Tag Archives: mHealth

How Telehealth Changes Senior Care

Many baby boomers would be willing to give virtual healthcare a try, but they want to be sure that an e-visit or other type of remote care is just as good as the care they would get in person. They also want to be confident that their health information stays private.

For seniors who live in rural areas with few doctors, telemedicine would improve their access to healthcare and be more convenient. For many people with chronic illnesses or mobility issues, making it to the doctor’s office can be an ordeal. With telehealth, they can have the doctor visit virtually.

What Is Telehealth

Telehealth is a collection of methods for enhancing healthcare, public health and health education delivery and support by using telecommunication technology. Today, telehealth covers four domains of applications. Each state and insurance company varies in its use and reimbursement of these applications. They are commonly known as:

  • Live Video Conferencing (Synchronous): This is a live, two-way interaction between a person and a provider by using audiovisual telecommunications technology. The Center for Connected Health Policy made a micro-documentary video, “Telehealth Saves Lives,” that shows how video telehealth can be a lifesaving technology.
  • Store-and-Forward (Asynchronous): This will allow recorded health history to be transmitted through an electronic communication system to a practitioner, usually a specialist, who uses the data to evaluate the case or render a service outside of a real-time or live interaction. This technology will allow access to specialty care, even when there are limited board-certified specialists in the community.
  • Remote Patient Monitoring (RPM): With RPM, patients will be able to transmit their personal health and medical data from one location to a provider in a different location via electronic communication technologies for use in care and related support. “Telehealth and Quality of Care” is another video from The Center for Connected Health Policy that demonstrates how remote patient monitoring can help individuals stay healthy in their home.
  • Mobile Health (mHealth): This is the healthcare and public health practice and education supported by mobile communication devices like, tablets computers, cell phones and iPads. Applications can range from text messages that encourage healthy choices to large-scale alerts about disease outbreaks.

Telehealth encompasses a variety of technologies and tactics that deliver virtual medical, health, and education services. Telehealth is a collection of means to enhance care and health education, not a specific service.

What Will Telehealth Do for Seniors?

The older we get, the more health issues that arise. Therefore, seniors are more likely to experience chronic conditions, such as diabetes and heart disease. Both illnesses require routine monitoring from healthcare providers.

With telehealth technology, doctors can now keep an eye on things such as blood pressure and sugar levels. Routine doctor’s visits can be costly and difficult for seniors to attend, especially if the elderly person has mobility problems or limited access to transportation.

The use of telehealth can improve communication between providers and patients, allowing physicians to monitor an older patient’s overall health. This level of monitoring can allow providers to discern when patients may be becoming sick or at risk of experiencing a medical emergency.

While seniors are at a higher risk for developing chronic conditions that require care provided by specialists, specialists are not always located in every community, and travel is often warranted. This can be difficult for seniors.

Telehealth removes the barriers of location and mobility, connecting more seniors with necessary care provided by specialists. Telehealth also makes it easier for family members who live far away to stay connected to their elders’ care program. This will relieve some of the stress associated with caring for seniors.

See also: Navigating Telehealth for HR and Employers  

When telemedicine is used, caregivers have greater access to providers. These providers can give them information that helps provide more effective care. Without a need for routine in-person visits to providers, caregivers can dedicate more time to care at home or in their own personal and professional lives.

Not only is telehealth more practical for routine monitoring and time efficiency, it is a more cost-effective option for both patients and providers.

  • Telehealth has the potential to make physicians more money, because telehealth allows for less time-consuming individual consultations, meaning the doctor has time to see more patients each day.
  • Telehealth means big savings for patients, because consultations delivered virtually usually cost less, and money is saved when travel is eliminated.

When nursing homes adopt telehealth technologies, up to $327 million can be saved each year through a reduction in the need for emergency room visits. Telehealth is a life saver and a money saver.

Medicare and Telehealth

Medicare tightly restricts what it will pay for, so seniors have a harder time getting telehealth covered. Some private insurance companies are increasingly covering certain services like virtual visits.

Luckily for Medicare recipients, Congress passed a law last winter that expands Medicare coverage for options such as video visits to diagnose stroke symptoms or check on home dialysis patients.

Medicare Part B would cover the cost of telemedicine services, but the patient needs to fulfill certain conditions.

Medicare Advantage programs are used by a third of beneficiaries and can start offering additional telehealth options. This is a step in the right direction, but it certainly doesn’t cover everything.

