Co-operative Models for Evidence-based Healthcare Redistribution (CoMEHeRe)
Lead Research Organisation:
UNIVERSITY OF EXETER
Department Name: Management
Abstract
CoMEHeRe aims to transform personal healthcare for the benefit of individuals through the use and management of biometric information created by wearable devices.
To do this it will combine data from an individual's wearables with DLT (blockchains) and machine learning to securely store and access data to enable the individual to share and benefit from their generated information. Sharing will be with state and private healthcare providers to enable more targeted, personalised patterns of treatment. Other benefits may arise from the individual participating materially in new markets created through the monetisation of this data.
Recent interest in cryptocurrencies such as Bitcoin has ignited interest in DLTs and the role they play in how shared agreements are defined, managed, and evolved for a variety of ecosystems and information sources typical of today's digital economy. Indeed, the focus of attention has shifted from DLT as a technological phenomena supporting new types of currency e.g., bitcoin to their likely impact in changing business and society. DLTs have the potential for rewriting conventional notions of how business transactions relate with customers, enhance transparency and trust, and create fresh opportunities for value creation and capture. In domains such as healthcare, the potential of DLTs to disrupt the status quo is clear. However, a critical research need must be addressed: how to expose the opportunities and threats, such as privacy and security from emerging business models enabled by this technological revolution.
CoMEHeRe aspires to build and assess the feasibility of the first publicly available software demonstrator to interface with insurers (AXA/PPP and its Seed Factory labs will be a partner) and the general public, using distributed ledger technologies to allow for data to be curated, hosted, and used as tradeable value by the individual's' choice.
To achieve this CoMEHeRe will address a number of research challenges by utilising a novel combination of technologies, including the blockchain - a form of secure DLT - to store health evidence derived from multi-modal signals extracted from users' wearables and the Internet of Things (IoT) sensors they interact with in the environment. In addition, the project will examine the potential use of Smart Contracts (simple programs) in healthcare management at the research, public policy, and individual levels. Such a use will be challenged by many kinds of contractual, ethical and moral issues: for example if ownership is taken away from the individual, smart contracts could be made partially or fully self-executing, self-enforcing, or both, by authorities or businesses seeking to optimise for cost instead of health benefit to the individual.
The CoMEHeRe project is an 18 month research project designed to create value in an innovative application domain for DLT in healthcare. To undertake this exciting, ambitious project we build on a strategic multi-disciplinary partnership at the University of Surrey that unites world-leading research groups focused on examining the business and societal impact of applications of digital technology (CoDE), multi-modal signal processing (CVSSP), and IoT and sensor-based communications infrastructures (ICS and 5GIC). This partnership is contained within a broader delivery consortium. This includes Axa/PPP offering the application context and a basis for assessing practical impact, Guardtime providing a DLT foundation for the research work, and BioBeats delivering machine learning platform expertise. To govern this work there will be an experienced Advisory Board bringing governance and guidance to ensure the project delivers meaningful results from which new research and practice can emerge. This experienced partnership has a practical record of previous work in these areas, and a broad network of relationships bringing deep support, and rapid promotion of research results.
To do this it will combine data from an individual's wearables with DLT (blockchains) and machine learning to securely store and access data to enable the individual to share and benefit from their generated information. Sharing will be with state and private healthcare providers to enable more targeted, personalised patterns of treatment. Other benefits may arise from the individual participating materially in new markets created through the monetisation of this data.
Recent interest in cryptocurrencies such as Bitcoin has ignited interest in DLTs and the role they play in how shared agreements are defined, managed, and evolved for a variety of ecosystems and information sources typical of today's digital economy. Indeed, the focus of attention has shifted from DLT as a technological phenomena supporting new types of currency e.g., bitcoin to their likely impact in changing business and society. DLTs have the potential for rewriting conventional notions of how business transactions relate with customers, enhance transparency and trust, and create fresh opportunities for value creation and capture. In domains such as healthcare, the potential of DLTs to disrupt the status quo is clear. However, a critical research need must be addressed: how to expose the opportunities and threats, such as privacy and security from emerging business models enabled by this technological revolution.
