Co-operative Models for Evidence-based Healthcare Redistribution (CoMEHeRe)

Lead Research Organisation: University of Exeter
Department Name: Management


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.

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.


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