Dr Ron Whelan, CEO of Discovery Health

This cutting-edge platform, Personal Health Pathways, tailors health and lifestyle actions to each individual’s unique needs, offering precise, intuitive, and data-driven guidance. Available to all adult Discovery Health Medical Scheme members via the Discovery Health app, the platform not only recommends targeted health actions, but also rewards members for completing them.

“For the first time, the needs of medical scheme members for precision and personalisation in their healthcare journey has converged with the data and technology to make it possible,” says Dr Ron Whelan, CEO of Discovery Health. “This marks a transformative shift in healthcare, where AI and big data enable us to deliver highly individualised health recommendations at scale.”

While established health guidelines and protocols remain important, precision and personalisation of healthcare will lead to even better patient engagement and health outcomes. “Precision medicine is inherently safer, as treatments are tailored to an individual’s genetics and biology. Similarly, clinical and lifestyle guidance can be optimised by analysing a person’s health status and determining which interventions, medical and behavioural, will yield the most health benefits,” Whelan says.

Research by Discovery Vitality has demonstrated the remarkable impact of physical activity on mortality, where mortality rates for individuals aged 45–65 can be reduced by 38% to 58% by transitioning from zero physical activity to moderate and high levels of physical activity. Similar research by Discovery Health has demonstrated how the adoption of certain clinical and lifestyle habits among people living with diabetes can reduce mortality by 16% to 18% and healthcare costs by 13% to 16%.

By making clinical and lifestyle recommendations more precise and personalised, Personal Health Pathways will lead to greater engagement and even better health outcomes.

Discovery Health has unparallelled repositories of clinical, lifestyle and behavioural data – likely the largest and most unique data set of its kind in the world – that underpin its ability to deliver precise and personalised healthcare. “With more than 40 million clients across 40 countries, Discovery has deep healthcare knowledge and experience. In South Africa, Discovery Health data includes almost 50 million life years of health claims and clinical data, and nearly 30 million life years of exercise and lifestyle data through Vitality,” says Whelan. “Our AI platform includes 33 terabytes of data, with 300 to 500 gigabytes added daily,” Whelan notes. “By applying advanced machine learning, we can uncover patterns and determine the causal impact of specific health and lifestyle interventions on long-term health outcomes. This unlocks a new frontier in personalised healthcare, empowering Discovery Health Medical Scheme members to make informed decisions about their health.”

Preventative care is both medically and economically beneficial, reducing disease risk and lowering healthcare costs. However, navigating healthcare is complex, and individuals often struggle to determine which actions to take and when. “Personal Health Pathways simplifies this process by dynamically tailoring health recommendations to each member’s evolving needs,” says Whelan. “These actions could range from improving lifestyle habits to adhering to prescribed medications, completing essential screenings, and consulting a healthcare professional when necessary.”

For a member with 12 actions, there are more than 7 million possible pathways through which to complete those actions. What sets this platform apart is that it provides the most appropriate pathway at any given point in time, with the AI platform continuously and dynamically adjusting each member’s pathway.

Personal Health Pathways now offers 2.1 million adult Discovery Health Medical Scheme members a personalised healthcare experience, accessible via the Discovery Health and Discovery Group apps. Designed for ease of use, the platform delivers highly specific, time-sensitive health actions that optimise long-term health benefits while considering a member’s propensity for completing each action. Upon completion, members unlock a range of rewards, including Discovery Miles to drive sustained engagement.

Alongside Personal Health Pathways, Discovery Health Medical Scheme has introduced the Personal Health Fund, a benefit that allows members to accumulate funds by completing actions within their Personal Health Pathway. These funds can be used for day-to-day medical expenses, including GP and specialist consultations, medication, radiology, and pathology, offering greater financial flexibility and promoting proactive health management.

“We know from behavioural science that rewards significantly enhance positive lifestyle and health-seeking behaviours,” Whelan says. “By incorporating personalised rewards, Personal Health Pathways fosters sustained engagement, leading to better health outcomes for members and lower healthcare costs for the medical scheme.”

This initiative aligns with Discovery’s core purpose: making people healthier and enhancing and protecting lives. “Discovery Health has a long track record of healthcare innovation,” Whelan adds. “With the sophistication of Personal Health Pathways, we are taking this to the next level.”

Beyond precision and personalisation of healthcare, Discovery Health is integrating AI into its operations and customer service to enhance efficiency and customer experience. With more than 80 million claims processed annually, 98% are auto-adjudicated through its sophisticated claims system. Meanwhile, Discovery’s call centres, which handle 25 000+ calls daily, leverage AI to match members with the most suitable agents based on query type, personal preferences, and the likely affinity between the agent and customer.

Generative AI and Large Language Models are also being deployed to ensure customer support and communication are precise, contextual, and tailored to each member’s needs. “By embedding AI across our operations, we are creating a hyper-personalised healthcare and service experience that improves efficiency, enhances customer experience, and ultimately empowers members to take control of their health,” Whelan says.

Discovery Health’s Personal Health Pathways represents a fundamental shift in how healthcare is delivered: precise, personalised, powered by data science and AI. By harnessing unparalleled data insights and cutting-edge machine learning, Discovery Health is empowering medical scheme members to take control of their health with tailored recommendations, real-time guidance, and meaningful rewards.

Visit our website for more info: www.discovery.co.za/portal/medical-aid/personal-health-pathways