Avatars, Trust, and the Future of Virtual Healthcare
Imagine logging into a virtual hospital from your living room. Before you see a doctor, you design an avatar—choosing your hair, face, and clothes. It feels small, even cosmetic. But according to new research, that moment may determine whether you trust the system enough to use it again.
As health systems face workforce shortages, aging populations, and post-COVID care backlogs, virtual hospitals—immersive, metaverse-enabled care platforms—are being pitched as part of the solution. Yet adoption has been uneven. Technology alone isn’t enough. What matters, this study shows, is how human these systems feel.
A 2025 study published in Frontiers in Public Health asks a simple but powerful question: What psychological factors actually drive people to use virtual hospitals? The answer centers on avatars, social presence, and digital health skills.
The Problem: Virtual Care Scales Faster Than Trust
Virtual hospitals can deliver hospital-level care remotely, reducing strain on physical facilities and clinicians. Countries including the U.S., Australia, and the U.K. are already piloting them.
But many users remain hesitant. Traditional evaluations focus on infrastructure, clinical outcomes, or cost savings. What’s often missing is the user experience—especially whether patients feel seen, understood, and socially connected in a digital space.
Assumption: If the technology works, people will use it.
Evidence suggests: People use virtual hospitals when they feel present and competent inside them.
The Study in Brief (Plain-Language Version)
Researchers ran an online experiment with 415 adults who explored a simulated virtual hospital. Participants customized an avatar, navigated hospital spaces, and completed a mock consultation.
The study tested four connected ideas:
- Avatar customization – How much control users have over their digital self
- Avatar identification – Whether users feel the avatar represents them
- Social presence – Whether the experience feels warm, human, and interactive
- eHealth literacy – Users’ confidence finding and using digital health information
The main outcome: intention to use a virtual hospital in the future.
What the Evidence Shows
1. Avatar customization directly increases adoption
People were more willing to use virtual hospitals when they could personalize their avatars. This wasn’t about aesthetics—it was about ownership and engagement.
2. Identification comes first, presence comes next
Customization worked through a chain reaction:
Customization → Identification → Social Presence → Use
When users felt their avatar was “me,” they felt more socially present—more like they were really there with others. That sense of presence strongly predicted willingness to use virtual hospitals again.
3. Digital skills amplify the effect
Here’s the twist: social presence mattered much more for people with higher eHealth literacy.
Users who knew how to evaluate online health information, navigate systems, and make digital decisions translated social connection into trust and intention. Those with lower eHealth literacy didn’t benefit as much—even when the environment felt human.
What This Means in Practice
For public health agencies
- Treat avatar design as core infrastructure, not decoration
- Pair virtual hospital rollouts with eHealth literacy supports
For health systems and NGOs
- Build onboarding that explains how to use virtual care, not just where to click
- Use avatars to reinforce dignity, identity, and trust—especially for remote patients
For community-based programs
- Expect uneven adoption where digital literacy is low
- Invest in training that builds confidence before launching immersive tools
Barriers and Real-World Constraints
- Digital inequities: Older adults and marginalized groups may benefit least without support
- Workforce readiness: Staff must learn to communicate through avatars, not just screens
- Policy gaps: Reimbursement and privacy frameworks lag behind immersive care models
Virtual hospitals risk becoming “high-tech, low-trust” systems if these barriers are ignored.
What’s Next for Research and Policy
The study raises important open questions:
- Will these effects hold in older or less tech-savvy populations?
- How do different avatar styles (realistic vs. cartoon) affect trust?
- Can boosting eHealth literacy increase the return on digital infrastructure investments?
Long-term studies are especially needed to see whether early trust leads to sustained use and better health outcomes.
Conversation Starters
- How might your organization support eHealth literacy alongside virtual care?
- Where could avatar-based design unintentionally exclude certain communities?
- Does this challenge how you’ve thought about “user-friendly” health technology?
Bottom Line
Virtual hospitals don’t succeed because they are advanced. They succeed when they feel human—and when people know how to use them. Designing for presence without building digital skills risks leaving the most vulnerable users behind.
