Introduction:
Remote Photoplethysmography (rPPG) imaging, a non-contact method used to measure vital signs (such as heart rate and heart rate variability) has emerged as a promising tool for its application in consumer health and wellness. rPPG imaging analyses variations in the light emitted by different layers of the skin which correlate with biometric readings. While its origins can be traced back to medical research and clinical settings, recent advancements have accelerated its use in everyday health monitoring and diagnostics.
rPPG imaging when integrated with in-person healthcare services and blood tests, has the potential to reduce the need for many confirmatory tests, offering significant benefits for life and health insurers. This holistic approach can enhance the accuracy of health assessments and empower individuals to proactively improve their health. It offers insurers valuable data insights for risk assessment and personalised wellness programmes and can be used to triage policyholders for more expensive health tests. As the technology develops, it could transform how we approach health and wellness, benefiting both individuals and insurers alike.
Alula Technologies and Ally Health collaborate to empower insurers and their policyholders with a comprehensive understanding of their health and wellness. By providing access to both digital and clinical health data, they enable informed and healthier lifestyle choices. Alula’s personalised health engagement app, VivaScore, aggregates various health and wellness datasets, encompassing wearable data and rPPG face scanning capabilities, while also incorporating data from blood tests and in-person health checks provided by Ally Health, a trusted on-demand private healthcare provider.
The pilot goals:
Last year, Hannover Re partnered with Alula Technologies, initiating a 12-week pilot from November to January. This pilot involved 30 employees from Hannover Re. The goals of the pilot were to understand the potential of Alula’s technology in improving personal health awareness and to explore how such insights could support preventative healthcare or early disease detection. Moreover, the pilot aimed to explore the combination of Alula’s digital health platform with smartphones, wearable technology, digital health checks through rPPG imaging, and comprehensive in-person biometrics and diagnostics data obtained by Ally Health. This integration provided an opportunity to transform a variety of health-related data from these sources into valuable insights. Its anticipated impact includes proactively identifying high-risk individuals and directing them towards medical consultation, thereby improving long-term health outcomes and potentially reducing life and health insurance claims. Furthermore, the pilot aimed to explore the potential of providing reinsurers and insurers with a clearer understanding of their risks while increasing engagement with their policyholders.
How Alula | VivaScore's "Health Score" works?
Alula's VivaScore app is a digital solution that records, measures, and tracks an individual's health status. The health score is a dynamic measure of an individual’s overall health status, ranging from 0 to 100, with 100 representing optimal health.
The score is normalised by age and gender for comparison and benchmarking purposes across different demographics. To calculate this, VivaScore utilises a variety of data sources, including:
- Devices: data from diagnostic, point-of-care, and wearable devices.
- Remote photoplethysmography imaging (rPPG): a digital face scan that measures vital signs.
- Electronic Health Records: comprehensive health records stored electronically.
- Healthcare providers: information from diagnoses and medication prescriptions.
- Health risk assessments: data from clinic and wellness assessments.
- Pharmacy clinics and pharmacies: nurse assessments, dispensed medication data.
- Pathology: diagnostic test results and pathology data.
The algorithm processes verified and validated data from these sources to calculate the score. It aims to minimise reliance on user self-reported information to enhance objectivity and accuracy. Health scores fluctuate with changes in health, conditions, emotional wellbeing, and lifestyle data, providing a current and updated health risk assessment. Health-related activities are also tracked and analysed to update this comprehensive health indicator. The full list of data points that are considered in the calculation of the score can be found below.
Pilot methodology:
The methodology employed involved initial blood tests, continuous wearable data collection, and rPPG face scanning technology to create dynamic, individual health scores to guide users towards improved health and wellbeing.
Participants were required to download Alula's VivaScore app and provide basic information such as gender, age, weight, and height, along with the option to connect their wearable devices. This enabled the tracking of additional metrics like sleep, activity, calories burned, steps taken, floors climbed, and heart rate. In just 30 seconds, participants completed a digital health check which uses rPPG face scan imaging to capture vital signs like breathing rate, heart rate variability, and blood pressure and were then provided with a health score. The aim was for participants to regularly complete a digital health check through the rPPG face scan imaging, which would evaluate any shifts in key health metrics throughout the pilot and track any changes to their health scores.
Two weeks after the app set up and initial digital health check, participants underwent a blood test and comprehensive in-person health check. A list of measurements can be found by clicking the button below.
