Developing a Machine Learning–Based Automated Patient Engagement Estimator for Telehealth: Algorithm Development and Validation Study

Patient engagement has been identified as being important to improve therapeutic alliance. However, limited research has been conducted to measure this in a telehealth setting, where the therapist lacks conventional cues to make a confident assessment. The algorithm developed is an attempt to model person-oriented engagement modeling theories within machine learning frameworks to estimate the level of engagement of the patient accurately and reliably in telehealth. The results are encouraging and emphasize the value of combining psychology and machine learning to understand patient engagement. Further testing in the real-world setting is necessary to fully assess its usefulness in helping therapists gauge patient engagement during online sessions. However, the proposed approach and the creation of the new dataset, MEDICA, open avenues for future research and the development of impactful tools for telehealth.