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February 20, 2026Journal of Medical Internet Research0 citationsOpen Access

Developing a Service Quality Index System for AI Health Care Chatbots: Mixed Methods Study

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YGYu GuXWXinyi Wang

Key Points

  • The aim is to create an index system that evaluates the service quality of AI health care chatbots using the SERVQUAL framework.
  • Compiled an initial indicator pool through literature review and expert consultations.
  • Mapped indicators into 5 domains based on the SERVQUAL framework.
  • Utilized a 2-round Delphi process and a virtual meeting for validation.
  • Determined indicator weights via the analytic hierarchy process.
  • Identified 26 indicators for service quality evaluation.
  • Achieved a 100% response rate in both Delphi rounds.
  • Developed an index system with 5 primary and 17 secondary indicators.
  • Ranked primary indicators by weight: assurance, reliability, human-likeness, tangibility, responsiveness.

Abstract

Background Artificial intelligence (AI) health care chatbots are gaining widespread adoption worldwide. It is imperative to understand the service quality of AI health care chatbots. However, there is limited guidance on how to comprehensively evaluate their service quality. Objective This study aimed to develop an index system based on the SERVQUAL framework for evaluating the service quality of AI health care chatbots. Methods An initial indicator pool was compiled through a comprehensive literature review and consultations with 4 experts. These indicators were mapped and categorized into 5 domains adapted from the SERVQUAL framework. The experts were recruited from hospital, university, and health commission settings by purposive sampling. The service quality index system was identified using a 2-round Delphi process, which included a virtual meeting between the 2 rounds. In the third round, indicator weights within each quality domain and subdomain were determined using the analytic hierarchy process. Results There were 26 indicators identified in the literature, based on which the 2-round Delphi process was conducted. A total of 20 experts were invited. The response rates in both rounds of Delphi and the analytic hierarchy process were 100%, and the authoritative coefficients were both >0.7. The final service quality index system for AI health care chatbots comprises 5 primary indicators and 17 secondary indicators. There were 3 (18%) indicators on assurance, 4 (24%) on reliability, 3 (18%) on human-likeness, 4 (24%) on tangibility, and 3 (18%) on responsiveness. The primary indicators, ranked from highest to lowest weight, were assurance (0.239), reliability (0.237), human-likeness (0.187), tangibility (0.170), and responsiveness (0.167). Conclusions This study pioneers the development of a service quality index system for AI health care chatbots adapted from the SERVQUAL framework. The results provide a validated tool for evaluating the performance of chatbots and offer valuable insights for health service managers and developers to enhance AI-driven medical consultation services.

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Cite This Study

Gu et al. (2026) studied this question.

synapsesocial.com/papers/6997fa12ad1d9b11b3452ff7https://doi.org/10.2196/83051
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