Equinox Consulting

Innovation corner – Digital Health & Insurance: To Prevent is to Conquer!

David Pimentel at 2015-11-12 in Le coin des innovations

This article is part of the creative approach adopted by Equinox-Cognizant: research and design the most promising digital innovations in health insurance.

To view the summary of our perspectives in this area, follow this link!

 

Wake-up call

The supplementary health insurance offering in France has seen very little change on the coverage content, especially so for the private market. Low product differentiation and high interchangeability automatically lead to a price war among insurers.

If the growth of this market is primarily driven by the phasing out of outpatient care from Social Security and the continued increase in healthcare expenses, being able to propose different solutions is an excellent way to capture new market shares. But to enjoy windfall benefits, one must be in the starting blocks.

On your marks, get set, go!

Idea of the day: offer location-based epidemiological alerts

And why not? Imagine that you are about to start your day in a commute-work-sleep pattern when your Smartphone informs you of an upsurge of nasopharyngitis cases around you. It would perhaps be wiser to take the bike today.

Informing and recommending the best procedures could reduce claim rate, especially by implementing an ultra-targeted prevention policy, or even custom-made for your customers.

Let’s go a little further: imagine that the insurer has a telemedicine device capable of supporting the initial cases of illness, or else, directing the insured to the nearest healthcare professional, who is immediately available, and is the cheapest … jackpot!

The role of the insurer is then no longer confined to that of a financial service provider, but extends to that of a protector, and that is THE big difference.

Professional services

Dr. Google

Data is crucial. In the era of Big data and particularly Open data, there is no dearth of data, but it still needs to be accessed and used.

In the context of data mining, in as early as 2008, Google had launched a particularly interesting initiative through its Google Flu Trends service: a tool for predicting and tracking flu and dengue outbreaks across more than 25 countries. What type of data? The search for keywords such as « flu » or « fever », by geographic area.

The initiative was however rejected, for lack of an algorithm which could properly manage the risk overestimation phenomena. In 2013, for example, the media issued an alert on a pandemic flu risk. Result: queries on Google went haywire, making Flu Trends overestimate the event by 50% compared to reality[1].

 »Open SNIIRAM »

If private players like Google are able to provide and process data, most of it is stored mainly on… the National Health Insurance database!

The French health insurance information system [« Système National d’Information Inter-Régimes de l’Assurance Maladie » (SNIIRAM)] has all necessary data to allow the private market to provide such type of new services. Pathologies, locations, prescriptions, fees charged by healthcare providers, in short, everything is right there!

However, Open Data in healthcare is following a slow progress, and has been running into a number of issues for a few years, particularly with regard to respect for private life. If members of the National Assembly voted in favour of more open data on April 11 this year, access mechanisms still seem to be particularly restricted and complicated[2]. It will therefore be necessary to wait before getting a more complete access, as available in Denmark and in the UK.

Conclusion

Although the concept of epidemiological reports is appealing, the difficulty in implementing it lies in using its full potential.

The low availability of qualitative data, and legal impediments with regard to datamining, suggest that it will still be – and unfortunately – a few years before such innovation can be implemented.

Meanwhile, more and more market players are moving in this direction, including the Google secret laboratory: Google X.

On the agenda in the next few months/years: tracker monitoring the heartbeat, level of exposure to light, noise level and skin temperature, or connected lenses.

In short, if playing with data is still a more or less distant idea, development of data gathering tools is for their part in full bloom, and it is perhaps there that the first battle has to be fought.

[1] Source: http://www.tdg.ch/sante/sante/Google-Flu-Trends-vaincu-par-ses-poussees-de-fievre/story/28554893

[2]For more information on this topic: http://blog.econocom.com/blog/opendata-et-sante-la-france-fait-un-nouveau-pas/

 

 

David PIMENTEL  David PIMENTEL

Consultant

Insurance

Source illustration image: Lab on a Chip

Subscribe to our newsletter