity to reach the individual directly. But that required a new approach. “We had to make this switch over from being a very clinically-driven, medical-facing product and also launching an app that’s available to the everyday individual,” the cofounder said.

“About four years ago now, we did a lot of work on how to build an interface that was friendly, yet at the same time authoritative and trustworthy, and using very strong clinically, but at the same time very simple, easy to understand, patient-friendly language.”

At the moment, the company is leading a stream within an initiative from the World Health Organisation on benchmarking AI in healthcare, which looks at AI-powered symptom assessments.

“We have, as part of that group, academics, industry stakeholders, experts, and a lot of other companies working in our space, our competitors, we work closely with them on this topic of what does good look like, how do we measure accuracy and safety, how do we benchmark these products,” Novorol explained.

However, Ada Health hasn’t chosen a “pure machine learning approach”, according to the CMO, with “human experts” playing a key role in ensuring that the app and the information provided is continuously improved, feedback from users is implemented and bias prevented “from the ground up”. 

Expanding with the user in mind

Now, their app is available in a variety of languages, including Portuguese, Spanish, and, most recently, Swahili, following a partnership with Fondation Botnar. This was prompted by the team finding that individuals were more likely to use the tool again if it was available in their own language.

But ensuring that services are tailored to the needs of users is not just about that. “It’s making sure that we’re adapting for local conditions, prevalences of diseases in that [specific] country, then cultural nuances, how you interact with an individual,” Novorol said. “We work with doctors (…), local clinicians trained in that language.”

A “much more personalised approach” to finding information

As companies like Ada Health continue to expand, many have been left wondering where this type of digital health tools fit into the wider healthcare system. Novorol cautioned that their app should be seen as the “first port of call”, and not a GP replacement. That is because it does not provide a diagnosis or a single condition as the cause of symptoms that someone may experience, but instead offers a range of possibilities and guides the user to seek appropriate care.

“What’s very important for us is being very clear about what Ada does and doesn’t do, being very clear about the promise and not overpromising,” Novorol told the audience at Slush. “The combination of Ada and doctor is powerful.”