Summary

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AI created for women’s health can revolutionize the way women connect and engage with health information and resources. This white paper explores unique applications of generative AI to reduce long-standing gender gaps in health care, improve access to vital health resources, and alleviate factors that contribute to poor women’s health outcomes

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Introduction

As we look to the future of health, AI is positioned as a force for change, poised to revolutionize diagnostics and personalized medicine. However, a pivotal question arises: where does AI stand in shaping the future of women’s health? To unlock its full potential for women, we must navigate two critical terrains- the realm of precise and comprehensive data and the role of women in building AI technology. The current deficit in the medical community regarding such data on women’s health is glaring. Until 1993, women were excluded from clinical trials, and even today, the analysis of this data by sex is lagging behind, with only about 34% of studies across healthcare conditions delving into sex-specific insights.

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The data is not limited to sex differences in clinical conditions. The experience of being a woman encompasses a range of complex issues. This includes the subtle yet significant impact of medical gaslighting, the considerable expenses incurred by women seeking health information and services, and the avenues women explore for information and support when their healthcare providers fail to listen. Together, these elements weave a detailed tapestry of data, highlighting the multifaceted nature of women's experiences. Yet, the complex scenario is further complicated by a significant obstacle: the historical exclusion of women in the development and application of new technologies. The predominantly male demographic among developers introduces the risk of internalized biases embedded into the technology, making it challenging to apply AI methodologies to advance women’s health.  Lisa Burton O’Toole, PhD, data scientist, and HearstLab VP says, “There are so often biases baked into the training data used for Generative AI tools. Having diverse teams building and testing Generative AI tools is critical, as these teams are more likely to recognize and address biases. This is doubly true when the Generative AI tools are intended for end users typically underrepresented in those training data sets, such as women.”  

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In this white paper, we explore what is needed to build AI for women drawing insights from various sources. We delve into the landscape of women's health, highlighting current challenges, the imperative for new treatment models with AI integration, and the alarming maternal mortality rate in the United States. This paper provides an in-depth exploration of the capabilities of generative AI, outlining how AI can be tailored to individual needs, improving accessibility, and positively impacting women’s health outcomes.

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In the realm of improving access to vital health resources, we discuss how AI chatbots contribute to enhancing accessibility to crucial health information. Addressing disparities in healthcare access and promoting inclusivity are central themes, positioning AI chatbots as pivotal tools in bridging gaps and ensuring equitable health resources for women.

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The Landscape of Women's Health 

 

Women's health covers the medical and healthcare aspects specific to women, addressing issues such as reproductive health, gynecology, maternal well-being, and conditions unique or more prevalent in women. It aims to ensure the overall health and well-being of women across their lifespan. Women constitute half of the global population and influence 80 percent of consumer purchasing decisions in the healthcare industry, have seen their health marginalized despite being primary healthcare decision-makers for their families. In the United States, women experience the highest rates of avoidable deaths compared to those in other affluent nations, particularly concerning pregnancy complications, with nearly 200 in 100,000 deaths being preventable. This alarming statistic underscores potential deficiencies in public health and healthcare delivery systems, emphasizing the urgent need for improved primary and preventive health services like cancer screenings, immunizations, and postpartum care for up to a year to curtail premature and unnecessary deaths. Additionally, women in the U.S. grapple with elevated out-of-pocket healthcare expenses, with over a quarter reporting annual family costs surpassing $2,000, even with insurance coverage.

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However, this reality is beginning to evolve. The women's health market has witnessed substantial growth, reaching an estimated total value of nearly $41.5 billion in 2022, and is projected to experience a compound annual growth rate exceeding 5 percent from 2023 through 2030. In the United States, the emphasis on improving healthcare quality, enhancing access, and narrowing health equity gaps, along with a shift toward value-based care by both government and private payers, is driving increased demand to address funding and research gaps. This positive shift aligns with an increased focus on evidence-based research and public discourse surrounding health issues that disproportionately impact women, attracting substantial investments in women's health globally from clinical, financial, and political entities.

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As healthcare shifts, a new market and focus on women's health emerges. This evolution presents new opportunities for innovation and growth. Over the last few years, many new companies have joined the women's health sector and growth has been observed not only in the fertility and menopause market but also in complementary services throughout the continuum of care.  Liz Euglow, Director of Wellbeing at Alera Group, says: It’s critical that every individual, regardless of role and placement within our society, be thinking about women’s health as something we need to address. Whether it’s a manager having an honest, destigmatized conversation with a colleague around their mental health, a politician funding or lobbying for women’s health rights, or an employer creating a greater benefits ecosystem and improved access to support women’s health through vendors and technology, there is something we can each be doing. This is why at Alera Group we are committed to being continuously curious around women’s health, intently listening for where the needs are and providing our employer clients with the data, knowledge, and information they require to build impactful women’s health benefit programs.” This evolving landscape in women’s health not only presents exciting opportunities for innovation but also underscores the importance of addressing untreated maternal and women's mental health as a significant risk for mortality. In the pursuit of comprehensive care in women's health, it becomes essential to consider and enhance mental health aspects alongside advancements in fertility and related services.

