Abstract
The authors are applying artificial intelligence and behavioral economics to pilot and refine an innovative approach for controlling type 2 diabetes mellitus (T2DM) at the University Hospital of the West Indies (UHWI) in Jamaica. Effective control of T2DM is challenging, usually requiring lifetime adherence to prescribed medications, recommended diet, and regular physical activity. To date, the authors have results from 7 patients over 7 months offered incentive earnings of US $11.13/month for achieving targets on daily steps and glycated hemoglobin (HbA1c). Pilot patients met step targets on 81% of days with data, earned 73% of potential incentives, and expressed satisfaction with the program. A planned extension—an artificial intelligence app for Problem-Solving Therapy—will guide patients to understand barriers to good T2DM control and develop, implement, and monitor solutions. The economic cost of T2DM at UHWI averaged US $8,990 per patient annually. The authors project a 20% reduction in diabetes complications and disease costs with economic benefits of US $1,798 per participant, or a benefit–cost ratio of $3.35 per $1.00 of program costs. The program is also economically progressive, as less educated and older Jamaicans experience the highest risk of T2DM and will receive the greatest health and economic benefits. The Government of Jamaica, households, and the overall Jamaican economy will all share the projected benefits. If the approach proves effective, it could be replicated widely across Jamaica and globally.