Accepted for/Published in: Journal of Participatory Medicine
Date Submitted: Apr 24, 2020
Date Accepted: Jul 27, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Extracting value from the way we live? Guiding health insurance models towards responsible digital innovations
ABSTRACT
As health systems struggle to successfully implement a digital transition in care and service delivery, the ubiquity of mobile technologies combined with the emergence of the “quantified-self” movement has already generated a phenomenal amount of data on the health and lifestyle of individuals. Because of important financial incentives in the health sector, a new insurance model called Pay-As-You-Live (PAYL) is emerging, which extracts value from user-generated data. As an interactive form of insurance, the principle of the PAYL model is to support clients in the management of their health. Despite significant promises for clients, there are critical issues that remain to be addressed, especially as PAYL models can significantly disrupt current collective insurance models and question the ‘social contract’ in so-called universal/public health systems. In this paper, we discuss the following issues of concern: the quantification of health-related behaviour, the burden of proof of compliance, client data privacy, and the potential threat to health insurance models based on risk mutualisation. We explore how more responsible health insurance models in the digital health era could be developed, in particular by drawing from the Responsible Innovation in Health framework.
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