The Impact of AI-Driven Chatbots and Virtual Assistants on Users' Satisfaction and Actual Usage in Digital Healthcare Services

Main Article Content

Latifa Alzahrani

Abstract

The domain of healthcare is undergoing rapid digital transformation, with users increasingly expecting efficient and seamless interactions. AI-powered healthcare chatbots are emerging as key tools in reshaping patient communication and promoting personalised health behaviour goals that align with individual preferences, needs, and constraints. This study draws on four key theoretical models: expectation-confirmation theory, the Technology Acceptance Model, trust theory, and perceived risk. The proposed framework was evaluated using partial least squares structural equation modelling from 434 users in Saudi Arabia. The statistical analysis validates the proposed research framework, which posits that meeting user expectations and ease of use have a strong influence on satisfaction and perceived usefulness. Trust boosts continued use, while perceived risk is surprisingly insignificant. Continuance intention is the strongest predictor of actual chatbot usage behaviour. These results offer valuable insights for healthcare technology developers and providers aiming to improve user adoption of AI-driven healthcare chatbots. The findings suggest that meeting or exceeding user expectations (confirmation) is crucial for satisfaction. Ease of use remains a fundamental requirement for perceived usefulness. Building trust is essential for encouraging continued usage intention. Satisfaction and continuance intention drive actual usage behaviour.

Downloads

Download data is not yet available.

Article Details

Section

Articles

How to Cite

[1]
Latifa Alzahrani , Tran., “The Impact of AI-Driven Chatbots and Virtual Assistants on Users’ Satisfaction and Actual Usage in Digital Healthcare Services”, IJRTE, vol. 14, no. 4, pp. 1–10, Nov. 2025, doi: 10.35940/ijrte.A1130.14041125.
Share |

References

A. Hussain, M. U. Farooq, M. S. Habib, T. Masood, and C. I. Pruncu, "COVID-19 challenges: can Industry 4.0 technologies help with business continuity?" Sustainability, vol. 13, no. 21, p. 11971, 2021. DOI: https://doi.org/10.3390/su132111971

Y. YahiaMarzouk, "Digital transformation in the healthcare sector: a novel strategic perspective," Journal of Health Organization and Management, 2025. DOI: https://doi.org/10.1142/S136391961740014X

P. Kumar, "Large language models (LLMs): survey, technical frameworks, and future challenges," Artificial Intelligence Review, vol. 57, no. 10, p. 260, 2024. DOI: https://doi.org/10.1007/s10462-024-10888-y

S. Paliwal, V. Bharti, and A. K. Mishra, "AI chatbots: Transforming the digital world," Recent trends and advances in artificial intelligence and internet of things, pp. 455-482, 2020. DOI: https://doi.org/10.1007/978-3-030-32644-9_34

A. Casheekar, A. Lahiri, K. Rath, K. S. Prabhakar, and K. Srinivasan, "A contemporary review on chatbots, AI-powered virtual conversational agents, ChatGPT: Applications, open challenges and future research directions," Computer Science Review, vol. 52, p. 100632, 2024.

DOI: https://doi.org/10.1016/j.cosrev.2024.100632

Y. Cheng and H. Jiang, "How do AI-driven chatbots impact user experience? Examining gratifications, perceived privacy risk, satisfaction, loyalty, and continued use," Journal of Broadcasting & Electronic Media, vol. 64, no. 4, pp. 592-614, 2020.

DOI: https://doi.org/10.1080/08838151.2020.1834296

M. Laymouna, Y. Ma, D. Lessard, T. Schuster, K. Engler, and B. Lebouché, "Roles, users, benefits, and limitations of chatbots in health care: rapid review," Journal of Medical Internet Research, vol. 26, p. e56930, 2024. Available at https://preprints.jmir.org/preprint/56930,

C. Stöhr, A. W. Ou, and H. Malmström, "Perceptions and usage of AI chatbots among students in higher education across genders, academic levels and fields of study," Computers and Education: Artificial Intelligence, vol. 7, p. 100259, 2024.

