Interesting! I hadn't thought of it in the context of ADHD. For me, a person will always be more effective than an automated reminder. You can dismiss the reminder or ignore it. For a lot of people, lying to another person and saying "I'm working" when actually you're not is a pretty difficult thing to do. Doing the same to yourself or a bot is pretty easy.

In terms of qualifications, I don't think that they're that important. It's more important to find someone who, in pop psychology terminology, has a high EQ. Some people are just good at 'connecting' with a stranger and making them feel good/motivated, and customers will again want to meet deadlines set with someone like this. So yes, you could organize the equivalent yourself through outsourcing, but I reckon some people would use this as a more specialised service where they don't have to explain the role of PA to the person they outsource, and they know that the PA is competent in talking and being encouraging.

To keep people engaged, all the PAs will be really aiming to develop a solid relationship with each customer (I still keep in touch with my editor even though she no longer works at the publishing house). Thus the PAs are definitely going to be a lot more real than any automated solution (although long-term plans would be to partially automate a lot of their work!)

Thanks a lot for the random thoughts - they're really helpful in clarifying my own random thoughts, and I'll probably use some content from your comment to flesh out the FAQ if that's OK :)