Generative AI Simulations: The Future of Patient Experience and Healthcare Innovation

Imagine being able to test drive every important digital healthcare experience before launch. Generative agent simulations are making this a reality, allowing healthcare organizations to understand what resonates with patients and how attitudes shift with different interactions. This technology creates AI-driven “agentic twins” modeled on real individuals, offering a rehearsal for every decision and ultimately simplifying care journeys.

Understanding Generative Agent Simulations

Unlike traditional models that rely on averages, generative agent simulations model individuals, not averages. This allows for a more nuanced understanding of how diverse populations respond to healthcare messaging, workflows, and service designs. Built on data from real people – including interview responses and past choices – these agents act as safe, accurate stand-ins for the individuals they represent.

How CVS Health is Utilizing the Technology

Over the past year, CVS Health has been leveraging generative agent simulations, powered by Simile, to guide decision-making. These simulations are built on a substantial dataset of over 2.9 million consented responses from more than 400,000 participants across 200+ behavioral scenarios.

Key Applications in Healthcare

Generative agent simulations are being used to:

• Uncover friction points across conclude-to-end user journeys.
• Quickly reach populations that are difficult to study.
• Test digital product changes before rollout.
• Benchmark competitive perception across markets.
• Understand the ‘why’ behind behavioral drivers.

Uncovering the ‘Why’ Behind Patient Behavior

Simulations assist uncover the motivations behind consumer preferences, revealing which experience factors matter most to specific patients and when they influence behavior. What previously required weeks of research can now be accomplished in hours, allowing teams to validate findings and prioritize ideas for in-market pilots, accelerating the delivery of better patient experiences.

Accessing Hard-to-Reach Populations

For health-critical or niche needs, such as chronic condition management, simulations allow exploration of sensitive questions that would otherwise be too slow or difficult to field directly. Experts remain involved to interpret the results, ensuring responsible application of the technology.

The Link Between Patient Experience and Health Outcomes

Positive patient experiences are linked to improved health outcomes, including better medication adherence, fewer acute medical events, and increased vaccination rates. Research suggests that understanding the factors influencing a patient’s willingness to stay on medication is crucial for improving outcomes.

Simile’s generative agents have helped identify key priorities like trust in the pharmacy, confidence in medication handling, and convenience. Follow-up “questions” to simulated patients revealed barriers to adherence, such as confusion, anxiety about refills, and past frustrations.

From Insight to Real-World Impact

Simulations complement, but do not replace, real-world research and human judgment. They help prioritize what to test in the market, with experts involved at every stage to monitor tone, fairness, and safety, ensuring insights are actionable and trustworthy. As organizations build from individual insights to broader scenarios, each step contributes to designing experiences that operate in the real world and remain centered on the people they serve.

The Future of Generative AI in Healthcare

Generative AI is poised to transform healthcare engagement, offering a critical extension of the care team and increasing the reach of clinicians and health systems. Generative AI voice agents, in particular, are showing promise in improving communication and personalization. Further advancements in AI-driven workflows are expected to significantly reduce scenario development time and improve the effectiveness of healthcare simulations. Ongoing research is exploring the apply of GenAI to augment simulation experiences in both virtual and physical environments.