A systematic review of chatbots in inclusive healthcare: insights from the last 5 years

Healthcare is one of the most important sectors of our society, and during the COVID-19 pandemic a new challenge emerged—how to support people safely and effectively at home regarding their health-related problems. In this regard chatbots or conversational agents (CAs) play an increasingly important role, and are spreading rapidly. They can enhance not only user interaction by delivering quick feedback or responses, but also hospital management, thanks to several of their features. Considerable research is focused on making CAs more reliable, accurate, and robust. However, a critical aspect of chatbots is how to make them inclusive, in order to effectively support the interaction of users unfamiliar with technology, such as the elderly and people with disabilities. In this study, we investigate the current use of chatbots in healthcare, exploring their evolution over time and their inclusivity. The study was carried out on four digital libraries (ScienceDirect, IEEE Xplore, ACM Digital Library, and Google Scholar) on research articles published in the last 5 years, with a total of 21 articles describing chatbots implemented and actually used in the eHealth clinical area. The results showed a notable improvement in the use of chatbots in the last few years but also highlight some design issues, including poor attention to inclusion. Based on the findings, we recommend a different kind of approach for implementing chatbots with an inclusive accessibility-by-design approach.