 

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Addressing Mental Health in Maternity Care

 

According to the 2017-2019 Maternal Mortality Review Committees, over 80% of pregnancy-related deaths were preventable. The primary cause of maternal mortality is mental health disorders, including suicide and overdose, accounting for nearly 23% of pregnancy-related deaths. This surpasses the mortality rate attributed to hypertensive crises like preeclampsia which stands at 7%. It is important to note that the United States is the only high-income nation experiencing a rising maternal mortality rate.

Eight in ten postpartum women experience some form of the baby blues, with Anxiety disorders and posttraumatic stress disorder (PTSD) affecting approximately 30% and 15% of perinatal and postpartum women specifically. Moreover, research indicates that up to one-fifth of women screening positive for postpartum depression may have bipolar disorder. Identifying bipolar disorder is crucial due to variations in its treatment compared to depression. Substance use is also a prevalent issue during and after pregnancy, significantly contributing to maternal mortality.

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Approximately 62 million American women of birthing age, constituting 96% of the potential perinatal population, reside in maternal mental health professional shortage areas. To address this gap, an estimated 13,885 providers are required nationwide. The Policy Center for Maternal Mental Health created a system for risk assessment utilizing census data and factors like intimate partner violence and poor mental health days. The resources encompass perinatal mental health certified (PMH-C) providers and psychiatrists with a focus in maternal mental health. The assessment revealed that 70% of U.S. counties lack sufficient resources for their perinatal populations, with nearly 700 counties exhibiting unacceptable maternal mental health risk scores. In Texas alone, approximately 43% of women giving birth live in high-risk counties. 

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A recent study looked at the estimated economic impact of untreated maternal mental health conditions (MMHCs) in Texas. They identified that Maternal Mental Health Conditions impacted 13.2% of mothers in Texas, but only 40% of those diagnosed were adequately treated. MMHCs, when left untreated, can become a multigenerational issue. Additionally, the study found that untreated MMHCs cost $2.2 billion for mothers and children born in 2019. This assessment covered the period from conception through five years postpartum. For mothers enrolled in Texas' Medicaid for Pregnant Women, the prevalence of MMHCs was 17.2%, incurring costs of $962 million.

 

Furthermore, we observed significant variations in the prevalence and costs of MMHCs among women of different races and ethnicities. The majority of these costs were borne by employers and healthcare payers, including Medicaid. In their conceptual framework, they discovered that untreated Maternal Mental Health Conditions (MMHCs) contribute to elevated rates of work absenteeism, reduced labor force participation, a higher likelihood of suicide, an increased risk of deteriorating maternal health leading to income loss, and diminished economic contributions.

 

For the children of mothers with untreated MMHCs, there is a heightened risk of low birth weight or preterm birth, a lower likelihood of being breastfed, an increased risk of sudden infant death syndrome, a greater risk of behavior and developmental disorders, an increased likelihood of compromised child health leading to heightened use of public sector services, and escalated healthcare costs.

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Bringing together leaders from various sectors, including healthcare, government, insurers, and mothers with lived experience, who delve into the root causes of poor maternal mental health outcomes can foster collaboration and strategic planning to tailor solutions to the unique challenges of women. Mandatory coverage of comprehensive maternity services by health plans and insurers to include group maternity care programs, certified birth doulas, postpartum doulas, and home health nursing care, along with enforcing coverage through Medicaid and commercial insurers, can ensure that mothers receive support throughout pregnancy, labor, delivery, and the postpartum period. In light of these concerning statistics, the natural question arises: in the face of such a massive and complex problem, what accessible and scalable solutions can be implemented? This is where Artificial Intelligence steps in.

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Conversational AI: A Solution Framework 

 

The terms chatbot and AI assistant are often used interchangeably, leading to potential confusion. While these terms are closely related, subtle distinctions highlight important differences in their capabilities. A chatbot is a broad, inclusive term encompassing any software simulating human conversation. This can range from traditional decision tree-style navigation to cutting-edge conversational AI, and chatbots are found across various communication channels such as phone trees, social media, apps, and websites.

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AI assistants, on the other hand, employ a range of AI technologies, including machine learning for optimizing responses, generative AI, natural language processing (NLP), and natural language understanding (NLU) for accurately interpreting user queries. Deep learning enables AI assistants to improve accuracy over time, allowing for more natural, free-flowing interactions without misunderstandings. 

