US health insurance firm Cigna is using AI to check if patients are taking their medications but experts fear the controversial scheme may be used to cancel policies or avoid paying out
By CONNOR BOYD HEALTH REPORTER FOR MAILONLINE
PUBLISHED: 07:09 EST, 13 December 2019
A US health insurance giant is using an AI system to monitor whether patients with chronic diseases are skipping their medication.
Cigna's technology, Health Connect 360, will be rolled out to millions of Americans next month.
But experts fear the technology will be used to cancel policies or avoid paying up if patients are found to be missing or incorrectly taking prescriptions.
Doctors and nurses will be able to constantly keep an eye on patients' health and step in when they have cause for concern.
For example, an alert may be triggered if patients forget to pick up their prescription or miss an appointment.
Patients insured with Cigna will be able to use an app on their laptops or phones to log onto the online database.
They will input updates on their health - such as blood-sugar levels, using glucometers for diabetics, and blood pressure readings for heart disease sufferers.
If the AI notices a sudden spike or drop in these levels, it alerts doctors the patient may not be taking drugs, or they may not be working.
For other patients, who are following their care plan and are healthy, the system will spare them needless trips to hospitals, the firm claims.
The system is intertwined with millions of patients’ medical records, as well as the online pharmacy Express Scripts, which Cigna acquired for $54billion this year.
Having access to medical records means the technology can cross-reference cases and predict which care to give specific patients based on what has worked for others.
Cigna said the AI can also predict whether patients might abuse or overdose on prescribed opioids, based on their history with medication.
It has been in development since 2017 and will be offered to Cigna’s 11million insurees and its staff in the New Year.
Portions of the artificial intelligence was successfully trialled on some customers earlier this year.
Cigna’s chief information officer Mark Boxer, who is spearheading the AI project, told the Wall Street Journal: ‘Our concept around the acquisition of Express Scripts - it was much more than just simply buying a pharmacy-benefits management [company].
‘It was buying a set of care-management capabilities, and access to data and intelligence that would be very, very hard to replicate.’
But Sam Smith, from the medical data campaign group MedConfidential, told MailOnline the insurer's interests are not the doctors nor the patients.
He said: 'Reducing payouts and increasing premiums is what insurance companies do, and they’ve always tried to use new technologies to do more of both.
'As monitoring from this app is used for one thing, it will be attractive to employers to monitor their staff even more - a digital dystopia masquerading as healthcare.'
Healthcare insurers across the US are all competing to perfect an AI system to give patients personalised care and save millions, if not billions, in payouts in the process.
But there have been several blips along the way. An algorithm used by hospitals to identify patients with chronic diseases was found to have a significant bias against black people in October.
The artificial intelligence, sold by health firm Optum, disproportionately advised medics to give more care to white people even when black patients were sicker.
It means just 18 per cent of black patients were suggested for a continued care programme, when 47 per cent of them were in desperate need of it.
The software helps medics decide the future of roughly 200million patients across the US each year.
Scientists from universities in Chicago, Boston and Berkeley flagged the error in their study, published in the journal Science, and are working with Optum on a fix.
They said the algorithm - designed to help patients stay on medications or out of the hospital - was not intentionally racist because it specifically excluded ethnicity in its decision-making.
Rather than using illness or biological data, the tech uses cost and insurance claim information to predict how healthy a person is.
The computer system has been programmed to believe the more money spent, the sicker the patient is.
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