Thanks to video games, the idea of talking to a virtual character is commonplace. Whether it’s the onscreen text of early Super Nintendo titles or the fully rendered characters of the Mass Effect series, people have long been able to understand how these features work.

But what if onscreen characters could be used for other applications besides gaming? Kognito is a New York company focused on designing simulations and avatars. These avatars and conversational scenarios are used for applications ranging from medical professional training, helping parents learn how to teach their kids about health and substance issues and veteran care. Check out the video below to see how Kognito’s products work.

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International Business Times spoke with Kognito CEO and co-founder Ron Goldman to learn more about the benefits and future of avatars and virtual conversation.  

IBT: How do Kognito’s simulations work?

Goldman: We are a health simulation company that believes very strongly that conversations are a very powerful tool to help people connect and support each other and drive changes in health behavior. What we do is we really leverage the power of simulation and gaming technology to create these experiences, which are digital experiences, that you can do on your phone or laptop or you can really learn how to lead conversations in real life that can change behavior in a positive way.

The way that we do that is just like everything else that we all learn how to do: We learn how to do it through practice. In our case, if you go into one of our simulations, you would learn how to lead a conversation in real life by having the ability to practice a similar conversation with a virtual, fully animated human that will respond to what you decide to say in the simulation that is coded with their own personality and memory and therefore mimicking real life behavior with you. If you open up one of our simulations, you will be told, just like in other video games, that you are going to play a certain role: You will have a challenge, which can be to talk to a person about a concern that you have about their drinking or you are going to play a doctor and you will need to talk to a patient and communicate bad news to them or talk to them about their dependency on opioids.

You are being told what’s your goal and what is the scenario that you are going to play and then you are presented with this virtual human on the screen with the ability to choose what to tell them. And as you make decisions on what to say, that virtual human will begin to respond to you, both by actually talking back but also moving on the screen. And your challenge is going to be how to continuously figure out what’s the right approach in the conversation to lead them toward your goal, which, depending on the scenario, can be the different things that I mentioned.

[It’s about] how do you really use a conversation as your toolkit to drive changes in behaviors of others, and it’s really based on, just like in other video games where you have different weapons to use to achieve your goal. In our case, the only tool that you have is what you can say, and how you’re going to adjust what you say, and how you approach the conversation depending on the personality of this virtual human and the challenge that they have.

This is literally allowing you to enter this risk-free environment, be presented with a virtual human who is acting as a real person would in a real situation and giving you the ability to say different things and learning by experiencing the consequences of those decisions on what works and what doesn’t work. We give you feedback along the way and there’s a virtual coach that will give you some ideas about what’s working and not working, but it’s really about helping you learn how to harness the power of conversation by actually experiencing it in a virtual space before you go do this in real life.

IBT: What types or groups of users have been responsive to Kognito’s products?

Goldman: We have developed programs that are being used in a number of different areas of health with different groups, from teachers in K-12 to faculty and students in higher ed to doctors and patients to military families, Native American groups. So, we have a very wide experience in a lot of different groups and different age ranges, genders, race, etc.

If you look at the data, there are literally no differences in how effective these experiences are between these different groups. I would say that the traditional thought about ‘this is very game like, so you’re probably getting more of the young audience engaged’ — I would say that’s not necessarily true. We see faculty and teachers and doctors and nurses, as well as older patients gravitating toward it, taking it, enjoying it, learning a lot from it and applying it in real life. This seems to be a fairly universal application based on our experience so far.

IBT: With the growth of programs like telehealth systems [where doctors provide long-distance care digitally], how comfortable do you think patients or individuals will be with primarily virtual experiences?

Goldman: We are not a telehealth platform, but telehealth points out how important conversations are when it comes to health. Health is a very personal thing at the end of the day, and as much as we have a lot of technology being embedded into health with all the apps and all the telehealth platforms and everything around it, at the end of the day, because health is so personal, conversations remain the most powerful and most important element of driving positive health outcomes. At the end of the day, telehealth [and] how effective it’s going to be will depend on how good that physician is in talking with a patient over the video and connecting with them and showing empathy, etc. with that patient.

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And that’s where we come in. We are the company that aims at making sure that all health conversations that occur, whether in person or over a telehealth platform, are done in an effective way. That doctors know how to connect with patients, how to engage them, how to communicate with empathy [and] that the same thing happens in a pharmacist’s conversation or a conversation at school. Because health is not just personal, health does not just happen at the doctor’s office — health is everywhere. It’s at home, it’s at school, it’s at the pharmacy, it’s at the workplace. All these people need to know how to have conversations.

So for me, the trend of telehealth is just one more indication that at the end of the day, it doesn’t matter how much technology we put around us and how addicted we get to the phones. When it comes to health, the ability of everyone involved in health to manage and lead a conversation in an effective way is the most critical part of effective health. We see, therefore, a tremendous opportunity for us as a company that can ensure that everybody involved in these conversations know how to do them well and the best way to learn how to do it is by giving you practice.

None of us learned how to ride the bike by watching a movie of somebody else doing it, we all had to get on the bike. No surgeon learned how to do surgery by watching a movie — they had to actually practice with different simulations and tools and get better and better. The same thing is [applicable] with communication and conversation.

[On virtual humans], there [are] tremendous amounts of research that [have] been done in the past 10 years that show, again and again, how all of us as real people are actually much more comfortable talking with a virtual human or are much more comfortable being honest and revealing about information. We’re much less defensive when it comes to any kind of feedback on our performance or approach, so virtual humans, when they are correctly designed, they are in some cases even more effective than a real person in certain types of conversation with real people. I think that’s why you’re seeing an explosion in the use of virtual agents. It’s not just because it can reduce some costs, but because in certain cases, you can get better information from patients when the virtual human is conducting the interview than when a real person does.

Now again, you have to have the virtual human designed correctly in terms of how they talk and how they move and how real or unreal they look on the screen, so I don’t want to say all virtual humans are equal, because they’re not. There are some great examples that are based on research in neuroscience, etc. and there are some very bad examples of virtual humans out there. But when they’re done well, the research shows that all of us as real people are actually more comfortable in many cases having conversations with these virtual entities than with real people and when it comes to health, that is pretty beneficial.