CoMEHeRe aspires to build and assess the feasibility of the first publicly available software demonstrator to interface with insurers (AXA/PPP and its Seed Factory labs will be a partner) and the general public, using distributed ledger technologies to allow for data to be curated, hosted, and used as tradeable value by the individual's' choice.
To achieve this CoMEHeRe will address a number of research challenges by utilising a novel combination of technologies, including the blockchain - a form of secure DLT - to store health evidence derived from multi-modal signals extracted from users' wearables and the Internet of Things (IoT) sensors they interact with in the environment. In addition, the project will examine the potential use of Smart Contracts (simple programs) in healthcare management at the research, public policy, and individual levels. Such a use will be challenged by many kinds of contractual, ethical and moral issues: for example if ownership is taken away from the individual, smart contracts could be made partially or fully self-executing, self-enforcing, or both, by authorities or businesses seeking to optimise for cost instead of health benefit to the individual.
The CoMEHeRe project is an 18 month research project designed to create value in an innovative application domain for DLT in healthcare. To undertake this exciting, ambitious project we build on a strategic multi-disciplinary partnership at the University of Surrey that unites world-leading research groups focused on examining the business and societal impact of applications of digital technology (CoDE), multi-modal signal processing (CVSSP), and IoT and sensor-based communications infrastructures (ICS and 5GIC). This partnership is contained within a broader delivery consortium. This includes Axa/PPP offering the application context and a basis for assessing practical impact, Guardtime providing a DLT foundation for the research work, and BioBeats delivering machine learning platform expertise. To govern this work there will be an experienced Advisory Board bringing governance and guidance to ensure the project delivers meaningful results from which new research and practice can emerge. This experienced partnership has a practical record of previous work in these areas, and a broad network of relationships bringing deep support, and rapid promotion of research results.
Planned Impact
Personal healthcare can be transformed by DLT and other new technologies through the design, development and evaluation of business models for commodifying and brokering casually captured personal healthcare data.
Impact on Individual Users
Relatively little attention is being directed at how the data from cheap mobile devices and wearable sensors, growing at an exponential rate, is secured, managed, and used for the benefit of individuals. As new technologies become more prevalent, many people are concerned about the use of these technologies in supporting, advising, and controlling key aspects of everyday life. CoMEHeRe will put individuals in the driving seat by giving them greater control over their data and health. This project will contribute to this critical debate, and explore the implications of wearable devices on healthcare provision. One of the most positive visible outcomes will be our contribution to understanding how individuals can achieve accurate insurance and care models tailored to their needs, enhancing their quality of life.
Impact on Policy Makers and the Economy
Availability of real-time data capture from wearable devices places new demands on policy, ethics, and law. New technologies such as DLTs expand the boundaries for policy makers and economists. CoMEHeRe will provide a testbed for exploring these questions in a critical domain of national importance. For example, CoMEHeRe will demonstrate the use of DLTs to execute peer-to-peer contracts. These will be used to measure and trade the value of any particular piece of healthcare evidence (or transaction) in order to optimise value both to healthcare suppliers such as the NHS, and more importantly to the individual.
Important questions can be explored through CoMEHeRe, including:
-- Which emerging health and insurance business models are enabled by digital technologies such as DLTs?
-- What is the role of health-based interventions in preventative care?
-- Is there a relationship between an individual's' biometric data, and increasing engagement and productivity in the workplace?
-- Can the motivation and commitment of individuals to the services offered by insurance providers be increased?
