Internet of Things to come
Experts share with Lauren Haigh the benefits of embracing digital innovation, as well as inherent risks and anticipated future developments
Whether it’s blockchain for fraud detection, Internet of Things-enabled (IoT) medical devices or artificial intelligence (AI) for personalisation, technological innovations are transforming healthcare in far-reaching ways. Electronic medical records (EMR) allow data to be more easily and securely stored and accessed, while telehealth enables healthcare professionals to connect with patients remotely; an advancement that has proven especially beneficial since the emergence of Covid-19. AI-enabled tools can sift through vast swathes of data and obtain important insights, providing personalised experiences for health insurance customers, for example. What is more, AI can expedite lengthy insurance processes such as claims, while chatbots can quickly and effectively respond to customers. Of course, there are risks, such as data breaches and malfunctioning devices. But providing these are adequately mitigated, the potential benefits and opportunities outweigh the possible dangers – and developments in the sector are continuing apace.
ITIJ spoke with Julius Bogdan, Vice President, Analytics, the Healthcare Information and Management Systems Society (HIMSS), who confirmed that AI is being adopted broadly across both healthcare providers and payers. “Some of the early benefits are population health management, better performance, operational efficiency and clinical decision support.” Looking at blockchain, Bogdan said it can assist with a variety of healthcare scenarios: “For example, interoperability, supply chain optimisation, physician credentialing, secure payments, patient consent management, smart contracting and fraud detection.”
Insurer GeoBlue began life as a technology company and is keen to harness this experience in myriad ways. “We take pride in leveraging tech to simplify the international healthcare experience for members,” Lynn Pina, Chief Marketing Officer, explained. “We see technologies like AI as the next natural frontier to explore to fulfil our company purpose. Today, GeoBlue leverages AI in different use cases across our business, mostly in the form of machine learning (ML). We apply it to enhance the customer experience, reduce fraud, increase exposure and drive sales.”
Predictive analysis and fraud detection
Health insurers are embracing these advancements to improve services and mitigate risk. Bogdan said that blockchain can optimise patient data management and reduce regulatory and compliance costs, among other things. “It can also improve interactions and secure payments among healthcare professionals, insurance companies and patients. Data transparency offered by blockchain technology can help solve the issue of multiple intermediaries throughout the life cycle of a policy. Blockchain smart contracts create immutable data based on a policy owner’s record, that can immediately accept or refute any claims made to the company.”
Data transparency offered by blockchain technology can help solve the issue of multiple intermediaries throughout the life cycle of a health insurance policy
William Cooper, Director of expat insurance provider William Russell Europe SRL, highlighted the importance of predictive analysis: “This is perhaps the biggest technological trend being utilised by health insurers and involves calling on advances in data-driven insights and AI to analyse medical records, clinical guidelines and alerts, faster and with greater accuracy. By using an ever-increasing bank of real-world clinical data and removing laborious manual tasks, insurers can use predictive analysis to provide consumers with more customised offers.”
Fraud detection is always a challenge around data, but again, healthtech can help, confirmed Cooper: “Health insurers can better detect fraudulent claims through automated social media analysis and behavioural pattern-based algorithms.” Pina agreed about its versatility: “We leverage ML in different areas of our business – including contact centre and customer feedback platform – for fraud detection and marketing campaigns. Numerous supervised and unsupervised AI models are deployed, that effectively determine what ‘normal’ looks like and identify ‘abnormal’ behaviours. All potential fraud still requires human investigation, but AI can reduce the number of false positives, while also uncovering schemes that wouldn’t otherwise be detected,” she said. “During an investigation, AI can also be deployed for social network analysis, to identify parties that may be conspiring together that would be less clear, even to trained investigators.”
IoT, AI and ML for personalisation
From medical devices to health monitoring, IoT is changing the game. For insurers, this enables the accumulation of vast data banks to protect policyholders. IoT, AI and ML technologies all facilitate personalisation, improving experiences. “IoT is giving health insurers another valuable route to collecting and monitoring patient data for AI and predictive analysis,” confirmed Cooper. “Healthcare devices and wearables, such as smartphones and smart watches, can collect data, while encouraging people to adopt healthy habits. Smart wearables also offer insurers the opportunity to incentivise health and fitness with rewards, building a more holistic, personalised plan for every consumer. The number of connected wearable devices worldwide more than doubled between 2016 and 2019, reaching 722 million. This number is soon expected to exceed one billion.” Insured Nomads is employing AI and ML for personalisation, said COO Brett Estep: “We are currently prioritising gateway technology for product distribution around the globe and increasing the volume of AI and ML capacity, so we can hyper-personalise each customer journey and experience. Gone are the days of simply gathering data and softly pushing it to consumers; it’s how you connect knowledge with what you know about your customer that will translate to pull-ahead moves in the market.” ML also has applications in organising customer feedback, which can help to make improvements, as Pina articulated: “Our third-party customer feedback platform leverages ML to process, structure and categorise. We can quickly see trends and sentiment within the large amounts of comments our customers provide. This data then helps us prioritise and deliver enhancements to improve the experience and/or remove pain points.”