Blood test results were communicated within 4 to 7 days, enabling participants to access their data and compare their traditionally measured scores to the results of their digital health checks obtained through rPPG face scan imaging. Participants could then observe any changes in their health scores from preceding digital health checks.
Each user also received a weekly report which provided insights into current health scores and activity levels, along with tailored suggestions for improvement based on measured health metrics. Users could track changes to key health metrics, based on digital health checks over time - a full list of which can be found by clicking the button below.
Pilot engagement & perceptions of the technology:
During the pilot, participants were actively engaged and enthusiastic about the digital health checks and the convenience of using the rPPG face scanning technology. This was particularly noticeable when participants had the chance to compare their results with the average for their age group and gender, as displayed on the app or with similar-aged peers in the pilot.
In total 237 digital health checks were recorded, averaging 8 per user across the 12-week pilot.
Fortnightly digital health checks
The percentage of participants who recorded a rPPG face scan to obtain a digital health check every 2 weeks.
Monthly digital health checks
The percentage of participants who recorded a rPPG face scan to obtain a digital health check every month.
The 30-second digital health check using rPPG face scan imaging was perceived as a quick, easy, and non-invasive method to consistently track health and wellbeing. Participants also valued the seamless integration with their wearable devices, one of the highest-rated elements of the app. Alula's VivaScore enables connectivity to a wide range of wearable devices/ data sources, including smartwatches, fitness trackers, and tracking platforms like Apple Health and Google Fit, as well as various wearable and wellness APIs. This would allow insurers to make use of existing wearable devices that policyholders may have rather than needing to supply expensive technology.
participants discovered new information about their health
reported behaviour changes by the end of the pilot.
“I have found the app useful and it’s told me things about my health that I didn’t know. I learned more about my cholesterol i.e. there are good and bad types.” – Pilot Participant
“I think it’s great software. I’m pleased I know more about my health now and can see how it would be useful for an insurer.” – Pilot Participant
The feedback and statistics not only highlight the success of the pilot in terms of user engagement and system performance but also suggest a potential model for how health monitoring could be integrated into insurance processes to benefit both the insurer and the insured. The pilot's results could lead to more personalised insurance plans, better risk assessment, and a more proactive approach to health and wellness within the insurance industry.
From the survey conducted at the end of the pilot, it was clear that participants recognised the value of Alula's technology for insurers, particularly for data-driven decision-making.
“This is a good tool for insurers for accessing the data and utilising this in a way that is beneficial to them and the customer.” – Pilot Participant
Pilot participants valued the app’s real-time health data—particularly from wearable device connectivity and digital health scans —which they regarded as key enhancements to risk assessment, believing these features could drive data-driven actions to aid direct risk management and underwriting decisions.
How can this be applied to insurance?
Incorporating Alula's VivaScore app into the life and health insurance industry unlocks numerous opportunities for utilising rPPG face scanning technology to obtain digital health checks. This integration can provide valuable data analytics to improve risk management and develop proactive healthcare strategies.
By integrating regular digital health checks and monitoring changes in the health scores, a more comprehensive triangulation of risk can be achieved. Over time, this data can activate interventions at thresholds established by the insurer. These interventions could provide blood tests or in-person health checks to those with higher-risk health scores (based on wearable data and digital health checks). In our pilot, we offered blood tests and health checks to all participants due to the small sample size. In practice, on a large insured book, it would be more valuable and cost-effective to encourage or refer the high-risk customers to a nurse for further testing/ screening.
One key advantage of the VivaScore app lies in its potential application to in-force business, enabling insurers to triage individuals, using digital health checks to identify specific traits for action. This approach allows insurers to effectively guide a subset of individuals toward nurse screenings or blood tests, offering personalised advice or treatments to reduce their risk and severity of ill health.
The app's synergy with wearable data opens up additional avenues for data-driven insights and optimisations. Even in the absence of wearables, the app independently offers significant value in monitoring key health indicators.
With a sample size of 30, the pilot was not large enough to test the effectiveness of the face-scanning technology. However, it does appear promising, with measures such as heart rate variability, mental health indices and blood pressure monitoring having the potential to give valuable insights that can ensure additional interventions and testing are focused on those policyholders who are likely to benefit. The nature of the technology, embedded into an app that only needs a smartphone camera to operate, is a low-effort and low-cost solution.