Impact on Society
There is a fundamental need to address workable, scalable solutions to improve preventative health and well-being which will be met by the CoMEHeRe project. It will leverage existing societal trends towards the use of technological interventions - computers, tablets and medical devices - supporting and increasing "external" connectivity to improve quality of life and promote a healthy lifestyle for individuals. For example, we will research how simple programs such as smart contracts can be used as computer protocols that facilitate healthcare advancement at the research and public policy (and later, product offering) levels. Increased use of DLTs will promote a new breed of smart applications for healthcare providers, health insurers and health-focused solution providers that would exploit more easily the latest medical research to develop personalised treatment paths. Health providers and patients will have access to the same information and be able to engage in a collaborative and informed discussion about best-case treatment options based on research and early intervention rather than using at present intuition and broad demographic targeting.
Impact on Knowledge
CoMEHeRe will impact all the academic and non-academic communities represented by the project consortium through contributing to the current body of knowledge with regards to implementation of DLT solutions in a healthcare context. The feasibility study taking place via CoMEHeRe will make a significant contribution to the beneficial increase in technology-enabled healthcare management through which individuals, healthcare providers, healthcare entities, and medical researchers share genetic, diet, lifestyle, environmental, and health data interventions.
Impact on Individual Users
Relatively little attention is being directed at how the data from cheap mobile devices and wearable sensors, growing at an exponential rate, is secured, managed, and used for the benefit of individuals. As new technologies become more prevalent, many people are concerned about the use of these technologies in supporting, advising, and controlling key aspects of everyday life. CoMEHeRe will put individuals in the driving seat by giving them greater control over their data and health. This project will contribute to this critical debate, and explore the implications of wearable devices on healthcare provision. One of the most positive visible outcomes will be our contribution to understanding how individuals can achieve accurate insurance and care models tailored to their needs, enhancing their quality of life.
Impact on Policy Makers and the Economy
Availability of real-time data capture from wearable devices places new demands on policy, ethics, and law. New technologies such as DLTs expand the boundaries for policy makers and economists. CoMEHeRe will provide a testbed for exploring these questions in a critical domain of national importance. For example, CoMEHeRe will demonstrate the use of DLTs to execute peer-to-peer contracts. These will be used to measure and trade the value of any particular piece of healthcare evidence (or transaction) in order to optimise value both to healthcare suppliers such as the NHS, and more importantly to the individual.
Important questions can be explored through CoMEHeRe, including:
-- Which emerging health and insurance business models are enabled by digital technologies such as DLTs?
-- What is the role of health-based interventions in preventative care?
-- Is there a relationship between an individual's' biometric data, and increasing engagement and productivity in the workplace?
-- Can the motivation and commitment of individuals to the services offered by insurance providers be increased?
Impact on Society
There is a fundamental need to address workable, scalable solutions to improve preventative health and well-being which will be met by the CoMEHeRe project. It will leverage existing societal trends towards the use of technological interventions - computers, tablets and medical devices - supporting and increasing "external" connectivity to improve quality of life and promote a healthy lifestyle for individuals. For example, we will research how simple programs such as smart contracts can be used as computer protocols that facilitate healthcare advancement at the research and public policy (and later, product offering) levels. Increased use of DLTs will promote a new breed of smart applications for healthcare providers, health insurers and health-focused solution providers that would exploit more easily the latest medical research to develop personalised treatment paths. Health providers and patients will have access to the same information and be able to engage in a collaborative and informed discussion about best-case treatment options based on research and early intervention rather than using at present intuition and broad demographic targeting.
Impact on Knowledge
CoMEHeRe will impact all the academic and non-academic communities represented by the project consortium through contributing to the current body of knowledge with regards to implementation of DLT solutions in a healthcare context. The feasibility study taking place via CoMEHeRe will make a significant contribution to the beneficial increase in technology-enabled healthcare management through which individuals, healthcare providers, healthcare entities, and medical researchers share genetic, diet, lifestyle, environmental, and health data interventions.
Publications
Brown Alan W.
(2019)
Delivering Digital Transformation: A Manager's Guide to the Digital Revolution
Coutts L.V.