Better health outcomes
AXA Health’s Andy McClure, Marketing & Proposition Director, reiterated how improved health outcomes can be achieved with IoT and ML technologies: “In our Taking Care service, we use IoT wearables and ML modelling to move from emergency response to preventative care for the vulnerable and elderly. Data from a wearable IoT smart device is used to build predictive models. It identifies patterns in behaviours which precede a fall or incident, with intelligence used to provide real-time alerts and preventative advice. And ultimately keep vulnerable and elderly people living more independently. In addition, one of our providers, Check for Cancer, is currently working with IBM. Tens of thousands of skin images are being scanned into software to test for cancer and clear scan images can be quickly detected, enabling patients to have peace of mind sooner.” Bogdan is also aware of AI’s potential: “Organisations can provide more personalised, data-driven care while optimising resource allocation and utilisation, and ultimately driving better patient outcomes.”
Organisations can provide more personalised, data-driven care while optimising resource allocation and utilisation, and ultimately driving better patient outcomes
Estep has seen the great potential of AI in disease diagnosis and treatment: “The comprehensive integration of ML and AI to reduce disease burden by expediting diagnosis and treatment, while merging limitless cloud-based data with new wearable technology to detect, monitor and intervene immediately, will be unprecedented in our sector,” he stated. Bogdan concurs: “AI algorithms can automate inefficient, manual processes and analyse the data, thus speeding up diagnosis and reducing errors. AI can provide near-real-time actionable information to drive significantly better care outcomes and reduce risk.” By partnering with other stakeholders, insurers can take full advantage, as Cooper underlined: “The future is digital, and now for the first time, telehealth technology is enabling insurers to offer on-demand access to quality healthcare anywhere in the world. By forming partnerships with already established telehealth providers, health insurers can give patients round-the-clock access to teleconsultations, e-visits and home monitoring at the touch of a button.”
Covid-19 and healthtech
McClure underlined how the Covid-19 pandemic has accelerated the use of healthtech: “At AXA UK, our Doctor at Hand virtual GP service supplied around 17,000 appointments per month at the start of 2020 and has now reached over 45,000.” Cooper has also witnessed the growth of telehealth services: “Over the course of the Covid-19 pandemic, telehealth services – such as those provided through apps and online hubs – became a necessity, as patients avoided public healthcare settings. Now, the added convenience and accessibility afforded by digital care solutions has turned telehealth into a norm, with data from McKinsey showing the use of telehealth has increased 38 times from pre-Covid levels,” he said. “This is hardly surprising when you consider the benefits to both patients and providers – shorter wait times, less expense, digital on-demand access to solutions and the ability to monitor patients remotely. Moving forward, technology trends anticipate even further investment in telehealth and digital care, enabling patients to choose the home over the hospital, further increasing efficiency and affordability of quality healthcare worldwide.”
Considering the challenges
The number of successful cyber attacks has risen significantly in recent years. For healthcare and insurance providers this risk is arguably even greater
Contemplating the risks associated with technology, Bogdan raised medical error, data disparities and privacy concerns. “Firstly, if an AI system recommends the wrong drug, fails to notice a tumour on a radiological scan, or allocates a hospital bed to one patient over another because it predicted wrongly which individual would benefit more, the patient could be injured. AI systems may suggest a treatment but fail to consider potential unintended consequences, due to structural issues in the model. Secondly, healthcare data is often messy and incomplete. The constant evolution of EMR presents challenges such as distributional shifts that can change data characteristics. Over time, disease patterns change, leading to a disparity between training and operational data. Thirdly, AI requires large data sets to create effective models for prediction, leading to privacy concerns. Another issue arises from the ability of AI models to predict sensitive information about patients.”
Cooper pointed out that cybersecurity is an ever-present concern. “The number of successful cyber attacks has risen significantly in recent years. For healthcare and insurance providers this risk is arguably even greater, due to the personal nature of records being stored,” he said. “Costs associated with ransomware attacks, data breaches and other cybersecurity incidents are huge. Not only can they prevent a business from functioning, but also lead to long-term damage to your business profile and consumer trust. IBM’s ‘Cost of a Data Breach 2022 Report’ quotes the healthcare industry as having the highest average cost to recover from incidents of cybercrime, at more than US$10 million.”
Future innovations
Despite potential risks, the benefits afforded by tech advancements are plentiful. But there’s a long road ahead for insurers, as Estep pointed out: “If the right combination of blockchain capability and AI tech can reduce disease and subsequently drive cost and waste from the system, I would say it has the potential to transform health insurance. But it’s not without headwinds, as I’m sure your readers understand. Transformational change within a dated and allopathic healthcare system will not be easy – and our industry needs to summit a mountain of compliance before we’re back downhill.” Bogdan believes that successful integration necessitates collaboration with diverse stakeholders: “To adopt blockchains and use them to the fullest, a large number of organisations need to be open to cooperating and exchanging data,” he said. “These include providers, pharmaceutical companies, governmental organisations, health insurance organisations, and various intermediaries who are obliged to protect their patient data, and therefore hesitate to freely share information.”
McClure spoke of the significant possibilities; the largest being the opportunity to save lives: “The benefits of tech and AI are huge, helping ensure healthcare is available and affordable and delivers better outcomes, thus reducing morbidity and mortality.” Pina confirmed that GeoBlue will responsibly incorporate ever-evolving technologies: “We continue to look for more ways to deploy them across our business, in a responsible, customer-centric manner.”
As innovation is harnessed, it is not without potential risk. But ultimately, blockchain, AI and IoT are enabling insurers and providers to push the envelope in fraud detection, personalisation and automation, speeding up processes, improving accuracy and driving forward holistic healthcare and insurance. Connected wearable devices and telehealth are two innovations with huge potential, and with the pandemic having accelerated the move to remote care, the convenience of these technologies is obvious. Although there may be resistance in the form of traditional, sometimes outdated processes, together the industry can thrive in new and exciting ways.