Costs are already a major issue for people who need continuing assistance, and telehealth is still new. For telehealth to save the most money, it will need to replace in-person care, not add to it.

More than half of adults of all ages would be comfortable with a video doctors visit via FaceTime or Skype to discuss medications, treatment for continuing care of a chronic illness or even for an urgent health concern.

High-risk patients who use daily telehealth monitoring are less likely to be readmitted to the hospital. This isn’t about just having Skype in the home; it’s about having a team of healthcare professionals who are supporting the care of a patient.

See also: Whiff of Market-Based Healthcare Change?  

The Security of Telehealth

The privacy and security of protected health information (PHI) is very important to insurance companies, doctors and patients. With new technology, usually, comes new challenges. With every problem comes a solution, and by making smart choices patient data can be protected.

Telehealth services are legally required to abide by Health Insurance Portability and Accountability Act (HIPAA) mandates. HIPAA is concerned with the protection of patient medical records, always improving privacy and reducing fraud.

To be sure the health data is safe, your telehealth system should comply with the HIPAA guidelines. To comply, you will need:

  • Business Associate Agreement (BAA): This is a written contract between a covered entity and a business associate that establishes the permitted uses and disclosures.
  • Transport Encryption: This must-have encryption for data security converts the sensitive information into a meaningless stream of seemingly random data.
  • Storage Encryption for the Videos Stored in a Device: This will encode backed-up and archived data on storage media.
  • Properly Stored Data: You have many options here like a flash drive or a cloud storage; in any case, make sure you choose a HIPAA-compliant product or service.

Telehealth can be a secure way to receive medical care and reduce further stress for seniors and caregivers. Telemedicine care is the future of healthcare. Telehealth will save money, time and patients’ lives.

5 Technologies That Connect to Customers

In the past, customers tended to ignore their insurance after they purchased it. They interacted with their agents only a couple of times a year — to purchase a policy or file a claim — and then they forgot about it.

Now, technological advancements give consumers the ability to connect with their insurance products and services at all times, creating highly personalized services that are in high demand. In fact, 77% of consumers are willing to provide usage and behavior data in exchange for lower premiums, personalized coverage recommendations or faster claims settlements.

The following five new technology trends will change the future of insurance for carriers and consumers alike.

1. Vehicle Telematics

Vehicle telematics transmit real-time data directly to insurers through devices installed in vehicles. As a result, consumers receive more accurately priced premiums and better risk assessment that isn’t solely based on demographic information.

Telematics can also help align your auto insurance premium with your driving usage. This is known as usage-based insurance (UBI). By 2020, it is projected that 70% of all auto insurance carriers will use telematics and some form of UBI.

2. Mobile Health

Mobile health, or mHealth, refers to apps and wireless devices that can be used in healthcare for prevention, treatment and rehabilitation. Both insurers and consumers can benefit from mHealth, and its popularity is demonstrated by the fact that the industry’s revenue is expected to reach $26 billion by 2017.

Mobile health allows insurance companies to sell policies that are specific to their consumers’ health data as well as their adherence to medications and treatment plans. Consumers can use mobile fitness apps to monitor and improve their health, ultimately reducing premium rates.

See also: 4 Technology Trends to Watch for  

3. Gamification

Gamification incorporates different aspects of games to add some fun to the insurance consumer’s experience while solving real-life issues. Insurance companies recognized the lack of customer engagement and have sought to improve this through gamification.

Though gamification techniques are fairly new to the insurance world, they are likely to benefit consumers. Gamification can turn formerly tedious activities — like tracking healthy habits or filling out a health risk assessment — into engaging games that result in rewards and continue to motivate consumers to live healthy lifestyles.

On top of its consumer influence, gamification will be used to improve the workplace. Forty percent of the Global 1000 top companies will use gamification as an incentive and to transform business operations. Keeping employees engaged, especially during a transition, can be highly difficult. Gaming technology is pioneering this issue. In 2012, the gamification market was $242 million. According to a M2 Research study, the market will be $2.8 billion by the end of this year. In other words, we have a lot to look forward to when it comes to interactive engagement as consumers and employees in the insurance world.

4. Drones and Aerial Imagery

While drones are often used as devices for personal enjoyment, they are also transforming the way insurance companies evaluate claims. In the past, insurers needed to visit a physical location to estimate damage and losses. However, drones can now capture aerial images that allow them to more quickly respond to catastrophic events and process claims. Cognizant, a consulting firm, estimates that drones will make insurance adjusters’ work flow 40% to 50% more efficient.