Deep Learning with Wearable Based Heart Rate Variability for Prediction of Mental and General Health
in Journal of Biomedical Informatics
Coutts, L.V.
Building Trust in Digital Health: Blockchain based User Consent
in IEEE Computer
Plans D
(2019)
Use of a Biofeedback Breathing App to Augment Poststress Physiological Recovery: Randomized Pilot Study.
in JMIR formative research
Ponzo S
(2020)
Efficacy of the Digital Therapeutic Mobile App BioBase to Reduce Stress and Improve Mental Well-Being Among University Students: Randomized Controlled Trial.
in JMIR mHealth and uHealth
Description | The academic contribution of CoMEHeRe has drawn attention to several important research questions, and brought new insights through its publications: 1. In developing architectural patterns for implementing blockchain and Distributed Ledger Technology (DLT) solutions. 2. By applying DLT approaches to store and manage personal health data, the work of this grant has provided several critical recommendations for how to structure DLT-based solutions to improve privacy and allow individual agency over personal data. 3. Through the experiments carried out using wearable devices for understanding stress, this project has raised the importance of using physiological data in empirical approaches to social science research. The work on CoMEHeRe has been instrumental in several areas beyond the academic community: 1. Informing educational offerings aimed at practitioners, executive leaders, and postgraduate students through the development of MBA modules, and via influences at corporate education groups such as Headspring, Oxford Group, Defacto Education, and Duke CE. 2. Inspiring and challenging conventional thinking at commercial organizations at corporate events for large corporations (e.g., SAP), for industry influencers (e.g., CIONET), and in industry consortia (e.g., LMForum). 3. Influencing thinking on digital strategy by delivering opinion pieces and commentary via blog posts, industry-focused articles, and through numerous informal discussions with industry leaders. 4. Impacting policy and decision makers through the personal influence of individuals from the CoMEHeRe project in their roles on advisory board and as consultants to key corporations. |
Exploitation Route | Other research teams in academia and industry can build on the results of CoMEHeRe by examining the research outputs of the project and seeking to adapt the methodologies and practice applied to their own contexts. Devices for data gathering such as wearables are in constant flux, and are increasing in accuracy and fidelity. Additional insights will be possible using such devices. In addition, we see significant movement in business and industry toward new business models enabled by data collected from these devices. For example, several insurance companies such as Vitality have adopted solutions that partially overlap with the research work undertaken in this grant. By working with those organizations, new directions for this work could be established to take the academic/business relationships forward. |
Sectors | Digital/Communication/Information Technologies (including Software) Education Financial Services and Management Consultancy |
Description | This grant is a no-cost extension to the previous CoMEHeRe awared (EP/P03196X/1). Hence, all findings described in that grant also apply here. With the maturing status and progress of the CoMEHeRe award, we are involved in a variety of conversations with commercial organizations at a strategic C-suite level where interest in the project and its results are very high. Broad knowledge and understanding of DLT technologies are currently rather poor. Hence, the scope, intent, and approach of CoMEHeRe are seen as a very important template for other activities. The progress of CoMEHeRe is being closely followed by those organizations. Companies engaged in these conversations have included Axa, Deloitte, Centrica, Resonate, Zoetis, and GSK. The results of our investiations have been reported in several major conference and workshop engagements, and have been explored through interactions in several SME companies including BioBeats, NotBinary, Human+, Anthropos, and CyberBlue. As reported in the previously associated CoMEHeRe award: The work on CoMEHeRe has been instrumental in several areas beyond the academic community: 1. Informing educational offerings aimed at practitioners, executive leaders, and postgraduate students through the development of MBA modules, and via influences at corporate education groups such as Headspring, Oxford Group, Defacto Education, and Duke CE. 2. Inspiring and challenging conventional thinking at commercial organizations at corporate events for large corporations (e.g., SAP), for industry influencers (e.g., CIONET), and in industry consortia (e.g., LMForum). 3. Influencing thinking on digital strategy by delivering opinion pieces and commentary via blog posts, industry-focused articles, and through numerous informal discussions with industry leaders. 4. Impacting policy and decision makers through the personal influence of individuals from the CoMEHeRe project in their roles on advisory board and as consultants to key corporations. |