DOI: https://doi.org/10.1016/j.caeai.2024.100259

J. Sidlauskiene, Y. Joye, and V. Auruskeviciene, "AI-based chatbots in conversational commerce and their effects on product and price perceptions," Electronic Markets, vol. 33, no. 1, p. 24, 2023. DOI: https://doi.org/10.1007/s12525-023-00633-8

P. Esmaeilzadeh, M. Maddah, and T. Mirzaei, "Using AI chatbots (eg, CHATGPT) in seeking health-related information online: The case of a common ailment," Computers in Human Behaviour: Artificial Humans, vol. 3, p. 100127, 2025.

DOI: https://doi.org/10.1016/j.chbah.2025.100127

J. N. K. Wah, "Revolutionising e-health: the transformative role of AI-powered hybrid chatbots in healthcare solutions," Frontiers in Public Health, vol. 13, p. 1530799, 2025. DOI: https://doi.org/10.3389/fpubh.2025.1530799

A. Aggarwal, C. C. Tam, D. Wu, X. Li, and S. Qiao, "Artificial intelligence–based chatbots for promoting health behavioural changes: systematic review," Journal of Medical Internet Research, vol. 25, p. e40789, 2023. https://preprints.jmir.org/preprint/40789

A. Parveen and G. Kannan, "Healthcare transformed: a comprehensive survey of artificial intelligence trends in healthcare industries," Digital Healthcare in Asia and Gulf Region for Healthy Ageing and More Inclusive Societies, pp. 395-424, 2024.

DOI: https://doi.org/10.1016/B978-0-443-23637-2.00017-5

J. Zhang, Y. J. Oh, P. Lange, Z. Yu, and Y. Fukuoka, "Artificial intelligence chatbot behaviour change model for designing artificial intelligence chatbots to promote physical activity and a healthy diet," Journal of Medical Internet Research, vol. 22, no. 9, p. e22845, 2020. https://preprints.jmir.org/preprint/22845

G. L. Tortorella, F. S. Fogliatto, D. Tlapa Mendoza, M. Pepper, and D. Capurro, "Digital transformation of health services: a value stream-oriented approach," International Journal of Production Research, vol. 61, no. 6, pp. 1814-1828, 2023.

DOI: https://doi.org/10.1080/00207543.2022.2048115

Z. Rashid, H. Ahmed, N. Nadeem, S. B. Zafar, and M. Z. Yousaf, "The paradigm of digital health: AI applications and transformative trends," Neural Computing and Applications, pp. 1-32, 2025. DOI: https://doi.org/10.1007/s00521-025-11081-0

A. Khamaj, "AI-enhanced chatbot for improving healthcare usability and accessibility for older adults," Alexandria Engineering Journal, vol. 116, pp. 202-213, 2025. DOI: https://doi.org/10.1016/j.aej.2024.12.090

G. Livieri, E. Mangina, E. D. Protopapadakis, and A. G. Panayiotou, "The gaps and challenges in digital health technology use as perceived by patients: a scoping review and narrative meta-synthesis," Frontiers in Digital Health, vol. 7, p. 1474956, 2025.

DOI: https://doi.org/10.3389/fdgth.2025.1474956

L. Laranjo et al., "Conversational agents in healthcare: a systematic review," Journal of the American Medical Informatics Association, vol. 25, no. 9, pp. 1248-1258, 2018. DOI: https://doi.org/10.1093/jamia/ocy072

S. G. Tetteh, L. Azupwah, A. Y. Agyemana, S. K. Adjei, A. P. Twumasi, and S. Mohammed-Nurudeen, "Artificial Intelligence in Healthcare: A Systematic Review of Virtual Healthcare Assistants," Asian Journal of Probability and Statistics, vol. 27, no. 7, pp. 43-62, 2025.

DOI: https://doi.org/10.9734/ajpas/2025/v27i7776

L. Liu and V. G. Duffy, "Exploring the future development of Artificial Intelligence (AI) applications in chatbots: a bibliometric analysis," International Journal of Social Robotics, vol. 15, no. 5, pp. 703-716, 2023. DOI: https://doi.org/10.1007/s12369-022-00956-0

M. Pan et al., "Application of artificial intelligence in the health management of chronic disease: bibliometric analysis," Frontiers in Medicine, vol. 11, p. 1506641, 2025. DOI: https://doi.org/10.3389/fmed.2024.1506641

M.-T. Ho, N.-T. B. Le, P. Mantello, M.-T. Ho, and N. Ghotbi, "Understanding the acceptance of emotional artificial intelligence in the Japanese healthcare system: a cross-sectional survey of clinic visitors’ attitude," Technology in Society, vol. 72, p. 102166, 2023.

