With a sweep of a smartphone camera, waves of infrared light penetrate the skin and beam back biometrics based on blood flow.
It sounds like science fiction, but this electro-optic technique – photoplethysmography (PPG) – is real and the subject of rising insurer interest due to its affordability and array of potential digital applications.
New survey results from RGA suggest consumer openness to the technology and exciting potential applications to improve health monitoring and disease management, as well as inform insurance processes such as underwriting.
PPG is distinct from facial analytics, although both optical technologies rely on human skin analysis and are already in use in consumer electronics such as cameras and wearable devices. The difference? Unlike facial recognition systems, the PPG scanners built into both consumer and clinical devices do not collect data based on physical features. PPG looks at what lies beneath, detecting minute volumetric shifts in the small blood vessels just under the surface of the skin, from fingers and wrists to ear lobes and faces, whereas facial scans rely on personal appearance to confirm or categorize identity or evaluate health status.
Signals Under the Skin
The non-invasive nature of PPG technology is a large part of its attraction. The technology relies on low-intensity infrared light that is absorbed or scattered based on blood flow levels to create a personalized picture of health. After detecting the intensity of light wavelengths, the scanners apply computer-based pulse wave analysis to convert this data into measures of heart rates, respiratory function, and oxygen saturation levels. Other important parameters such as heart rate variability and mental stress levels can be derived, and it may even become possible to determine blood pressure, glucose level, or hemoglobin parameters important to the insurance industry.
RGA surveyed 875 employees worldwide to assess attitudes towards the use of PPG technology to capture biometric data for wellness programs and/or underwriting. The survey results offered some intriguing insights into consumer sentiment, both positive and negative, although the internal RGA sample is likely not representative of the general population. More than 60% of respondents were moderately or very willing to use PPG technology to monitor and maintain good personal health. Overall, half of all respondents also expressed interest in sharing the same data as part of the underwriting process and to reduce life and health insurance premiums. In addition, 64% of all respondents were either very or moderately comfortable with the use of a smartphone camera for a one-minute period to capture this data – while only 9% expressed discomfort with the time to complete the assessment.
At the same time, more than one-tenth of respondents completely rejected PPG, while a wider group of more than a quarter indicated either a low level of willingness and/or refusal to consider the technology to monitor personal health. Within these groups, personal privacy, trust, and accuracy were leading concerns, with worries about data security and misuse being highest in the Americas.
The findings suggest perception problems must be addressed if insurers plan to adopt this technology.
See also: What is Wellness and Why Does It Matter to Insurers?
A Bright Future?
PPG technology is of particular interest to insurers wishing to obtain heath metrics from consumers who may not own wearables such as Fitbit or Garmin.
Because smartphone usage is ubiquitous worldwide, PPG technology that uses a smartphone camera provides an opportunity to gather health metrics without requiring the use of a separate wearable device. While health metrics from PPG-enabled phones have not been validated by large-scale clinical studies, it is possible to foresee a future in which at least some standard clinical devices could be replaced by a single smartphone. Indeed, if confirmed, PPG technology could augment the underwriting process by substituting physical examinations for heart or respiratory rate, oxygen saturation, or blood pressure with a digital process; even hemoglobin or glucose labs could be replaced with remote use of PPG.
A few clouds still obscure this sunny future, however. As noted, the accuracy of PPG technology and data are yet to be studied in-depth at a clinical level or under real-life conditions. At the same time, consumer expectations for data accuracy remain high. In RGA’s research, respondents shared an expectation that biometric measurement accuracy would need to be equal that of standard medical devices (within a 5% deviation), particularly to support underwriting decisions.
PPG solutions as non-invasive health monitoring tools will likely make more inroads in both clinical and non-clinical settings. More biometric parameters are being studied to support healthcare, wellness, and disease management, making these solutions adaptable and versatile, while at the same time providing a means to facilitate the rise of telehealth. The insurance industry should keep an eye on technological advancement and accelerate adoption of clinically reliable technology, but also consider issues like bias and trust in the management and security of personal data privacy.
RGA continues to monitor developments in PPG technology, and related behavioral science research, as well as exploring partnerships with innovators and insurtechs to investigate future-focused applications. To learn more, view our recent Technovate miniseries with Binah.ai, a company putting PPG to work via our handheld devices to address this ever-changing preventative health and wellbeing landscape.
New Year, New Users: Are New Year's resolutions a timely marketing opportunity for wellness products? https://www.rgare.com/knowledge-center/media/articles/new-year-new-users-are-new-year-s-resolutions-a-timely-marketing-opportunity-for-wellness-products
A review on wearable photoplethysmography sensors and their potential future applications in health care https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426305/
Photoplethysmography revisited: from contact to noncontact, from point to imaging https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822420/
On the Analysis of Fingertip Photoplethysmogram Signals https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394104/
Sources of Inaccuracy in Photoplethysmography for Continuous Cardiovascular Monitoring https://www.mdpi.com/2079-6374/11/4/126
Advances in Photoplethysmography Signal Analysis for Biomedical Applications https://www.mdpi.com/1424-8220/18/6/1894/htm
The use of photoplethysmography for assessing hypertension https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6594942/