Sector | Agriculture, Food and Drink,Digital/Communication/Information Technologies (including Software),Education,Healthcare |
Impact Types | Societal Economic |
Description | MBA Module on Digital Innovation |
Geographic Reach | Europe |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | Developed and delivered an MBA module for the Emlyon MBA Programme. This was delivered over 2 days on 8/9 April 2020 to 35 students. |
Description | Video recordings on digital disruption and its impacts |
Geographic Reach | National |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | Recorded a short series of videos for Oxford Group as part of a broader set of educational materials they created on digital disruption, digital transformation, and the future of business. These were released online and via youtube. |
URL | https://www.youtube.com/watch?v=1Iettq6qVzI&t=11s |
Description | DIGIT |
Amount | £3,699,961 (GBP) |
Funding ID | EP/T022566/1 |
Organisation | Engineering and Physical Sciences Research Council (EPSRC) |
Sector | Public |
Country | United Kingdom |
Start | 03/2021 |
End | 02/2026 |
Description | Next Stage Digital Economy Centre in the Decentralised Digital Economy (DECaDE) |
Amount | £3,816,713 (GBP) |
Funding ID | EP/T022485/1 |
Organisation | Engineering and Physical Sciences Research Council (EPSRC) |
Sector | Public |
Country | United Kingdom |
Start | 09/2020 |
End | 09/2025 |
Description | vHive Collaboration |
Organisation | Zoetis |
Country | United States |
Sector | Private |
PI Contribution | We have attended meetings and discussions with the Veterinary Health Innovation Engine (vHive) project (www.vhive.buzz) to discuss wearable devices, health management systems, blockchain for health, and the relationship between human and animal health. The CoMEHeRe project has presented details of its work and findings to the vHive participants and reviewed relationships between digital transformation in animal and human health. We frequently communicate and share experiences on these topics, and are actively in discussion about open research calls and development of future grant proposals. |
Collaborator Contribution | The vHive project is funded primarily by Zoetis through a multi-million-pound research investment. An additional award was made by the Local Enterprise Partnership, Enterprise M3. The University of Surrey provides a home for the vHive project within the university's School of Veterinary Medicine. Through this collaborative project, a number of projects are underway under the broad theme of digital health. |
Impact | New research bids to EPSRC for a Centre for Doctoral Training (CDT). On-going commercial discussions to spin out technologies into new joint ventures. Several discussions have taken place on food standards and animal welfare policy with DEFRA and DIT. Additional partnership discussions have taken place with Pirbright research centre. This is a multi-disciplinary collaboration between the Surrey School of veterinary Science, the Surrey Engineering Centre for Vision, Speech, and Signal Processing (CVSSP), and the Exeter Business School. |
Start Year | 2018 |
Title | Biobeats circadian analysis tool |
Description | Project partner development of circadian analysis tool for determining effects of stress partially influenced by CoMeHere study on student stress, now being deployed to over 5000 employees in pharma and advertising companies in London and Australian cities, as well as New York. |
Type Of Technology | Software |
Year Produced | 2019 |
Impact | Project partner development of circadian analysis tool for determining effects of stress partially influenced by CoMeHere study on student stress, now being deployed to over 5000 employees in pharma and advertising companies in London and Australian cities, as well as New York. |
Company Name | Unities Limited |
Description | Unities is a research and advisory firm that helps organizations improve the use and impact of digital technologies through research, analysis and guided programmes in digital transformation. |
Year Established | 2019 |
Impact | Performed reviews and offered advice to several large commercial organizations. |
Website | http://unities.co.uk |
Description | Blog article |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Blog article for Digital Leaders on "Three Keys Digital Transformation" looking at issues in digital transformation. Digital Leaders is a network of over 10,000 leaders/practitioners in industry and government. |