The insurance industry’s growing use of drones will help improve safety practices in the aftermath of a disaster by having fewer people — insurance agents and consumers — on the ground taking photos. Drones also allow insurance carriers to better assess how an event occurred and the resulting damages with high-resolution images from all angles.

5. Home Automation

As consumers continue to adopt smart home technology, from voice-controlled lights to sensors that detect pipe leaks, they will benefit from home insurance premiums that are more directly tied to their lifestyles.

Some insurance companies offer discounts to homeowners who use smart home technology that can decrease their home’s risk of damage or burglary. Smart thermostats, smoke detectors, security systems and deadbolt locks can all improve a home’s safety and can decrease your homeowners or renter’s insurance bill.

See also: How Technology Breaks Down Silos  

Insurance companies will continue to adapt as this technology continues to popularize. More and more homeowners are investing in smart home technology — 45% of all Americans, in fact.

New technology has paved the way for a more personalized experience for insurance customers. As a result, insurance companies are shifting away from transaction-based services and are moving toward building relationships with their always-connected consumers.

Will Fintech Disrupt Health, Home Firms?

The integration of technology in the insurance company’s value proposition is turning out to be one of the main evolutionary trends in the sector, and digital initiatives have been for a couple of years now one of the priorities of insurance groups. Until today, though, they have brought only limited improvement when it comes to the competitive abilities of the insurer.

The best practices at the international level show that, to obtain concrete benefits, the innovation has to be directed toward clearly determined strategic objectives.

An interesting example is the American company Oscar – a start-up that in less than two years has managed to raise more than $300 million at a valuation of more than $1.5 billion. It has radically innovated the customer experience of individual health insurance policies by directing the innovation effort toward two key factors that are crucial for the profitability of the medical spending reimbursement business: deductibles and “emergency” visits.

Oscar has created an insurance value proposition based on a smartphone app that incorporates a highly advanced search engine – including a search based on symptoms – allowing the insured to identify and compare the medical structures part of the preferred network. In this way, the client receives support in optimizing direct spending before reaching the deductible; this basically postpones when the insurance company starts to pay and thus reduces the amount of spending (medical reimbursements) by the insurer for the remainder of the year.

The company addresses emergency visits by providing chat with a specialist and a call-back system that the insured can choose at will from inside the network. This represents a comfortable alternative and reduces the number of urgent visits.

Health insurance and connected health

In these last months, I have been considering how to replicate the motor telematics experience for the health insurance sector. Insurance companies see the benefits from a telematics black box and how the return on investment in this type of technology can be maximized by the insurer: This is possible by taking into consideration not only the underwriting of the car insurance policy but by also looking at the services provided to the client, at loss control and at customer loyalty. In health insurance, similar benefits are achievable by using mHealth devices and wearables.

The first element is risk selection, seen in car insurance as:

  • the capacity of auto selection and dissuasion of risky behavior,
  • the integration of static variables traditionally used for pricing with a set of “telematics data” gathered within a limited time and used exclusively for supporting the underwriting phase.

The creation of a value proposition that is focused on the use of wearables and that uses “gamification” makes the product attractive to individuals who are younger and healthier – generating a self-selection effect comparable to the motor telematics experiences. Oscar, since the beginning of January, has been offering clients a pedometer connected to a mobile app. Every day, the app shows a personalized objective that, if attained, means $1 earned by the customer. Each month, the customer can receive a maximum of $20 as cash back from the company.

The second source of value generation is services. The use of telematics data represents an incredible opportunity for offering new health services and for offering a better customer experience: for example, the geolocation of medical structures and doctors who are part of the network, linked to a medical reimbursement policy.

Medibank, of Australia, has integrated in its health policy (using a smartphone app) a series of services built on informative contents and advice. The services are medical – as done by the Italian insurance fund Fondo Assistenza Benessere, using an app called Consiglio dal Medico (an Italian start-up partnering also with Uber) – as well as related to wellness. Medibank, using this package of services, produced 10% growth in the company’s top line. This Australian player has created an app for noncustomers that gives access to wellness discounts and attracts customers who can later be offered other insurance, too.

The ability to provide health services with a high perceived value (from the client’s point of view) can also allow the company to increase the efficiency of guidance inside the preferred network – this is a crucial aspect for controlling the loss ratio of a medical reimbursement product. The loss control actually represents the third area of value creation, just as it does for the auto business.

