Substance Use Disorder Artificially Intelligent chatbot for screening, assessment & referral: SUD Bot

摘要 阿片类药物的流行被认为是我们#年面临的最严重的公共卫生危机之一。 在美国，甲基苯丙胺等兴奋剂的使用使病情恶化。美国的预防性 服务工作组(USPSTF)建议对不健康的药物使用进行筛查，并附上 提供和转介服务，包括准确的诊断、有效的治疗和 为18岁及以上的人提供适当的药物使用障碍(SUD)护理。自动化 对SUD进行筛查和评估，并消除治疗的污点和其他障碍 提高规模、效率和公平获得紧急医疗服务的机会。而人工智能(AI) 使用自然语言处理(NLP)和机器学习(ML)的聊天机器人越来越多 常见的是，它们(A)缺乏用有说服力的方式模拟社会对话的系统 对激励行动的响应(B)不能与服务交付互操作以链接用户 立即与诊所预约；以及(C)FDA没有根据监管规定批准 完成医疗结果评估的医疗设备。具体到SUD，有一个 迫切需要人工智能聊天机器人，将与SuD护理和资源相关的耻辱降至最低。 在这一阶段，STTR，Clinic Chat，LLC将建立在先前研究的基础上，证明他们的 聊天机器人与Be Well合作，支持更好地获得慢性病药物 德克萨斯州，一家提供SUD服务的公司，用于开发和测试可行性、适航性和 使用下一代AI聊天机器人(称为SUD机器人)来促进访问和 对SUD服务和资源的利用。我们的目标是1：增强现有的诊所聊天人工智能 具有(A)有说服力的SUD筛选和治疗消息和(B)基础设施的聊天机器人 能够模拟人类对话，并可以通过以下方式使用英语和西班牙语 多平台，即文本消息，包括语音和视频；2：构建快速医疗保健 互操作资源(FHIR)链接，允许用户自行安排约会 用于治疗或通过Be Well德克萨斯州内的康复网络获得同伴支持；以及 3：进行测试版测试，以确定启用FHIR的功能和适航性 Sud Bot系统。我们将在三年内招募200名用户使用支持FHIR的SUD Bot系统 长达一周的波动穿插着基于用户反馈的迭代系统改进。 完成此第一阶段研究将生成启用FHIR的最小可生存产品(MVP) 初始功能和导航反馈已准备好用于第二阶段STTR随机临床 试行系统效能测试。我们的目标是拥有一个有效且可扩展的工具，它可以 适用于提供SUD服务的任何组织，并通过收费实现商业化 用于服务或医疗补助/医疗保险报销。

ABSTRACT The opioid epidemic is considered one of the most severe public health crises we are facing in the U.S. and is worsened by use of stimulants such as methamphetamine. The US Preventive Services Task Force (USPSTF) recommends screening for unhealthy drug use accompanied by offers of and referrals to services that include accurate diagnosis, effective treatment and appropriate care of a substance use disorder (SUD) for persons aged 18 and older. Automating screening and assessment for SUD and removing stigmas and other barriers to treatment can improve the scale, efficiency, and equitable access to SUD care. While artificial intelligence (AI) chatbots using natural language processing (NLP) and Machine Learning (ML) are increasingly common, they (a) fall short of systems that mimic social conversations with persuasive responses to motivate action (b) are not interoperable with service delivery to link users immediately with clinic appointments and (c) aren’t FDA approved under mandates to regulate medical devices that complete assessments for medical outcomes. Specific to SUD, there is a compelling need for AI chatbots that minimize stigma associated with SUD care and resources. In this Phase I STTR, Clinic Chat, LLC, will build on prior research showing the success of their chatbots to support improved access to chronic illness medication in partnership with Be Well Texas, a provider of SUD services to develop and beta-test the feasibility, navigability, and acceptability of using a next generation AI chatbot, called SUD Bot, to facilitate access to and utilization of SUD services and resources. We aim to 1: Enhance existing Clinic Chat AI Chatbots with (a) persuasive SUD screening and treatment messaging and (b) infrastructure with capacity to simulate human conversation and be accessible in English and Spanish via multiple platforms, i.e., text messaging, including voice and video; 2: Build fast healthcare interoperative resource (FHIR) linkages that will allow users to self-schedule appointments for treatment or to access peer support through the recovery network within Be Well Texas; and 3: Conduct a beta-test to determine the functionality and navigability of the FHIR-enabled SUD Bot system. We will recruit 200 users to use the FHIR-enabled SUD Bot system in three weeklong waves interspersed with iterative system refinement based on user feedback. Completion of this Phase I study will generate an FHIR-enabled minimum viable product (MVP) with initial functionality and navigability feedback ready for a Phase II STTR randomized clinical trial testing system efficacy. Our goal is to have an effective and scalable tool that can be adapted for use in any organization delivering SUD services and commercialized through fees for service or Medicaid/Medicare reimbursement.