DOI: https://doi.org/10.1016/j.techsoc.2022.102166

E. Di Sutam et al., "A comparative study on user satisfaction from manual to online information system using define-measure-analyse-improve-control (DMAIC) in service administrative process," Journal of Advanced Research Design, vol. 122, no. 1, pp. 27-45, 2024.

DOI: https://doi.org/10.37934/ard.122.1.2745

M. Hussain, A. Javed, S. H. Khan, and M. Yasir, "Pillars of customer retention in the services sector: Understanding the role of relationship marketing, customer satisfaction, and customer loyalty," Journal of the Knowledge Economy, vol. 16, no. 1, pp. 2047-2067, 2025.

DOI: https://doi.org/10.1007/s13132-024-02060-2

P. Iyer, A. Davari, and A. Mukherjee, "Investigating the effectiveness of retailers’ mobile applications in determining customer satisfaction and repatronage intentions? A congruency perspective," Journal of Retailing and Consumer Services, vol. 44, pp. 235-243, 2018.

DOI: https://doi.org/10.1016/j.jretconser.2018.07.017

D. Golinelli, E. Boetto, G. Carullo, A. G. Nuzzolese, M. P. Landini, and M. P. Fantini, "Adoption of digital technologies in health care during the COVID-19 pandemic: systematic review of early scientific literature," Journal of Medical Internet Research, vol. 22, no. 11, p. e22280, 2020. https://preprints.jmir.org/preprint/22280

A. J. Desmal, S. Hamid, M. K. Othman, and A. Zolait, "A user satisfaction model for mobile government services: a literature review," PeerJ Computer Science, vol. 8, p. e1074, 2022. DOI: https://doi.org/10.7717/peerj-cs.1074

L. Alzahrani, "Analyzing Students’ Attitudes and Behavior Toward Artificial Intelligence Technologies in Higher Education," International Journal of Recent Technology and Engineering (IJRTE) 2023. DOI: https://doi.org/10.35940/ijrte.F7475.0311623

Z. Wang, Y. Wang, Y. Zeng, J. Su, and Z. Li, "An investigation into the acceptance of intelligent care systems: an extended technology acceptance model (TAM)," Scientific Reports, vol. 15, no. 1, p. 17912, 2025. DOI: https://doi.org/10.1038/s41598-025-02746-w

O. Saoula et al., "Building e-trust and e-retention in online shopping: the role of website design, reliability and perceived ease of use," Spanish Journal of Marketing-ESIC, vol. 27, no. 2, pp. 178-201, 2023. DOI: https://doi.org/10.1108/SJME-07-2022-0159

A. Alsyouf et al., "The use of a technology acceptance model (TAM) to predict patients’ usage of a personal health record system: the role of security, privacy, and usability," International Journal of Environmental Research and Public Health, vol. 20, no. 2, p. 1347, 2023.

DOI: https://doi.org/10.3390/ijerph20021347

R. K. Kampa, "Combining technology readiness and acceptance model for investigating the acceptance of m-learning in higher education in India," Asian Association of Open Universities Journal, vol. 18, no. 2, pp. 105-120, 2023.DOI: https://doi.org/10.1108/AAOUJ-10-2022-0149

E. Unal and A. M. Uzun, "Understanding university students’ behavioural intention to use Edmodo through the lens of an extended technology acceptance model," British Journal of Educational Technology, vol. 52, no. 2, pp. 619-637, 2021. DOI: https://doi.org/10.1111/bjet.13046

W. Tian, J. Ge, Y. Zhao, and X. Zheng, "AI Chatbots in Chinese higher education: adoption, perception, and influence among graduate students—an integrated analysis utilising UTAUT and ECM models," Frontiers in Psychology, vol. 15, p. 1268549, 2024.