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AI assistants represent a further evolution of AI chatbot software. They not only use conversational AI and deep learning for self-improvement but often integrate robotic process automation (RPA) into a unified interface. This enables virtual agents to directly act upon the user's intent without requiring additional human intervention. 

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To illustrate these distinctions, consider a user inquiring about tomorrow's weather. A traditional chatbot may respond to the specific phrase "tell me the weather forecast." An AI chatbot can understand a more casual question like "what’s tomorrow’s weather looking like?" An AI assistant goes a step further, not only predicting rain but also offering to set an earlier alarm to accommodate potential rain delays in the morning commute.

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AI assistants could reshape the landscape of healthcare services if leveraged to analyze extensive datasets, identify patterns, and offer education with empathy. AI-powered virtual health assistants efficiently handle routine tasks, allowing skilled medical professionals to focus on more complex responsibilities aligned with their training. 

The role of AI health assistants involves posing straightforward questions to users, such as inquiring about symptoms like fever, cold, or body ache, and assessing the duration of these symptoms. Analyzing user inputs, the virtual assistant then delivers solutions through voice or text, which may include recommendations for rest, scheduling doctor's appointments, or suggesting emergency care. While virtual assistants in healthcare are currently in the early stages, they are anticipated to experience significant growth by 2029. 

 

According to a report from Global Virtual Assistants in Healthcare Market – Analysis and Forecast, 2019-2029, the revenue for the medical virtual assistant market is projected to exhibit a compound annual growth rate of 26.29% between 2019 and 2029. AI is perceived as a catalyst for enhancing various facets of healthcare operations and delivery. The potential cost savings attributed to AI applications stand out as a compelling incentive for their widespread adoption within the healthcare system. Projections indicate that AI applications have the capacity to significantly reduce annual healthcare expenditures in the United States, with an estimated cost savings of USD 150 billion anticipated by 2026.

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While women’s health research lacks funding, AI has the potential to close the long-standing gender gap in research and transform how health care is delivered by making it more efficient and personalized. In healthcare, the AI technologies that prove most valuable encompass machine learning, natural language processing, rule-based expert systems, physical robots, and robotic process automation. Machine learning, for instance, can be applied to generate real-time predictions regarding the necessity for induction or even cesarean birth. 

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Russell Foltz-Smith, AI Entrepreneur and OpenAI Dev Ambassador and Microsoft MVP says, “No doubt the analytic capability of AI will continue at breakneck pace, as determined by the investments and ambitions of capital markets and technologists.  However the basic accessibility of such capability remains the greatest impediment to widespread societal improvements that AI could bring. ‘Conversation as UI’ is as dramatic and necessary a shift in usability as search engines were to making the internet consumable by the masses. Investment needs to increase in UX work, particularly in user groups considered last in every tech hype cycle.” 

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AI can play a pivotal role in enhancing women's health. Personalized communication, made possible through AI, facilitates the analysis of vast datasets, providing tailored insights and recommendations. This could involve a pregnant individual receiving tailored mental health support through virtual platforms, ensuring timely interventions to prevent or address issues related to suicide or overdose. In doing so, AI not only contributes to improved maternal mental health outcomes but also fuels advancements in the broader female technology sector.

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In the realm of conversational AI and its applications in women’s health, the significance of female creators cannot be overstated. Female-led innovation has proven to be a driving force in creating solutions that cater to the unique needs of women. Studies reveal that startups founded and led by women are more successful, generating higher returns on investment. Furthermore, organizations with women in decision-making roles exhibit improved performance and financial outcomes. To truly transform the status of women’s health and bridge existing gaps, it is crucial to empower female developers, fostering an environment where their expertise and insights can drive innovation, empathy, and equity in AI-powered solutions.

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To truly transform the status of women’s health and bridge existing gaps, it is crucial to empower female developers, fostering an environment where their expertise and insights can drive innovation, empathy, and equity in AI-powered solutions. According to Lucia Abelenda, lead developer at Ema, a conversational AI assistant trained on women’s health information, “AI will inevitably be subject to the biases of their human creators, so diversity in the engineering team behind every product becomes vital. Women have unique health needs and experiences that may not be fully understood or might be overlooked by male-dominated development teams.” 

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As we navigate the flaws and limitations within the healthcare system, the transformative potential of AI becomes increasingly apparent. It empowers individuals to be proactive about their health, fostering a sense of responsibility and encouraging informed decision-making even before stepping into a doctor's office. Lucia Abelenda, lead developer at Ema says, “Medicine can be subjective, with varying opinions from one doctor to another. Without the right information and support, making decisions can feel overwhelming. That's exactly what Ema is all about: contributing to a future where women's health and well-being is prioritized, understood, and improved through technology, and I'm excited to play a role.” Embracing AI in women's health opens up new avenues for personalized care, ensuring that the unique needs and experiences of women are not only acknowledged but also prioritized in the pursuit of overall well-being.

