🧠 From Static Scripts to Living Systems: Why Our Future Health Depends on Letting Go of the Past

Building the future doesn’t mean discarding the past. It means daring to evolve what we once needed into what we now deserve.

This afternoon, I sat alone in a room with senior leaders at the World Health Organization. No slides. No tech. Just an honest conversation about digital health, equity, and the future of tobacco cessation.

As I walked out, one word kept ringing in my head:

Florence.

The WHO’s virtual health worker.

Launched in 2020, mid-pandemic.

Built to reach people when in-person services vanished overnight.

Florence was more than a digital tool.

She was a statement of urgency and humanity — an avatar created in record time to support millions trying to quit smoking, stay safe, and access care from anywhere.

Let me be clear: Florence was absolutely the right innovation for that moment.

She did what no call center could.

She scaled empathy when clinics shut down.

She spoke six languages and reached 49 countries.

She offered evidence-based help in a world gripped by uncertainty.

But now, in 2025, we stand at another inflection point.

And the question isn’t whether Florence was good.

It’s whether we’re brave enough to build what comes next.

⏳ Good Isn’t Static

Florence was a first-generation solution in a zero-time environment. She was designed around rule-based logic, pre-scripted dialogue trees, and finite-state interactions. She could guide, but not grow with the user.

That model worked — until it didn’t.

Because addiction isn’t linear.

Behavior change isn’t a checklist.

And empathy can’t be hardcoded.

We now have tools that can listen, adapt, retain memory, and hold space for relapse and readiness. Tools that don’t just deliver information — but deliver transformation.

It’s time to evolve from static scripts to living systems.

🤖 Enter TAMI: GenAI for Human Behavior

At Open Health Network, we’ve partnered with UCSF to develop TAMI — a GenAI-powered health companion trained in motivational interviewing. TAMI is not just a “chatbot with feelings.” She’s an intelligent system that can:

• Detect readiness to quit

• Mirror ambivalence without judgment

• Nudge at the right moment

• Celebrate small wins

• Adapt to cultural nuance

• Speak across channels, including WhatsApp, SMS, voice, and low-data web

She remembers yesterday. She’s present today. She’s ready for tomorrow.

🌐 A Global Future Demands a GenAI Upgrade

When Florence launched, she reached people in 49 countries — but not one survey respondent came from a low-income nation. Not because the intent wasn’t there — but because tech that looks global isn’t always designed to be accessible.

The next generation of health AI must:

• Be offline-ready

• Run on feature phones

• Speak local dialects, not just “approved languages”

• Understand context, not just keywords

GenAI is the first technology that can truly do this — if we build it intentionally.

💡 Why I’m Optimistic

The very fact that WHO launched Florence proves this:

They get it.

They understood — before most institutions did — that behavioral health at scale requires empathetic, intelligent, digital systems.

And based on my conversation today, it’s clear they understand what comes next. They know the future isn’t CGI and scripts. It’s adaptive, relational, evidence-based companions that can evolve with the science, the user, and the world.

That’s why I’m hopeful.

Not because Florence was perfect.

But because her existence means we’ve already started the journey.

Now, we just need to keep walking.

🧭 From Florence to TAMI: A Continuum, Not a Rejection

This isn’t about replacing Florence.

It’s about honoring her role as a bridge to what’s possible.

She showed us people will talk to a virtual health worker.

TAMI shows us people will keep coming back if it listens, adapts, and grows with them.

Behavioral change doesn’t happen in one conversation.

Neither should health tech.

🚀 Closing Thought

Florence helped in crisis.

TAMI is here for continuity.

We don’t need to burn down yesterday to build tomorrow.

We just need to keep evolving — bravely, intelligently, and globally.

If you’re working at the intersection of AI, health, and behavior change — especially in underserved communities — let’s connect. The future of digital health is not a question of tools. It’s a question of courage.