DOI: https://doi.org/10.3389/fpsyg.2024.1268549

Alzahrani, L., Seth, K.P. Factors influencing students’ satisfaction with continuous use of learning management systems during the COVID-19 pandemic: An empirical study. Education Information Technologies, vol. 26, 6787–6805, 2021. DOI: https://doi.org/10.1007/s10639-021-10492-5

Y. Guo, "Digital trust and the reconstruction of trust in the digital society: An integrated model based on trust theory and expectation confirmation theory," Digital Government: Research and Practice, vol. 3, no. 4, pp. 1-19, 2022. DOI: https://doi.org/10.1145/3543860

I. A. Ambalov, "An investigation of technology trust and habit in IT use continuance: a study of a social network," Journal of Systems and Information Technology, vol. 23, no. 1, pp. 53-81, 2021. DOI: https://doi.org/10.1108/JSIT-05-2019-0096

S. Alagarsamy and S. Mehrolia, "Exploring chatbot trust: Antecedents and behavioural outcomes," Heliyon, vol. 9, no. 5, 2023.

DOI: https://doi.org/10.1016/j.heliyon.2023.e16074

O. Schilke and F. Lumineau, "How organisational is interorganizational trust?" Academy of Management Review, no. ja, p. amr. 2022.0040, 2023. DOI: https://doi.org/10.5465/amr.2022.0040

S. Xiao and M. Warkentin, "User experience, satisfaction, and continual usage intention of IT: a replication study in China," AIS Transactions on Replication Research, vol. 7, no. 1, p. 5, 2021. https://aisel.aisnet.org/trr/vol7/iss1/5/

C. Pelau, D.-C. Dabija, and I. Ene, "What makes an AI device human-like? The role of interaction quality, empathy and perceived psychological anthropomorphic characteristics in the acceptance of artificial intelligence in the service industry," Computers in Human Behaviour, vol. 122, p. 106855, 2021. DOI: https://doi.org/10.1016/j.chb.2021.106855

X. Wang and Z. Cheng, "Cross-sectional studies: strengths, weaknesses, and recommendations," Chest, vol. 158, no. 1, pp. S65-S71, 2020.

DOI: https://doi.org/10.1016/j.chest.2020.03.012

B. J. Oates, M. Griffiths, and R. McLean, Researching information systems and computing. Sage, 2022.

M. Nayak and K. Narayan, "Strengths and weaknesses of online surveys," Technology, vol. 6, no. 7, pp. 0837-2405053138, 2019.

DOI: https://doi.org/10.9790/0837-2405053138

G. Cepeda-Carrion, J.-G. Cegarra-Navarro, and V. Cillo, "Tips to use partial least squares structural equation modelling (PLS-SEM) in knowledge management," Journal of Knowledge Management, vol. 23, no. 1, pp. 67-89, 2019. DOI: https://doi.org/10.1108/JKM-05-2018-0322

M. Sarstedt and J.-H. Cheah, "Partial least squares structural equation modelling using SmartPLS: a software review," ed Springer, 2019.

DOI: https://doi.org/10.1057/s41270-019-00058-3

M. Goller and F. Hilkenmeier, "PLS-based structural equation modelling: An alternative approach to estimating complex relationships between unobserved constructs," in Methods for researching professional learning and development: Challenges, applications and empirical illustrations, Springer, 2022, pp. 269-292. DOI: https://doi.org/10.1007/978-3-031-08518-5_12

G. W. Cheung and C. Wang, "Current approaches for assessing convergent and discriminant validity with SEM: Issues and solutions," in Academy of Management Proceedings, vol. 2017, no. 1: Academy of Management, Briarcliff Manor, NY 10510, p. 12706.

DOI: https://doi.org/10.5465/AMBPP.2017.12706abstract

J.-H. Cheah, S. Amaro, and J. L. Roldán, "Multigroup analysis of more than two groups in PLS-SEM: A review, illustration, and recommendations," Journal of Business Research, vol. 156, p. 113539, 2023. DOI: https://doi.org/10.1016/j.jbusres.2022.113539

Most read articles by the same author(s)

<< < 2 3 4 5 6 7 8 9 10 11 > >>