As a result, offering this technology to a life or health insurance policyholder supports an early intervention approach to claims. This proactive approach has the potential to mitigate risks and encourage individuals to seek assistance or treatment at an earlier stage. Such an approach could reduce overall claims costs and the need for more cost-intensive interventions or in-person healthcare interactions. Small, yet personalised, nudges towards improvement could be significantly beneficial, both for the individual's health and the efficiency of the healthcare system.
Next Steps:
Acknowledging the importance of a more extensive pilot to explore the potential of face-scanning technology in life and health insurance, our goal is to pilot Alula's technology for in-force claims management with an insurer to integrate digital and clinical health data into an early intervention approach for preventative healthcare. This will enable us to collaboratively manage risks and enhance the overall health outcomes for policyholders by leveraging cutting-edge technology for timely and effective healthcare interventions.
Hannover Re is also undertaking a separate and more extensive pilot to explore the potential of face-scanning technology by benchmarking against nurse screening results at the point of medical underwriting with the potential to replace certain medical underwriting tests. The insights from this pilot, once available later this year, will be instrumental in shaping our strategies and sharing further developments.
Our webinar explores these ideas in more detail and is available to watch here. If you would like to discuss any of these points in more detail, please get in touch with us.
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Contacts:
Tim Smith
Head of Protection
Hannover Re UK Life Branch
Tel. +44 7919 56 7348
tim.smith@hannover-re.com
Lisa Balboa
Head of Life & Health Digital Business Accelerator
Hannover Re
Tel. +44 7388 94 3454
lisa.balboa@hannover-re.com
Gareth Matthews
Chief Underwriter
Hannover Re UK Life Branch
Tel. +44 7435 54 8634
gareth.matthews@hannover-re.com
Privacy
Privacy is at the heart of Alula’s VivaScore. VivaScore rigorously adheres to local data privacy laws, ensuring the confidentiality and protection of all user data. Personal health information is never shared in a manner that could identify individuals to their employers, insurers, or healthcare providers. Data shared with organisations is strictly aggregated and anonymised, preserving the anonymity of individuals at every point. Once the service use concludes, all personally identifiable health data is securely deleted and not shared with any third parties. Additionally, all weekly summary reports are password-protected, guaranteeing continuous safeguarding of user data.
About the companies
Alula Technologies
Alula Technologies is a global technology group headquartered in London, UK. Alula provides clients in employee benefits, insurance and healthcare with technologies to help them better understand risk and improve business processes and customer experiences. We integrate rich data insights with modern technologies to unlock efficiencies and drive effective decisions.
Ally Health
Ally Health is solving for the last mile of healthcare to enable a future of decentralised health. Our technology gives patients access to on-demand clinical care at home (e.g. blood testing, health assessments, wound care etc). Ally Health partners with healthcare providers and insurers to help them serve unmet patient demand, improve outcomes and grow revenues.
Hannover Re
Hannover Re is one of the world’s leading reinsurers. It transacts all lines of property & casualty and life & health reinsurance and is present worldwide with more than 3,500 staff. The German business of the Hannover Re Group is written by the subsidiary E+S Rück. Established in 1966, Hannover Re is recognised as a reliable partner for innovative risk solutions, exceptional customer intimacy and financial soundness. The rating agencies most relevant to the insurance industry have awarded both Hannover Re and E+S Rück outstanding financial strength ratings: Standard & Poor's AA- "Very Strong" and A.M. Best A+ "Superior".
At Hannover Re UK Life Branch, you’ll find that we are somewhat different. As part of a strong, secure, global reinsurance group, we have unyielding support from a world-class organisation. From standardised reinsurance products to tailor-made financial solutions, we prioritise long-term partnerships over short-term expediency, profitability over premium volume, and excellence over adequacy. We’re dedicated to a philosophy that promotes access, inclusion and certainty, helping our clients develop and deliver innovative new products that provide clear value to the broadest possible cross-section of society.
Based on this approach, we’ve been pioneering new markets and new approaches ever since we began life back in 1984. We aim to create mutually profitable long-term client partnerships by responding to our client’s issues and aspirations with innovative and effective solutions that genuinely give them what they need. Our clients trust us to deliver the information, the ideas and the insights on which to base products that can open new revenue streams and deliver on their promise.
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