You turn on your home computer or your handheld device and you see an old friend—a familiar face reminding you to take your medication or your daily walk. Such is the concept created by one Northeastern University professor who intends to bring health care communication and education into your living room—or even your handbag—in an effort to increase fitness and improve chronic disease management and medication adherence.

Timothy Bickmore, Ph.D., an assistant professor of computer and information science at the Boston, Massachusetts, university, has been researching face-to-face interaction and nonverbal cues between health care consumers and providers since working on his dissertation at the Massachusetts Institute of Technology. He became interested in creating a simulated character that could serve as a health educator and advocate for members of the population that needed health or fitness reminders. One particular group that fit the bill was the geriatric population.

“I have done two field studies in physical activity promotion—one with geriatrics that had very little computer experience,” Bickmore explained. “The idea was that everyone knows how to have face-to-face interaction.”

The main question, however, was whether or not everyone knew how to interact with an animated character on a computer screen. In Bickmore’s research, they did.

Bickmore’s studies involved participants at a computer answering multiple choice questions asked by “Laura,” the virtual health coach on the computer screen, and receiving education based on their answers.

“It worked very well,” he said. “The participants were very happy with it and had no problems.”

Additional research funded by the National Library of Medicine involved placing Laura on a personal digital assistant (PDA) to serve as a real-time physical education counselor.

“The PDA has an integrated accelerometer so we can do real-time interventions,” Bickmore explained, encouraging patients to take their walk at a particular time each day.

Bickmore’s technology could also serve as a valuable tool at the bedside. An ongoing study funded by the National Heart, Lung and Blood Institute (NHLBI) at Boston Medical Center involves the provision of bedside education prior to discharge through animated figures named Elizabeth, a Caucasian character, and Louise, an African-American character. Other virtual coaches are in development.

“There are lots of mistakes to be made at discharge and patients often aren’t properly educated,” he added, acknowledging the fact that workforce shortages and time demands often prevent nurses from sitting down for an hour to educate patients upon discharge. “This new study looks at automating the patient education so the hospitals can better use their resources. It’s not trying to replace anyone, but to provide more time for the nurses.”

Bickmore sees his technology serving to help patients manage chronic diseases and adhere to medication instructions, particularly as the technologically savvy baby boomer generation begins to need more medical care. By creating a character with which the consumer can establish trust and a simulated friendship, consumers have a constant reminder to take care of their health.

“The social and emotional aspects are the keys to maintaining the long-term interaction,” Bickmore concluded. “How is it that you keep them engaged? I think it’s by showing appropriate caring and befriending them. It’s the same things people do to make relationships work over time.”