For anyone, a visit to see the doctor can be overwhelming. All the information is a real challenge to remember. On top of that, imagine the visit is for your child who has a rare disease, needs frequent and complicated care, and the doctor is quite far away. These are just some of the challenges that children and caregivers face with Cerebral Palsy and other mobility limiting disabilities. On top of that, if the child is provided a wheelchair, the maintenance can become a headache on it’s own. We are making these problems easier to handle by using chatbots to keep in touch with information and product support. Our recent field trial in Kenya proved that this approach has big potential to change lives. We call our chatbot “Meerkat Bot”.

With Meerkat Bot, we can deliver helpful articles on caregiving for specific conditions, maintenance reminders, instructions on basic repairs, and we can serve complex repair situations. If the wheelchair’s front caster wheel wears out, a common problem, the user can identify the broken part on an image, answer questions to further diagnose the problem, determine if their product is still in warranty, and arrange for the replacement part to be shipped to them for free via Facebook Marketplace. Then, when the part arrives, they receive a video installation tutorial and have access to the troubleshooting database.  Periodically, the parent can answer diagnostic questions that reveal the child has outgrown the chair or something else that requires an in person visit. Peer support for caregivers and users is quite valuable and because Meerkat Bot is embedded in social media, facilitating introductions via groups is easy. All of this is done via the chatbot 24/7. Best of all, we receive periodic surveys users so that we understand their product satisfaction and the impacts the product is having on their health and participation.

“Meerkat Bot allows data based decision making for assistive products like never before. Over time a user’s body changes and this can cause pain from regular use. That and other issues results in a high rate of product abandonment. Regular contact with users will allow for product improvements and easy interventions, such as guiding the user on how to make a small adjustment to better fit their body. Data on these problems has been scarce and difficult to collect. We are encouraged that Meerkat Bot is showing early signs of being part of a solution.” Keoke King, CEO at Participant.

Parents of children with disabilities have a fulltime job of caregiving. Their arms are full, literally. While most kids start walking before they are really heavy, many kids with CP don’t. This means that getting out of the house for daily trips or to appointments with therapists, poses danger of injury to caregivers and the children. A wheelchair is a good solution, but if it develops a problem, the issue may prevent trips out, even important trips to the clinic.

Ideally, a therapist or specialized wheelchair mechanic would offer support. But, with overstretched health care budgets and low population density in many places, this is not practical. Actually, this doesn’t work well even in the best of situations in wealthy countries. 

Product support is a big problem and is even made worse by the COVID-19 pandemic. COVID creates a particularly high risk for children with Cerebral Palsy and similar conditions because they often have compromised respiratory systems. Via Meerkat Bot, caregivers can avoid some doctor visits and the risk of infection to their children. At the same time, Meerkat Bot adds a tool to the telemedicine toolbox and can assist with automation of followup and monitoring functions.

Isolation, stigma, and mobility challenges are frequently hand in hand with disability. These challenges make it difficult to go out. At it's best, social media is an excellent solution for people stuck at home. And, now, social media technology is providing accessible product support and community that is accessible, fun, and rich with good quality information.

A Chatbot is artificial intelligence (AI) software that can simulate a conversation (or a chat) with a user in natural language through messaging applications, websites, mobile apps or through the phone. Meerkat Bot runs on the Facebook Messenger platform, other platforms, and independently via our website.

WHO has identified provision, initial fitting of the wheelchair and ongoing therapy, as a significant barrier. Our founders understand that to see users achieve participation; these problems must get solutions. This is  where the chatbot will help connect the end-user, the therapists and mobility products manufacturers.

Users will need access to repair information and parts. In wealthy countries, vendors provide these services, but often with poor service ratings. Our approach is to leverage technology and avoid the cost and supply chain complexity.

Doctors and therapists can also use chatbot as a tool for providing Telehealth, which would be relatively inexpensive and efficient for both the caregivers and medical practitioners, as opposed to physical clinic visits. 

Meerkat Bot adds value because it keeps products functioning longer, provides quick support and improves user outcomes. Also, it allows data gathering so that all can understand the health and participation outcomes resulting from the products. For instance, the NGOs and foundations that sponsor the provision of devices can easily monitor their impact on their beneficiaries' health because each device serial number will be attached to a chat account. 

Users will also benefit from community building, self-help articles and sharing their experiences with other users like them. This aspect of the community will address challenges of isolation faced by parents of children with disabilities and caregivers of persons with disabilities. 

We already carried out two pilots using similar technology, in January and May 2020, with a partner in Kenya. We stress tested the concept adoption with five women who were very low income earners, with minimal education and low bandwidth devices. The pilot was over two weeks and all participants reported that the conversation was easy and the help was relevant and effective. The User Experience (UX) quality was rated to be good with notes that the bot was fast, cheap to use, reliable, and understandable.

For the pilot, we assembled a large pool of candidates. Some had smartphones which could not support the full Facebook Messenger, which is required for Meerkat Bot. And, others were selected for the pilot. Facebook is reportedly redeveloping Messenger from the ground up so that it is lighter weight and will give all users, regardless of smartphone, the same service level. The second major issue was related to Facebook changing the rules on how chatbots and automated messages can be used. To address this we are moving Meerkat Bot outside of Facebook and into a bot service that can reach users through Messenger’s API or other platforms API. This resolves most of those problems and allows better functionality on our website.

Since the users were from a lower socio-economic background, our pilot proved that this technology has the potential for scale, to give better product support to the underserved. This is encouraging because our vision is to serve a very large customer base and product support for complex wheelchairs is a very expensive responsibility even in the USA, Canada, and other wealthy countries. Developing this system may allow a much better user experience and dramatically lower costs.


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