Attuning Algorithms: Designing AI for Relational Intelligence for Patient Care
TL;DR
The essay argues for designing the chatbot as a relational intelligence bridge – more than a tool, but deliberately not a person, to analyze how AI can be attuned to the organizational culture of neonatal care, supporting fragile lives, mediating relational and emotional stakes, and complementing clinical judgment without replacing it.
Abstract
This essay – written as a reflexive field report – examines the integration of artificial intelligence (AI) into neonatal intensive care units (NICUs) through PreeMe, a digital health platform grounded in long-term anthropological and epidemiological research on neonatal illness trajectories, parent-infant bonding, and NICU family experiences. In the NICU, premature infants confront physiological fragility while parents navigate radical prognostic uncertainty and profound emotional overwhelm. As PreeMe develops an agentic AI chatbot, a central design question emerges: Should this nonhuman actor be named or personified? To address this, the essay introduces the concept of vi(abilities) to analyze how AI can be attuned to the organizational culture of neonatal care, supporting fragile lives, mediating relational and emotional stakes, and complementing clinical judgment without replacing it. Two additional concepts guide this inquiry: relational ecologies, which frame care as an interconnected system of human interactions critical to survival, and relational return on investment, which revalues affective and relational labor as drivers of both clinical and economic outcomes. The essay argues for designing the chatbot as a relational intelligence bridge – more than a tool, but deliberately not a person.