Year(s) Of Engagement Activity | 2019 |
URL | https://digileaders.com/three-keys-ways-delivering-digital-transformation/ |
Description | Blog article |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Blog article on "How agile delivery can power digital transformation". Digital Leaders is a network of over 10,000 leaders/practitioners in digital transformation. |
Year(s) Of Engagement Activity | 2019 |
URL | https://digileaders.com/how-agile-delivery-power-digital-transformation/ |
Description | Blog article |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Blog article on "Accelerate your innovation to drive digital transformation". Digital Leaders is a network of over 10,000 leaders/practitioners in digital transformation. |
Year(s) Of Engagement Activity | 2019 |
URL | https://digileaders.com/foster-innovation-to-drive-digital-transformation/ |
Description | Blog posts and opinion pieces |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | A new series of weekly blog posts and opinion pieces was started in mid-2020. These discuss the implications of data-driven digital innovation on business and society. They are strongly influences by experiences from CoMEHeRe and refer to result obtained from that work. |
Year(s) Of Engagement Activity | 2020,2021 |
URL | http://www.alanwbrown.com/dispatches |
Description | Discussions at CIONET Events |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Invited speaker at CIONET events. These are roundtable events with senior executives at companies, typically at CIO or CTO level. The talks I presented on digital transformation and future digital skills were strongly influences by research results and experiences. |
Year(s) Of Engagement Activity | 2020 |
Description | HR Practitioner article |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Article in HR Magazine discussing the impact and implications of digital transformation. |
Year(s) Of Engagement Activity | 2020 |
URL | https://www.hrmagazine.co.uk/ |
Description | Hackathon participation and support |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | I participated in a Hackathon to help practitioners and postgraduate students design digital solutions. This was supported by Zoetis. I participated by mentoring a team delivering a solution to the hackathon. |
Year(s) Of Engagement Activity | 2020 |
Description | Invited presentation at SAP InnovationX 2020 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Invited presentations on the impact of digital disruption at a large-scale event in London in March 2020. The SAP InnovationX event was attended by over 1000 senior business leaders from a variety of business domains. |
Year(s) Of Engagement Activity | 2020 |
URL | https://events.sap.com/gb/uki-innovation-x/en/home |
Description | Presentations and Reports via Headspring Corporate Education group |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Industry/Business |
Results and Impact | Invited to work with Headspring Corporate Education group to develop and deliver presentation materials on digital transformation topics for their major clients. This includes multi-national organizations in financial services, industrial manufacturing, and retail. |
Year(s) Of Engagement Activity | 2020 |
URL | https://www.headspringexecutive.com/ |
Description | Talk at LMForums - Driving change in the new world |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | A talk presented at the LMForums event -- Driving change in the new world. This looked at digital disruption and included lessons from CoMEHeRe on blockchain technologies. |
Year(s) Of Engagement Activity | 2020 |
URL | https://www.lmforums.com/ |
Description | Webinar on Agile Leadership |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | An invited webinar presentation to a large audience via scrum.org, the largest aorganization worldwide delivering training an education to software practitioners on agile delivery methods. |
Year(s) Of Engagement Activity | 2020 |
URL | https://www.scrum.org/resources/agile-leadership-and-challenges-digital-transformations |
Description | Workshops with AXA, SwissRE and other insurance and risk companies |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Industry/Business |
Results and Impact | Workshops with AXA, SwissRE and other insurance and risk companies outlining potential learnings from CoMeHere outcomes for future actuarial science. Attendance: 30. Conducted throughout January and February 2020. Outcomes potentially influential in the wider practice of private medical insurance companies, particularly within AXA (105 million lives insured). |
Year(s) Of Engagement Activity | 2020 |