Do-it-yourself (DIY) health is increasingly challenging traditional healthcare models. The most striking example of this is the Open Artificial Pancreas System (OpenAPS). This project uses open source reference implementation to allow Type 1 diabetics to link their glucose monitoring device to their insulin pump. In doing so, the function of the pancreas can be artificially mimicked by providing automated and precise insulin delivery based on the user’s blood glucose levels. Although in isolation the insulin pump and the blood glucose monitoring device are each regulator-approved, there is currently no approved device on the market that provides a closed loop system for insulin delivery. Individuals have therefore taken matters into their own hands to create a DIY solution for glucose regulation that directly links the glucose monitor to the insulin pump. Through the power of open source code this solution has been shared across the diabetic community.
OpenAPs is just one example of growing trend towards DIY health that looks set to bring advancements in medical treatment, diagnosis and monitoring. Embracing this trend will provide health insurers with new opportunities.
Although health insurers would be unable to be associated with and promote unapproved DIY treatments such as OpenAPS, at a more overarching level insurers should not overlook the power of online communities to disrupt conventional medical treatment pathways. Patients are increasingly turning to the internet as a source of medical knowledge. They are seeking to obtain trusted online medical information and guidance that enables them to play a more active role in their treatment decisions. This has the potential to shift the balance in the patient-doctor relationship.
Health insurers could help to satisfy consumer demand for patient-empowerment by building online communities that support their customers in deciding which physicians and treatment pathways will be most suitable for their medical needs. Such a platform could give details on quality of care ratings and geographic convenience of providers. In addition, there could be the opportunity for customer ratings of medical facilities and staff. With health insurers managing the platform, these ratings would be able to be conducted in a more verifiable and trustworthy manner than current rating platforms such as rateMDs. This is because insurers could provide the option to rate a given physician or medical facility only once a customer has attended their appointment or undergone their medical procedure at that facility with that particular physician.
In addition to altering the medical treatment process, DIY health also has the potential to revolutionise medical diagnosis. For example, health tech start-up CliniCloud is providing a connected home medical kit which includes a non-contact thermometer and a digital stethoscope that are controlled via a mobile app. The app allows data to be stored and sent directly to a user’s doctor. In partnership with a virtual GP service, doctors are also able to carry out remote diagnostics by listening to the patient’s heart and lung sounds in real time while the patient remains in the comfort of their own home.
This is only the start of the DIY diagnostics transformation that looks set to take place. The recent Tricorder XPRIZE saw teams competing to develop handheld, portable devices that accurately diagnose 13 health conditions (including anaemia, COPD, diabetes and pneumonia) and capture 5 real-time vital signs (blood pressure, heart rate, oxygen saturation, respiratory rate, temperature) in a household setting. The winning team was awarded $2.6M for their device DxtER. This device is an autonomously functioning AI consumer medical device prototype that in addition to carrying out diagnostics can also share this data with an individual’s healthcare provider.
Such advances in DIY diagnosis have the potential to disrupt traditional health insurance pathways. Some diagnostic tests could be carried out at home through virtual GP consultations. Also, with accurate and verifiable home medical diagnosis kits, the traditional role of the GP as a gatekeeper to more specialised care could be relaxed. Based on AI-derived medical results, direct authorisation for referral to more specialised physicians could be granted by insurers as part of an automated process. For example, if a home medical kit detected early signs of COPD then instead of visiting a GP, customers could be directed straight to a specialist physician for further testing.
In addition to treatment and diagnostics, there is also a growing trend towards DIY health monitoring. Ever since the popularisation of the bathroom scale in the 19th century, many people have tracked their own health on a day-to-day basis. The bathroom scale represents an early form of DIY health technology that has helped to create the 21st century quantified-self movement. As part of the quantified-self movement individuals are using sensors on wearable devices and smartphones to log and monitor their health on an ongoing basis.
Devices that track users’ physical activity and heart rate in real-time are growing in popularity with the wearable tracker market forecast to be worth $6bn by 2020. Widespread adoption of wearable health tech could provide health insurers with a rich source of data on their customers’ activities. Many health insurers are now actively promoting the use of wearable devices amongst their customers. Analysis and insights from quantified-self data could help to streamline the health insurance underwriting process, as well as improve claims forecasting.
There is also the potential for insurers to try to use sensors on wearable devices and smartphones to encourage their customers to take a DIY approach to a healthier lifestyle. Based on the data from their wearable sensors, each customer could receive a personalised mobile app-based diet and exercise plan. Acting as a personalised health and lifestyle coach, the app would be able to provide customers with a structure approach to improve their fitness. This in turn could help to reduce the claims burden for insurers, for example by helping to tackle the growing chronic disease burden.
The way ahead
Advances in DIY health have the potential to improve medical diagnosis, treatment and monitoring. However, the wealth of sensitive health data created by these devices poses a challenge. If health insurers are to leverage customers’ health data to improve the efficiency of their insurance operations and to meet consumer demand for greater empowerment in the healthcare process, then large scale data analysis of real-time health data will be needed. Not only will insurers have to develop the capabilities for this type of data analysis, but data privacy protocols will also need to be reinforced to ensure that sensitive customer information is not divulged. Nevertheless, for health insurers who embrace DIY health initiatives by investing in data protection systems and data analytics platforms that facilitate DIY diagnosis, treatment and monitoring there should be large opportunities for gains in operational efficiency and market share.