No one likes talking about the end. But one would conceive that when talking about death humans would naturally favour talking to another human. However, research from last stages of life not-for-profit company Violet Initiative might have found quite the opposite.

The company used “EVE,” a conversational AI tool developed by The Evolved Group, to help people talk about traditionally taboo topics and those they might not feel comfortable discussing.

To find out more about the research, the tech and why humans might find talking to a robot more palatable than a person, WLT sat down with Melissa Reader, Violet Initiative’s CEO for an in-depth chat about uncomfortable conversations.

Can you explain more about the research you have carried out?

Our research entitled Private Thoughts was commissioned with insights technology company The Evolved Group. Our research explored the experiences of 1,025 Australians around death and dying. We used a conversational AI tool ‘EVE,’ developed by The Evolved Group, to delve deeper into respondents’ attitudes and experiences with death and dying, removing the fear of judgement from a human that would normally inhibit truthful and revealing responses.

It’s been fascinating learning about the ways that Conversational AI can help people to talk about taboo topics – in ways they just don’t feel comfortable talking to another person.

Melissa Reader, CEO, Violet Initiative

It seems to suggest safety in anonymity. A highly empathetic, intuitive conversational AI experience can run sentiment analysis over a conversation and respond to people’s emotional readiness. It can detect specific phrasing and language and draw insights from these to guide the conversation. It’s been particularly successful helping people feel seen and heard, and giving them more certainty in times of high emotion and uncertainty.

We are thinking about this deeply as we develop the next range of Violet’s products and services. This approach gives enormous scope for access, scale and personalisation – meeting people where they are, understanding their circumstances and emotional readiness and responding to particular cultural contexts and languages, in a way that a single human could never do. And making this ‘always on’ available 24/7 where, and when people need it. Of course, alongside this, we are appropriately cautious about the ethical governance and ‘guardrails’ that will be essential and we are establishing Expert Advisory Committees, governance processes and guidelines to assist with that.

Through the research with The Evolved Group, we found that over any two-year period, 95 per cent of Australians will have experienced the death of a significant person in the last two years, with over 50 per cent having had a close encounter with death themselves.

Our research exposed a concerning lack of discussion and preparation regarding death and dying and emphasized the cost of doing nothing to make the process of death and dying easier for Australians, their loved ones and health professionals – death has an annual expenditure exceeding $1 billion on our health and economic systems. Current systems are at capacity, and our ageing population means that the number of deaths each year will double by 2040. So, the cost of doing nothing is simply too high.

The research has helped us to shine a light on a whole life stage we don’t acknowledge, plan for or talk about. The last 12 months of a person’s life – the last stage of life is all too often a complex, disorganised, expensive, over-medicalised experience that is full of regrets. Too often, we do too little, too late. So many of the research findings support this.

We’ve done an exceptional job at understanding all of the other life stages – pregnancy, birth, the first 1,000 days, adolescence, marriage, separation, divorce and retirement. Whole service industries have sprung up in service of these life stages, we have social norms and we know how to access support services and how to support each other. There is an absolute void across the last stage of life. We want to change that so that this life stage can be the best it can be for everyone involved.

Our research also highlights the importance of addressing issues in our ageing economy and the need for increased funding to do so. Our over 65s population will double and over 85s triple in mere decades. The consequences of a lack of preparation and funding for the last stage of life include decreased workplace productivity due to unresolved grief, delays in processing deceased estates and insurance claims, aged care workforce burnout, and unplanned hospital admissions, increasing pressure on our already overstretched hospitals. Without addressing these challenges, they will continue to exacerbate over the coming years.

Why do you think people are more likely to open up to an AI tool compared to a human?

I’ve found that people can unknowingly bring preconceptions and biases to conversations. We felt it was really important to offer research respondents a way to open up about death free from those judgements. The conversational AI tool we created with The Evolved Group produced a safe and contained environment where respondents were able to have a conversation without the fear of judgement but still remained highly empathetic.

EVE asks a series of questions and then uses the respondent’s answers to probe more difficult subjects. The tool would always offer support from the Violet Initiative – whether it be our Guided Support service, the opportunity to speak to a volunteer Violet Guide, or providing helpful information – if the conversation became challenging for respondents or triggered a certain emotion.

Tech is sometimes presented as dehumanising, do you think this research shows the opposite? Or, is it more about our application of technology that makes it human?

We genuinely believe there is a sweet spot between the role of technology and human interaction. It all comes down to the design and application of technology. In the past, chatbots have been used in a simplistic way and aren’t equipped to respond to or resolve complex issues. Tonality also isn’t a consideration in a lot of cases, with chatbots unable to emulate the human nature of a conversation. For the Violet Initiative’s research, tonality and pacing were important considerations when we developed the AI tool.

Twelve months ago this just simply wouldn’t have been possible. But the very recent uplift in these empathetic, conversational AI tools has been just remarkable. We’ve been so impressed by what’s possible. By getting these elements right, it feels more human – and respondents felt like it was a trusting space where they were seen and heard – it didn’t feel as though they were conversing with a bot.

Is Australia ready for digital service delivery in healthcare? 

Australia is certainly ready for it. In fact, it’s an absolute necessity to drive access, scale and better outcomes. COVID gave us all the acceleration we needed to adopt telehealth services and we have to continue to build and leverage this adoption, to move forward, quickly.

There is a growing appetite across several industries for the use of emerging technologies, such as AI and there are many examples of evidence supporting this adoption and early expansion.

At the Violet Initiative, technology has been greatly beneficial to those who use our services. We have found that many people look for our services and advice late at night, usually when they’re overwhelmed. They are often caring for someone in the last stage of life and haven’t had the time or privacy to gather the information they need. Being able to use AI tools such as EVE, which can deliver information and advice 24/7, has been really important and helpful.

I think it is important for any digital healthcare service to be delivered in a way that will help rather than hinder it.

What advice would you give to other business leaders approaching tech as a solution?

We are at a point in time where technology simply has to be part of your business’s present, and future. Whether that’s through super-charged service delivery, AI tools or specific products, my instinct is that those businesses that avoid or resist digital transformation will simply be left behind in the next five to 10 years.

We all have an enormous responsibility to use technology with appropriate levels of ethical governance and risk management. If you are not building this into your digital transformation work, you are exposing your business, your customers, your employees and your reputation.

Get the right people around you. We can’t all be experts in these emerging technologies and how they may add value to your business – so my advice would be to spend the time building the right relationships and finding the right Executive roles, or external Advisors – either in Australia or overseas – to connect and oversee all the dots between your strategy and the potential for digital transformation. This can’t be underestimated.