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Improving Access to Vital Health Resources

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Improving access to vital health resources is paramount for promoting and safeguarding women's health on multiple fronts. Enhanced accessibility ensures that women can readily obtain timely and accurate information about their well-being, enabling informed decision-making regarding their health. With easier access to essential health resources, women can engage in proactive health management, leading to early detection and prevention of potential health issues. 

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According to the Center for Healthcare Strategies, 36% of adults in the United States have low health literacy and use more healthcare services than those with higher literacy. The rates are higher among marginalized and underserved populations, emphasizing the need to tackle healthcare disparities and advocate for inclusivity in delivering essential health information and services. IBM Watson is actively involved in research related to diabetes management, advanced cancer care, and drug discovery. Despite these efforts, it has not yet demonstrated clear clinical benefits for patients.  Kaushee Ganeshan, the Founder & CEO Health AI Insights, says, “Inclusivity in AI means more than equal opportunity; it's about crafting health technologies that truly understand women's needs.”

 

By prioritizing patient needs and dismantling barriers to entry—be they geographical, socioeconomic, or informational—AI enhances access, empowering women to seize control of their health. This approach encourages a proactive and preventative mindset, ultimately contributing to overall well-being and the reduction of health inequalities. 

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For instance, Nurx, a birth control platform, employs AI algorithms in its "smart questionnaire" feature to identify the most suitable birth control options. As users complete the online questionnaire for a prescription, the platform utilizes AI to analyze their medical history, behaviors, and preferences, offering personalized recommendations for the most effective birth control choices.

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As AI redefines the panorama of women's health, this synergy finds its most vivid expression in Ema, a conversational AI assistant designed by women, explicitly for women. Ema taps into precise and comprehensive data on women's health. It draws upon the expertise of female engineers and healthcare providers, playing a pivotal role in shaping AI technology tailored to the unique needs of women. Beyond its role as an AI assistant, Ema functions as an exclusive API integrated into other companies' tech stacks, providing empowerment to women and mothers through the delivery of education, support, and guidance via proprietary generative AI models.

 

Ema is designed to improve health management by leveraging the power of conversation, memory, and data prediction. Using advanced algorithms and machine learning, Ema is able to analyze vast amounts of health-related data to create personalized predictions for each individual. Ema seamlessly integrates into the company's tech stack, considering an individual's health history, lifestyle, and pertinent factors. Within the broader tech infrastructure, Ema utilizes this information to predict potential health issues and offer recommendations aligned with the company's mission and goals to enhance women's health. 

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Dr. Karoline Hilu, MD and MBA with HearstLab Entrepreneur in Residence says, “With clinician oversight, generative AI like Ema can provide critical missing support, education, and triage for women and their families. These day to day topics too often fall through the cracks or are too uncomfortable to ask. Ema is solving a key gap in the market.” 

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One example of this is in collaboration with a perinatal therapist practice. Ema conducts depression screenings and introduces bite-sized therapy content. This service is designed for those who may be unable to afford traditional therapy costs or simply prefer a more flexible approach to support during challenging times. This service aligns with the company's mission to enhance women's health and improve access to care. Ema serves as a valuable lactation support tool for another company specializing in the sale of baby bottles designed to replicate the natural flow of mother's milk. Through this collaboration, Ema enhances the lactation support experience, providing detailed guidance and assistance to mothers in need.

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Conclusion

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As we gaze into the future of healthcare, the transformative potential of AI, becomes increasingly evident. To fully unleash its benefits for women, we must navigate precise and comprehensive data and the involvement of women in AI technology development. Our exploration extends to the capabilities of generative AI, showcasing how AI assistants can be customized to individual needs, fostering connectivity, improving accessibility, and positively influencing women's health outcomes. The theme of addressing healthcare disparities and promoting inclusivity emerged as central pillars, positioning AI assistants as indispensable tools in bridging gaps and ensuring equitable health resources for women. 

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The collaborative efforts of leaders across diverse sectors, encompassing healthcare, government, insurers, and individuals with lived maternal experiences, hold the potential to address the fundamental factors contributing to unfavorable maternal mental health outcomes. By convening these stakeholders, a shared understanding of the nuanced challenges faced by women can be cultivated, facilitating strategic planning and the development of tailored solutions. A pivotal aspect of comprehensive maternal care involves the integration of generative AI technologies. These innovative tools can augment existing efforts by providing personalized insights, early risk assessments, and targeted interventions to support maternal mental health. By leveraging generative AI, we can scale the precision and effectiveness of interventions, ensuring a more proactive and personalized approach to maternal care.

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