Within the health industry, it will soon be possible to generate significant economical benefits employing telemedicine to optimize spending with medical reimbursements or to link the reimbursement to the actual observance of the client’s medical prescriptions. In the medium to long term, the objective is to have behavioral and contextual data to prevent fraud and early warning systems that can spot altered health conditions and that allow preventive and timely intervention.

South African-based Discovery has successfully tried out this second approach. It reduced the loss ratio of the cluster of insured who suffer from diabetes – mainly reimbursements linked to complications because of lack of self-control. Discovery provides an instrument for measuring the blood sugar level through a connected app and rewards the insured.

Discovery’s Vitality program represents the international best practice regarding the fourth axis of value creation: behavior guidance, by using a loyalty-based system that rewards non-risky behavior. The South African company has integrated – in its very complex reward system – devices for measuring physical activity and has incorporated their usage among the “rewarded” types of behavior. Discovery’s experience in several different countries proves the effectiveness of this approach in terms of:

  • commercial appeal
  • capacity to acquire less risky clients
  • ability to gradually reduce the risk profile of the single client.

Pricing based on individual risk is the last benefit achievable with the integration of wearables and health insurance policies. Constant monitoring of the level of exposure to risk lets the insurer create tariffs based on the health state, lifestyle and context of a person. As already done in the auto telematics business, this will be a goal to be attained after some years of data gathering and systematic analysis of the historical series together with information regarding medical reimbursements.

Home insurance and connected home

Homes are another area in which, at an international level, there has been experimentation with how to integrate an insurance policy with actual sensors. There already exists a replication of the business model used more than 10 years ago in the auto insurance sector — an up-front discount between 10% and 25% of the insurance premium based on installation of a device at the client’s house and by the payment of a fee for services or a lease for the technology. This approach, which has been adopted in the U.S. by State Farm, Liberty Mutual and USAA and in Italy by IntesaSanpaolo Assicura, BNP Paribas Cardif, Groupama e Poste, is based on two of the five levers of value creation: first, loss control – focused on flooding, fire and theft – and second, value-added services. American companies have even reached the point where they offer clients a wide range of services provided by selected partners (such as Nest) and tied to the home “ecosystem,” which can even include medical assistance services.

An interesting and innovative example of the use of such technology for the assessment and risk selection in home insurance is the one adopted by Suncorp with a retail touch to it, and by ACE Group, which focuses more on the insurance needs of high net worth individuals (HNWIs). Both companies have used a partnership with a start-up called Trōv – a smartphone app that allows registering and organizing the information referring to personal objects, including through photos and receipts – to evolve their underwriting approach when it comes to the risk connected to the contents of the house.

Domotics, or home automation, is growing at a high rate even in Italy and represents a material part of the revenues generated by the Internet of Things, according to data provided by the Osservatorio of the Politecnico di Milano. A horizontal domotics solution – with thermostats, smoke and water detectors, sensors present in appliances and other household items, sensors at the entrance and antitheft alarms, sensors spread within the building – would let an insurance company track the quantity and level of exposure to risk. This includes, for example, the periods and ways in which the home is used but also the state of the household and the external conditions to which it is exposed (humidity, mechanical vibrations, etc.).

The insurer could price based on individual risk, adopting pricing logic based on behavior, as already done in the motor sector. This could open up growth opportunities, such as for secondary houses used only for vacation and rarely insured. This scenario, which sees the growth of solutions built on connected objects within the home – if correctly approached by insurers by reviewing their processes to make the most of the potential offered by gathered data – can lead to important benefits in loss control: Some studies have estimated that there is the potential to cut in half the current expenses for claims.

To turn this opportunity into reality, it is essential that the insurer acquire the ability to connect its processes (through adequate interfaces) with the different connected objects. Insurers must create an open digital platform that uses the multiple sensors to be found in the home “ecosystem” – just like those used in the health sector.

The change of paradigm doesn’t only concern fundamental aspects of the technological architecture – like data gathering or standardization of data coming from heterogeneous sources – but affects the strategic choices of the business model. For insurers, it becomes a necessity to define their level of ambition for their role in the ecosystem and for their cooperation with other players to create solutions and services around an integrated set of client’s needs.

It is extremely interesting to see the journey made by American Family Insurance, which – in partnership with Microsoft – has launched a start-up accelerator focused on home automation.

Insurers have to start thinking strategically around how adapt insurance business to IoT, before some new Fintech comers do it.

This article originally appeared in the Insurance Daily n. 749 and n. 750 Editions.