Ray-yuan Chung

Ray-Yuan Chung, Athena Ortega, Zixuan Xu et al.

In pediatrics, patients, caregivers, and clinicians share responsibility for health decisions, but limited collaboration can undermine outcomes. We conducted a qualitative study examining decision-makers perceptions toward collaborative decision-making technologies, including interactive dashboards, VR simulators, and AI voice assistants. Findings reveal differences in user opinions across groups and indicate technology acceptance is linked to users trust of these technologies. Technology developers and researchers need to explore design and implementation strategies that build and facilitate trust or appropriate distrust between users and these novel technologies before these tools can effectively support collaborative decision-making.

Ray-Yuan Chung, Xuhai Xu, Ari Pollack

Large language model based health agents are increasingly used by health consumers and clinicians to interpret health information and guide health decisions. However, most AI systems in healthcare operate in siloed configurations, supporting individual users rather than the multi-stakeholder relationships central to healthcare. Such use can fragment understanding and exacerbate misalignment among patients, caregivers, and clinicians. We reframe AI not as a standalone assistant, but as a collaborator embedded within multi-party care interactions. Through a clinically validated fictional pediatric chronic kidney disease case study, we show that breakdowns in adherence stem from fragmented situational awareness and misaligned goals, and that siloed use of general-purpose AI tools does little to address these collaboration gaps. We propose a conceptual framework for designing AI collaborators that surface contextual information, reconcile mental models, and scaffold shared understanding while preserving human decision authority.

Ray-Yuan Chung, Jaime Snyder, Zixuan Xu et al.

In pediatric chronic care, the triadic relationship among patients, caregivers, and healthcare providers introduces unique challenges for youth in managing their conditions. Diverging values, roles, and asymmetrical situational awareness across decision-maker groups often hinder collaboration and affect health outcomes, highlighting the need to support collaborative decision-making. We conducted co-design workshops with 6 youth with chronic kidney disease, 6 caregivers, and 7 healthcare providers to explore how digital technologies can be designed to support collaborative decision-making. Findings identify barriers across all levels of situational awareness, ranging from individual cognitive and emotional constraints, misaligned mental models, to relational conflicts regarding care goals. We propose design implications that support continuous decision-making practice, align mental models, balance caregiver support and youth autonomy development, and surface potential care challenges. This work advances the design of collaborative decision-making technologies that promote shared understanding and empower families in pediatric chronic care.

Feng Chen, Manas Satish Bedmutha, Ray-Yuan Chung et al.

Implicit bias can impede patient-provider interactions and lead to inequities in care. Raising awareness is key to reducing such bias, but its manifestations in the social dynamics of patient-provider communication are difficult to detect. In this study, we used automated speech recognition (ASR) and natural language processing (NLP) to identify social signals in patient-provider interactions. We built an automated pipeline to predict social signals from audio recordings of 782 primary care visits that achieved 90.1% average accuracy across codes, and exhibited fairness in its predictions for white and non-white patients. Applying this pipeline, we identified statistically significant differences in provider communication behavior toward white versus non-white patients. In particular, providers expressed more patient-centered behaviors towards white patients including more warmth, engagement, and attentiveness. Our study underscores the potential of automated tools in identifying subtle communication signals that may be linked with bias and impact healthcare quality and equity.

Feng Chen, Luna Xingyu Li, Ray-Yuan Chung et al.

Digital portals in retirement communities often create physical and cognitive barriers for older adults, leading to digital avoidance. Generative AI offers a solution by enabling natural language interaction, yet its adoption is hindered by the opaque, "Black Box" nature of these systems and lingering usability challenges. To address this, we evaluated a voice-enabled Large Language Model (LLM) chatbot at a continuing care retirement community in the Pacific Northwest. Through a mixed-methods Co-Design and Literacy Workshop (N=25), we applied a "Glass Box" approach combining multimodal accessibility with intentional AI education. The intervention significantly improved participants' technical understanding (p=0.004) and perceived transparency (p=0.001), shifting their interaction model from blind trust to informed reliance prioritizing verifiable evidence. While voice input reduced cognitive load, usability scores dropped significantly for users aged 80 and older (r=-0.50), indicating that truly age-inclusive AI must evolve beyond touch-based interfaces toward zero-touch navigation.

Luna Xingyu Li, Ray-yuan Chung, Feng Chen et al.

Low technology and eHealth literacy among older adults in retirement communities hinder engagement with digital tools. To address this, we designed an LLM-powered chatbot prototype using a human-centered approach for a local retirement community. Through interviews and persona development, we prioritized accessibility and dual functionality: simplifying internal information retrieval and improving technology and eHealth literacy. A pilot trial with residents demonstrated high satisfaction and ease of use, but also identified areas for further improvement. Based on the feedback, we refined the chatbot using GPT-3.5 Turbo and Streamlit. The chatbot employs tailored prompt engineering to deliver concise responses. Accessible features like adjustable font size, interface theme and personalized follow-up responses were implemented. Future steps include enabling voice-to-text function and longitudinal intervention studies. Together, our results highlight the potential of LLM-driven chatbots to empower older adults through accessible, personalized interactions, bridging literacy gaps in retirement communities.